Ireland’s Clare Island as multimodal rural telehealth and telemonitoring testbed

June 30, 2023 | by

A ‘feel-good’ story figuratively and literally. Clare Island is an island off the west Irish coast in the Atlantic. It is located at the entrance to Clew Bay, part of County Mayo, with a lighthouse and abbey ruins that are tourist attractions. Its connection to the mainland is a 20-minute ferry service to Louisburgh on the mainland, generally adequate for its 138 people scattered in its 5 x 3-mile terrain. Galway, the largest city in the area, is nearly two hours south, and Westport is four hours. This makes it difficult when islanders need healthcare beyond their single small medical clinic with two resident nurses and weekly visiting GP.

The islanders are now part of a Digital Health Project designed by the University of Galway that can best be described as multimodal. The university’s Health Innovation via Engineering (HIVE) laboratory has been working on rural health projects at least since 2019 since the HIVE lab delivered via drone insulin from Galway to Inis Mór in the Aran Islands. On Clare Island, the HIVE lab has worked with islanders to connect them to better healthcare access on and off island, and also with each other.

  • Enabling video consultations with remote physiological monitoring, including blood pressure, weight, and blood glucose. This connects to clinics on the mainland, freeing up local clinic time. Irish company MyPatientSpace provides the platform.
  • The RPM for islanders is augmented by an artificial intelligence algorithm that allocates clinic slots if data readings for blood pressure or glucose readings indicate the need for an in-person clinic visit.
  • A recent demonstration showed how a drone could deliver an epipen to the local clinic, while MADRA the robot (Medical Autonomous Droid Remote Assistance–above left) scaled mountainous terrain to deliver first aid.

A private 5G wireless system was installed to facilitate video and RPM, as well as to connect a number of isolated islanders and their families on the mainland with always-on video, primarily to counter loneliness. Withings has also equipped islanders with Pulse HR watches. These enable self-monitoring both via the watch and through a supplied tablet. Over 80 islanders, aged from 18 to 90, have already signed up to the project, which began in September 2022.

The project is funded through a public-private partnership led by technology company Cisco and Cúram (Merative) software, the Science Foundation of Ireland Research Centre for Medical Devices at the University of Galway, in partnership with Ireland’s Health Service Executive (HSE).  The €1 million remote health project is intended to be a template for other rural areas in Ireland. The head of the project is Professor Derek O’Keefe, a physicianeer (physician and engineer) with resident Dr. Ian McCabe as project manager. His grandmother moved to Clare Island in 1939 as an operator connecting the island to the mainland via radioed Morse Code. Irish Times, RTÉ, University of Galway news archive (2022), EuroPMC paper 

Photo credit: Kevin Johnson/Clare Island Home Health Project. ‘Madra’ the robot (center). Jack Pinder (Public Patient Involvement), Dr Jennifer Doran (Project Physician), Dr. Ian McCabe (Project Manager), Prof. Derek O Keeffe (Project Lead), and Hemendra Worlikar (Project Engineer) 

Weekend news roundup: GE Healthcare spins off, adds CTO; Allscripts now Veradigm; NHS Brainomix AI stroke trial success; Withings home urine scanner; Careficient buys Net Health EMR; CommonSpirit’s class action suit on data breach

January 7, 2023 | by

GE Healthcare now trading on its own. On Wednesday, GEHC rang Nasdaq’s traditional opening bell virtually on its first day of trading Wednesday (4 Jan). The bell ringing was unique as the first company in Wisconsin to do so from their plant in Waukesha. GE retained approximately 19.9% of the outstanding shares of GE HealthCare common stock with the remaining 80.1% distributed to current GE shareholders. Today it closed at $58.95 and remains headquartered in Chicago. (It moved from Amersham UK back in 2016.) Management is now independent, with Peter Arduini as CEO and adding yesterday a new chief technology officer, Taha Kass-Hout MD, MS, from Amazon’s health AI area to lead the company’s new science and technology organization through their four areas: Imaging, Ultrasound, Patient Care Solutions, and Pharmaceutical Diagnostics. Release, Yahoo Finance  Also Mobihealthnews

Remember back in 2019 when problematic EHR Practice Fusion was renamed Veradigm? Allscripts has now renamed the entire company as Veradigm, after expanding it to analytics and research. After two years of reorganizing and downsizing (plus paying off Practice Fusion fines), selling off their hospital/large practice EHRs to Constellation Software/N. Harris Group for $700 million last May, the slimmed-down Veradigm Network encompasses electronic health records, practice management systems, and patient communication platforms. Interestingly, a search first leads you to a main corporate website under Allscripts and doesn’t forward automatically to Veradigm, making this a softer-than-usual name change. Now Veradigm can pick up a few companies on the market, as they announced last year. Release    Hat tip to HISTalk

NHS using Brainomix AI to diagnose stroke faster, tripled near-full recoveries to 48%.  The key finding: patients diagnosed using AI made near full recoveries increased from 16 to 48%. The trial of e-Stroke Suite took place in 22 hospital trusts in England across 111,000 suspected stroke patients. The AI in the e-Stroke Suite cut average diagnosis to treatment time by an hour from 140 to 79 minutes. The AI technology was developed by UK company Brainomix. Daily Mail, Oxford Academic Health Science Network case study (Note: Oxford AHSN, Brainomix, and Royal Berkshire NHS Foundation Trust (RBH) are partners in the National Consortium of Intelligent Medical Imaging (NCIMI).)

Withings is debuting the U-Scan, an in-home urinalysis device, at CES. The 90 mm device sits in the toilet bowl and uses cartridges to analyze urine components, sending results to the Withings Health Mate app. Cartridges for Europe so far are Cycle Sync for menstrual period tracking and ovulation windows, and Nutri Balance for hydration and nutrition. Nutri Balance analyzes specific gravity, pH, vitamin C, and ketone levels. The U-Scan will debut in Europe at the end of Q2, with the U-Scan starter kit priced at €499.95.  Both await FDA clearance. Withings U-Scan page, Mobihealthnews

Careficient buys Net Health’s home health/hospice EMR. Careficient already is present in the home health, hospice and home care cloud EMR market. Net Health is selling its home health, hospice, home care and palliative solutions EMR, marketed under HealthWyse and Hospicesoft, as well as its revenue cycle management (RCM) division, to concentrate on wound care and rehabilitation therapy. This expands Careficient’s client base by 750 locations in 39 states. Transaction cost was not disclosed. Release

Add to the cost of hacking multiple class action lawsuits. CommonSpirit Health, based in Chicago and the second largest health system in the US covering 21 states under CHI and Dignity Health names, not only has to remedy a massive 600,000 patient data breach discovered last October [TTA 3 Dec], but also fight a class action lawsuit filed 29 December by a patient in the US District Court for the Northern District of Illinois. Financial, health insurance, and medical information were all breached. The suit requests damages exceeding $5 million and injunctive relief, including stronger data protection practices. It will be the first of many as a quick search indicates multiple law firms seeking claimants. FierceHealthcare, WGNRadio

Mid-week roundup: UnitedHealth-Change trial kicks off; Amazon’s One Medical buy questioned; Cionic’s neural sleeve designed by Yves Behar; Medable-Withings partner; Orion Health’s new CEO; IBM Watson Health’s Simon Hawken passes

August 3, 2022 | by

The Department of Justice lawsuit to block the $13 billion acquisition of Change Healthcare by UnitedHealth Group started on Monday. It is a bench trial in US District Court in the District of Columbia that will last 12 days, concluding on 16 August with a verdict date to be determined. The DOJ and the plaintiffs, including Minnesota and New York State, are presenting their case over seven days. UHG and Change will have five days. It’s expected that UHG CEO Andrew Witty and former chief David Wichmann will be testifying. The American Hospital Association (AHA) was a key player in pushing for a DOJ action (their article here). TTA recapped the main competitive issues in play on 23 March, along with this Editor’s opinion that the merger will be blocked given this current administration’s anti-trust stand. ‘It will be one for the books–the ones marked ‘Nice Try, But No Dice’. FierceHealthcare, HealthcareFinanceNews

Will Amazon’s acquisition of One Medical be reviewed by the Federal Trade Commission (FTC)? That is what Senator Josh Hawley (R-Missouri) is requesting. He cites that Amazon will have “access to enormous tranches of patient data. While HIPAA and other privacy laws exist to thwart the worst potential abuses, loopholes exist in every legal framework.” He also cites, somewhat broadly, that information of this type could be used to suggest over-the-counter blood pressure medications to a One Medical patient shopping at a Whole Foods Market. (What is meant here is that there are many supplements that claim to benefit blood pressure available OTC, such as Garlique; however, there are many OTC meds that can increase blood pressure such as decongestants.) This Editor agrees with Senator Hawley that the acquisition should be carefully reviewed by FTC and, to go further, HHS as it involves patient data.) Hawley Senate.gov page 

The Cionic Neural Sleeve, designed to aid people with mobility issues, is getting a design upgrade via Yves Behar and his fuseproject. The Neural Sleeve [TTA 30 June] aids the legs through sensors in the sleeve that monitor movement for muscle firing and limb position, then analyzes them through an app to optimize functional electronic stimulation (FES) delivered through the sleeve. The Behar team, according to the release, has delivered a neural sleeve “designed for everyday wear, and importantly, is easy to put on and take off – a critical design element for those with inhibited mobility. The lightweight, breathable fabric feels like an athletic legging, and is available in multiple colors and sizes. Paired with the intuitive CIONIC app, the sleeve enables the user to be in control of their own mobility journey.” Cionic is taking pre-orders for delivery in early 2023. Also The Robot Report.

Medable partners with Withings for clinical trials. Medable, a clinical trials platform, is partnering with Withings Health Solutions to connect Withings devices for monitoring at home. Withings devices will provide medical-grade measurements, including temperature, heart rate, blood pressure, sleep patterns, and weight to connect the data into Medable’s decentralized clinical trial platform. Direct monitoring also assists in attracting and retaining subjects in clinical trials, plus improving accuracy, by eliminating subject manual reporting and checkins. Financial terms and duration were not disclosed. Release, FDA News, FierceBiotech

Short international take: Orion Health, an Auckland, New Zealand-based health IT company headed by Ian McCrae for the past 30 years, announced he is stepping down for health reasons. Replacing him in late August as CEO will be Brad Porter, coming from Fisher & Paykel, a NZ-based medical device company. Mr. Porter is Mr. McCrae’s son in law.  Orion recently won what could be the largest health information exchange system in the world for Saudi Arabia, covering 32 million people. Healthcare IT News 

And a sad passing: Our UK and European Readers likely know Simon Hawken from his long career with IBM, including Watson Health (now Merative) and Merge Healthcare, and earlier with BEA Systems. HISTalk reported that he passed away on 25 July. This Editor has not been able to find other notices, so is asking for Reader help and comments.

Thursday news roundup: bet on Oracle-Cerner closing next week, VA EHR progress reports mandated, Homeward-RiteAid rural care, Medtronic-DaVita kidney JV, Withings reenters RPM, Lightbeam buys Jvion AI

June 1, 2022 | by

The Oracle acquisition of Cerner will close as early as Monday next week, no later than mid-June. Mid-June is the prediction of Seeking Alpha. They based it on Oracle-Cerner already passing Australia’s Foreign Investment Review Board, no questions posed by the UK antitrust authority, and the US waiting period expiring in February. As rumored [TTA 25 May], European Commission regulators approved it today (Barrons, paywalled) which predicts the close will be next Monday. Hat tip to HISTalk for their alert yesterday.

Scrutiny of Cerner’s $16 billion EHR implementation with the Department of Veterans Affairs by Congress ramps up. New legislation due to be signed by the president shortly will require the VA Secretary to submit regular reports 30 days after the last day of each fiscal quarter on the VA’s Electronic Health Record Modernization (EHRM) program. Content will include spending, performance metrics, outcomes, safety, transitioning from VistA to Cerner Millenium, interoperability, and progress or issues with all. Text of Senate bill, FierceHealthcare  TTA’s previous article on Cerner EHR interoperability problems with DOD and VA

Bringing healthcare to rural America is Homeward with a freshly inked deal with RiteAid. Founded by former Livongo president Jennifer Schneider, MD, Homeward will set up distinctive purple mobile van clinics at up to 700 Rite Aid location parking lots in rural communities starting Q3 this year. Michigan will be the first market. Homeward will accept regional Medicare Advantage plans and Medicare.

The company is targeting the 60 million Americans who live in rural areas and have been losing access to basic medical care as local practices and clinics close. Their technology enablement will be for appointments, checkins, telehealth, remote patient monitoring, and scheduling home visits. Homeward announced its launch at the recent ViVE2022 in March including $20 million in funding from General Catalyst. Other Livongo alumni with the new company are Brian Vandenberg, former general counsel, Amar Kendale, former chief product officer, and Bimal Shah, MD, former chief medical officer at Livongo. Nice to know that they have moved to another healthcare chapter of real need, versus cruising the Caribbean in very large yachts. FierceHealthcare, Homeward release

Medical device giant Medtronic and DaVita are establishing a joint venture by next year to advance kidney care therapies and technologies, including new products to be used in clinics and in the home. The intent of the JV is to increase the availability of kidney care including dialysis. 10% of adults worldwide–700 million people–have chronic kidney disease. 2.6 million have kidney failure. The JV is expected to be formed in early 2023 with each company owning an equal share. Initial investment is not disclosed. According to the release:

  • Medtronic will contribute its Renal Care Solutions (RCS) business including the current product portfolio (renal access, acute therapies, and chronic therapies), product pipeline, and global manufacturing R&D teams and facilities.
  • Both companies will provide an initial investment to fund the new company (NewCo) and future certain operating capital.

FierceBiotech, Medtronic release

Withings reenters remote patient monitoring with Withings RPM. Their initial entry was with MedProCare back in 2019 but apparently in the repositioning of the company since the buyback from Nokia in 2018, it was back-burnered. The new RPM will be based on an app that will:

  • track time for CMS-compliant billing reports and uploadable to the provider EHR
  • support billing for CMS codes 99453, 99454, 99457, 99458
  • a digital patient-facing assistant
  • full connectivity to Withings devices such as scales, blood pressure monitors, and sleep monitors
  • implementation support by their Health Solutions teams

Withings RPM page, Outsourcing-Pharma

Looking hard for an M&A that relates to us in this very quiet market, Lightbeam Health Solutions, a population health software company, is acquiring Jvion Inc. Jvion has AI-enabled prescriptive analytics and social determinants of health (SDoH) solutions which will be combined with Lightbeam’s health analytics and outcomes for payers and providers. Terms of the acquisition and leadership transitions were not disclosed. Lightbeam release

ATA conference roundup: a new board chair, a digital app review pilot, and company announcements

May 5, 2022 | by

The American Telemedicine Association (ATA) 2022 conference and expo is a wrap, after starting on Sunday through to Tuesday. While your Editor could not attend due to other commitments that precluded a trip to Boston, one industry insider who visited the expo–his first in-person event in two years–reported that after a slow start on Sunday, the floor busied up on Monday. Business was being done, finally and not virtually. What were the busy booths and what was ‘hot’? Companies in the areas of telemental health and remote patient monitoring (RPM). (Did you attend? What was your impression? Leave comments below.)

ATA had two major announcements of its own during the conference:

  • Kristi Henderson, DNP, NP-C, FAAN, FAEN, has been named as Chair of the ATA Board for a two-year term. Henderson is the CEO of Optum Everycare, where she leads a team building digital and virtual health solutions to improve quality outcomes and experiences for patients and providers. She has served on the board since December 2020. As Chair, she is succeeding Joseph Kvedar, MD and Professor at Harvard Medical School among other positions. Dr. Kvedar will become Immediate Past Chair and Senior Advisor to the ATA. Announcement
  • ATA, the American College of Physicians (ACP), and ORCHA, the Organization for the Review of Care and Health Applications,  announced a framework for the assessment of professional and consumer digital health technologies, including mobile apps and web-based tools. ACP and ORCHA, which has experience assessing compiling libraries of apps, will be piloting a test of the framework against a database of digital health tools. The goal of the pilot is to “determine how the library can be useful to physicians in recommending high-value digital health tools to their patients, and what other barriers to wider adoption of digital health tools may exist.” Announcement

Quite a few company announcements were made during ATA–a selection:

  • Johns Hopkins Bloomberg School of Public Health highlighted the publication of a major scientific study (full text) documenting telehealth outcomes in JAMA Network Open. This Johns Hopkins-based research was partially supported by the ATA. The study followed a national cohort of 40.7 million commercially insured persons from July to December 2021 and included 21 chronic and non-chronic conditions. Fourteen-day follow-ups for persons with an initial telehealth visit were compared to persons receiving in-person care. On average, patients participating in an initial telehealth consult for a new health condition did not require more unplanned hospitalizations or follow-up ED visits within 14 days of their initial consult compared with patients making an initial in-person visit. The exception was respiratory conditions. Release
  • BioIntelliSense, which last year scored $45 million in funding for its on-body sensors, announced two major collaborations for remote patient monitoring (RPM) with UC Davis Health and Houston Methodist.
  • CDW Healthcare and Caregility announced a strategic partnership to expand their virtual care capabilities, including Caregility’s new Inpatient Virtual Engagement solution (IVE), also launched during ATA. 
  • Connect America, which snapped up Lifeline last year, launched Connect America Home, a single health and safety platform connecting (PERS) and remote patient monitoring (RPM) with supporting services, including AI-enabled virtual health assistance and Social Determinants of Health (SDoH) support, along with analytics. Release.
  • AliveCor announced the launch of KardiaComplete, a comprehensive heart health enterprise solution designed to drive improved health outcomes and reduce the cost of cardiac care. The service will be available through self-insured employers, health insurance plans, and health systems to those diagnosed with hypertension and arrhythmias, like atrial fibrillation.
  • Withings launched Withings RPM, the company’s most advanced remote patient monitoring solution designed to enhance the patient experience. It is a single platform that enables clinicians to order and send Withings RPM devices, manage data from multiple patients with automated alerts and reminders, communicate via SMS, phone, and in-app video calls, billing, sleep tracking, and more. 

TTA was a media partner of ATA 2022.

Wednesday roundup: Amazon Care now (actually) nationwide, Australia’s Eucalyptus telehealth’s A$60M, Withings 2 buys, Glooko buys xbird, HoloLens for nurse-GP comms in Cumbria

February 9, 2022 | by

Amazon Care, which has compiled a history of playing their news quite close to the vest, coyly dropped another hankie on their website today with a blog post that confirmed that their virtual care platform is now available nationwide. In 2022 they will be adding in-person services to 20 more cities, including San Francisco, Miami, Chicago, and New York City. Companies offering Amazon Care as an employee benefit include Silicon Labs, TrueBlue, and Whole Foods Market (an Amazon company). Back in October, TTA outlined our thoughts on Amazon Care’s structure, offerings, cheap pricing, and our opinion that Amazon’s real aim is to accumulate and own national healthcare data on the service’s users. Then they will monetize it by selling it to pharmaceutical companies, payers, developers, and other commercial third parties in and ex-US. Patients may want to think twice.

On a lighter note, Australia’s Eucalyptus telehealth scored a tidy Series C of A$60 million ($42 million), led by Airbnb and Canva’s early investor, BOND, plus previous investors. Eucalyptus’ telehealth platform markets five services: men’s health-focused Pilot, women’s fertility brand Kin, skincare site Software, sexual health business Normal, and menopause service Juniper. The fresh funds will go towards software development and expanding into the UK. Mobihealthnews

Withings is also on a bit of an acquisition tear, buying Berlin-based nutrition app 8fit on top of last month’s Impeto Medical, which developed a tool for monitoring peripheral neuropathies. 8fit offers efficient workouts, customized meal plans, and self-care
guidance in six languages. While the acquisition cost was not disclosed in the release, Withings plans to invest $30 million to integrate 8fit features into their products. Impeto, a R&D company, developed an FDA cleared technology that measures the ability of sweat glands to release chloride ions in response to electrical stimulus. For those with neuropathy, that sweat gland innervation is reduced and sudomotor function is impaired. Impeto’s tool has already been integrated into Withings’ smart scale, the Body Scan, to be released in the second half of 2022 after FDA clearance. Release, Mobihealthnews

Another Berlin-based company in AI that’s been acquired is xbird. The buyer is Glooko, a diabetes and chronic condition monitoring platform. xbird captures data generated by devices and processes it through algorithms and machine learning models, and will expand expands Glooko’s advanced analytics capabilities and tools. The management and staff will join Glooko GmbH. Glooko release

Closing our update is a Cumbria catchup. Nurses at Kendal Care Home are wearing Microsoft’s mixed-reality HoloLens 2 headset to call GPs through Microsoft Teams. Using the HoloLens, doctors can talk to both the nurses and patients. Kendal Care Home has been working with local GPs, Kendal Integrated Care Community, and University Hospitals of Morecambe Bay NHS Foundation Trust to train staff in the use of the headset, which started use at Kendal in October 2020 and has largely replaced their tablets and smartphones for telehealth consults. In addition to Kendal, the Heart Centre at Alder Hey and Imperial College Healthcare NHS Trust used HoloLens 2 during the pandemic. DigitalHealth.net

News roundup: Hacks, ransomware of medical records, security cameras spike; Withings launches new mobile-direct devices; Bluestream Health adds Leon Medical (FL) to telehealth

March 13, 2021 | by

In recent weeks, hackermania has been romping in healthcare. A compilation of incidents revealed just in the past few weeks have affected hundreds of thousands of patients, employees, and providers:

  • Security cameras produced by Verkada, Inc. were hacked across the US, including at Tesla. Healthcare organizations affected by the hack were Daytona Beach, Fla.-based Halifax Health, where the video showed “what appeared to be eight staffers tackling a man and pinning him to a bed.” Texarkana, Texas-based Wadley Regional Medical Center and Tempe (Ariz.) St. Luke’s Hospital were also hacked. The means in was described by one of the hackers (appropriately female for this month) as through a “super admin” account where the username and password appeared online. Becker’s Health IT 10 March, Bloomberg News
  • 210,000 MultiCare patients, providers, and employees of Tacoma, Wash.-based MultiCare had personal information exposed in a December ransomware attack on their medical practice management company’s IT services vendor. Becker’s Health IT 9 March
  • A clinic in North Carolina had a six-day ransomware attack starting 23 February. Hackers demanded a $1.75 million payment in exchange for giving back the clinic access to its data. The clinic came back online 1 March but did not disclose any payment. Becker’s Health IT 5 March
  • NBC News revealed that hackers stole employee files from Gallup, New Mexico-based Rehoboth McKinley Christian Health Care Services after a ransomware attack on its computer network in February. Those employee files were posted online; information included employee job applications and background check authorizations with Social Security numbers. Earlier attacks by the same hacker group included Leon Medical Centers of Miami-Dade Florida (see following) and Nocona (Texas) General Hospital resulted in the online publishing of tens of thousands of patient records. Becker’s Health IT 4 March
  • Hackers attacked biochemical machines used to prepare samples in Oxford University’s Division of Structural Biology. Forbes received the information from Hold Security chief technology officer Alex Holden, who provided screenshots of the hackers’ access to Oxford University systems, and notified the university.
  • The cutely-named DopplePaymer attacked a county government office in Chatham County, North Carolina, and stole residents’ PHI and PII between November 2020 and this past January. Becker’s 10 Feb 
  • And on the ‘Someone Got Fired For This One’ list is the response to hacking at Boise, Idaho’s Saint Alphonsus Health System. The health system had a data breach in January. Patients were routinely notified. However, the mail merge, not the hack, created an incorrect status for some patients, sending them letters as if they were deceased or a minor. Becker’s Health IT 10 March

It’s cold comfort when the US Department of Justice announces that they are indicting three North Korean hackers who inflicted the WannaCry malware and $1.3 bn in extortion damage on the world back in 2018. All three were members of North Korea’s intelligence agency, the Reconnaissance General Bureau (RGB). The likelihood of their extradition is one word: none.

And in other news….

Withings unveils new professional devices. The Body Pro smart scale and BPM Connect Pro, distributed to doctors, out of the box will transmit health data directly from patient to doctor. Neither require Wi-Fi nor a mobile phone, since they have embedded SIM cellular cards to directly connect to a mobile network. They are both sold through Withings’ professional division. FierceHealthcare

Telehealth provider Bluestream Health has added Leon Medical Centers, a seven-location Miami-Dade FL provider. Bluestream Health provides whitelabeled secure telehealth services that combine with medical workflows to approximately 50,000 providers in 500 facilities. Release.

Withings closes $60 million Series B round to fund expansion, B2B development

July 29, 2020 | by

Withings, a digital health developer with devices ranging from smart scales to analog-style smartwatches , this week closed on a substantial Series B funding of $60 million. Led by Gilde Healthcare, the round also had participation from long-term Withings partners and investors, Idinvest Partners and Bpifrance through their Large Venture funds, as well as BNP Paribas Development, Oddo BHF Private Equity, and Adelie Capital. Their total funding is now estimated at $93.8 million. According to their release, Withings will be using the funds to globally scale its dedicated business-to-business division MED PRO and further develop consumer health devices. With this, they will also add about 100 positions in the US and France, including expansion of sales, marketing and R&D.

Founded in 2008 in France, TTA has tracked Withings since 2009 with a scale that Tweets your weight (at a hefty $159). In April 2016, the company was sold to Nokia for a hefty €170 million and became Nokia Digital Health. Nokia’s hope was to use Withings and its pricey (at least in the US market) but stylish and innovative IoT devices to spur its own development of consumer digital health. Two years later, Nokia sold back Withings to co-founder and former chairman Éric Carreel, having not experienced much success in the consumer sector. Shortly thereafter, they premiered a revived Go (with an e-ink face) and the Steel HR Sport smartwatch, then progressed into heart and sleep monitoring.

MED PRO is a relatively new division that concentrates on professional uses of their devices and data analytics within health systems, health plans, disease management programs, and academic and pharma research. Withings also appointed a new global Medical Advisory Board which includes Dr. John Halamka, President of the Mayo Clinic Platform, Dr. Stéphane Laurent, former Head of Clinical Pharmacology in Hôpital Européen Georges Pompidou in Paris, and Craig Lipset, former Head of Clinical Innovation at Pfizer.  Mobihealthnews, Crunchbase

The CES circus opens its largest tent yet in health tech, AI, 5G, and more

January 8, 2020 | by

CES kicked off today in Las Vegas (7 Jan), taking over the town in multiple locations, and will be making news through Friday 10 January. Like the circus, there are three health tech ‘rings’ at CES this year: Accessibility, Digital Health (Digital Health Summit), and Fitness and Wearables.

  • Digital Health Summit over the two days of its conference has shifted focus from the gadgets and wearables of their past conferences to prevention, health data, voice tech, machine learning, AI, bioelectronics (low current devices for treatment), behavioral health, and passive monitoring. There’s also a soupçon of star power with Katie Couric and Dr. Mehmet Oz, and some Grizzled Pioneer speakers and moderators such as Laurie Orlov, Chris Otto, Sean Slovenski, and Jane Sarasohn-Kahn. The Digital Health Summit is itself a Grizzled Pioneer as it goes back at CES to 2013–and my, how the players have changed. (Whatever happened to Sonny Vu?)
  • The Wearables Tech Summit is about the form and function of wearables, plus VR, AR (augmented reality), and of course Peleton.
  • Accessibility is sadly a mismatch (mish-mash?) of home networks, 5G, IoT, and a pitch competition.

What’s big? 5G, AI anything, and autonomous vehicles. What’s faded in the stretch? Robots.

Back to health tech…here’s some highlights:

  • Philips has several new or tweaked products at CES this year
    • A smart version of the Sonicare toothbrush that collects and shares real-time toothbrushing data. The BrushSmart program works with Delta Dental of California to analyze the data for insights into oral care. Users get benefits such as exclusive dental care offers, the Philips Sonicare ExpertClean toothbrush and free brush heads when they brush regularly.
    • The Avent mother and childcare app adds a new feature called Baby+ to track baby’s growth and receive ongoing advice specific to each stage of their baby’s development.
    • The SmartSleep system adds the SmartSleep Deep Sleep Headband 2 to actively improve deep sleep with features such as Fall Asleep Sounds, SmartAlarm, and the SleepMapper app. Release
  • OMRON is adding to its heart monitoring services with HeartGuide, the first wearable blood pressure monitor, and Complete, the first wearable that combines a blood pressure monitor and EKG. The company is also launching this summer a heart health coaching and incentive app, OMRON Connect 2.0, that states it changes behavior, combining its two existing apps HeartAdvisor and OMRON Connect. Release
  • Withings’ newest is the ScanWatch which will be able to take an ECG and monitor for sleep apnea. The ECG has three leads on the watch on the side of the watch’s bezel and an SpO2 sensor to monitor apneic episodes and oxygen saturation. FDA and CE approval are pending, and when released later this year will cost $249 to $299 depending on size.  ZDNet
  • ZDNet and TechRepublic have a running special feature on CES’ big trends for business. The annoyance factor you’ll have to endure is the running CBS commercials for various programs.
  • Mobihealthnews rounds up interesting devices and software such as the Nanit baby sleeping bag that monitors an infant’s breathing, Reliefband’s low current anti-nausea band, Samsung’s Ballie rolling robot plus collaborations with Kaiser Permanente (cardiac rehab) and IrisVision (low vision/macular degeneration assistance), and more.
  • John Lynn, another Grizzled Pioneer, in Healthcare IT Today typically diverts from the mainstream coverage in spotlighting smaller companies in atypical areas. Examples are France’s Adok smart projector with the potential to be used collaboratively in practice offices, new connected apps for Neofect’s smart gloves for arm/hand rehab, two air filters to monitor both inside and outside air quality (as a social determinant of health!), Xenoma’s wired pajamas for fall detection, the Mateo bath mat which can measure weight and body mass, and a smart diaper from Smardii.

More to come in the next days!

News roundup: Teladoc acquires MédecinDirect, Blue Cedar closes $17M Series B, Hill-Rom buys Voalte, Withings bolsters sleep tracking

March 20, 2019 | by

Teladoc grows its global reach with the MédecinDirect acquisition. Paris-based MédecinDirect currently has 24/7 telehealth operations within France, with patients able to text, video, or phone GPs or specialist doctors 24/7. Terms were not disclosed and the sale is subject to regulatory approval, but expected to close within the first half of this year. Founded by François Lescure, a pharmacist, and Marc Guillemo, a digital marketer, in 2008, the company’s client base grew to more than 40 leading insurance partners and nearly half of the top 30 private medical insurers (PMIs) in France.  MédecinDirect will become the French unit of Teladoc, which now has operations in the UK, Australia, Canada, Spain, Portugal, Hungary, China, Chile and Brazil, covering 130 countries in more than 30 languages with a growing specialist base from earlier acquisitions Best Doctors and Advanced Medical. Teladoc seems to have moved on from its financial and accounting problems that marred 2018, but still is not profitable. Release, Mobihealthnews.

App security innovator Blue Cedar closes on its Series B for $17 million. New investor C5 Capital, a specialist venture capital firm focused on cyber security, joins $10 million (2016) Series A investors Benhamou Global Ventures, Generation Ventures, Grayhawk Capital, and Sway Ventures. Daniel Freeman from C5 Capital will join Blue Cedar’s Board of Directors, Blue Cedar pioneered the approach of securing data from the app to the provider location on a client’s servers or in the cloud, without the smartphone or other mobile device being managed and without additional coding. TTA last year profiled Doncaster UK-based MediBioSense Ltd. using Blue Cedar to protect their VitalPatch app [TTA 23 Jan 18] and later as a case study in how digital partnerships happen and develop [TTA 17 Feb 18]. Release, Blue Cedar blog.

Hill-Rom increases its technology bets with Voalte. Voalte is a mobile communications platform used by hospitals and large healthcare organizations for care teams to securely exchange information and data. The privately held company from Sarasota Florida currently serves 200 healthcare customers, 220,000 caregivers, and more than 84,000 devices. Terms of the acquisition were not disclosed but is expected to close during Hill-Rom’s fiscal third quarter of 2019. Hill-Rom, primarily known for its ubiquitous hospital beds, late last year teamed with Israeli company Early Sense to create a smart hospital bed that monitors heart and respiration rates [TTA 12 Dec 18], which ties nicely with Voalte’s monitoring. Release.

Tossing the sheets in your bed at home? The newly reconstituted Withings comes to the rescue with deepening its sleep monitoring with an upgraded sleep sensor mat that detects sleep breathing disturbances in frequency and intensity. The connected Withings Sleep app monitors sleep cycles, heart rate and snoring, displaying scores through the companion Health Mate App. Not quite a sleep apnea diagnostic, but significant breathing interruption detected during sleep could indicate the need for further investigation.  Mobihealthnews

It’s not a bubble, really! Or developing? Analysis of Rock Health’s verdict on 2018’s digital health funding.

January 21, 2019 | by

The doors were blown off funding last quarter, so whither the year? Our first take 10 January on Rock Health’s 2018 report was that digital health was a cheery, seltzery fizzy, not bubbly as in economic bubbles.  Total funding came in at $8.1 billion–a full $2.3 bn or 42 percent–over 2017’s $5.7 bn, as projected in Q3 [TTA 11 Oct]–which indicates confidence and movement in the right direction.

What’s of concern? A continued concentration in funding–and lack of exiting.

  • From Q3, the full year total added $1.3 bn ($6.8 bn YTD Q3, full year $8.1 bn) 
  • The deals continue to be bigger and fewer–368 versus 359 for 2017, barely a rounding error
  • Seed funding declined; A, B, C rounds grew healthily–and D+ ballooned to $59M from $28M in 2017, nearly twice as much as C rounds
  • Length of time between funding rounds is declining at all levels

Exits continue to be anemic, with no IPOs (none since 2016!) and only 110 acquisitions by Rock Health’s count. (Rock only counts US only deals over $2 million, so this does not reflect a global picture.)

It’s not a bubble. Really! Or is it a developing one? Most of the article delivers on conclusions why Rock Health and its advisors do not believe there is a bubble in funding by examining six key attributes of bubbles. Yet even on their Bubble Meter, three out of the six are rated ‘Moderately Bubbly’–#2, #3, and #5–my brief comments follow. 

  1. Hype supersedes business fundamentals (well, we passed this fun cocktail party chatter point about 2013)
  2. High cash burn rates (not out of line for early stage companies)
  3. Unclear exit pathways (no IPOs since ’16 which bring market scrutiny into play. Oddly, Best Buy‘s August acquisition of GreatCall, and the latter’s earlier acquisitions of Lively and Healthsense didn’t rate a mention)
  4. Surge of cash from new investors (rising valuations per #5–and a more prosperous environment for investments of all types)
  5. High valuations decoupled from fundamentals (Rock Health didn’t consider Verily’s billion, which was after all in January)
  6. Fraud or misuse of funds (Theranos, Outcome dismissed by Rock as ‘outliers’, but no mention of Zenefits or HealthTap)

Having observed bubbles since 1980 in three industries– post-deregulation airlines in the 1980s, internet (dot.com) in the 1990s, and healthcare today (Theranos/Outcome), ‘moderately’ doesn’t diminish–it builds to a peak, then bursts. Dot.com’s bursting bubble led to a recession, hand in hand with an event called 9/11.

This Editor is most concerned with the #5 rating as it represents the largest divergence from reality and is the least fixable. While Verily has basically functioned as a ‘skunk works’ (or shell game–see here) for other areas of Google like Google Health, it hardly justifies a billion-dollar investment on that basis alone. $2 bn unicorn Zocdoc reportedly lives on boiler-room style sales to doctors with high churn, still has not fulfilled its long-promised international expansion, and has ceased its endless promises of transforming healthcare. Peleton is a health tech company that plumps out Rock Health’s expansive view of Health Tech Reality–it’s a tricked out internet connected fitness device. (One may as well include every fitness watch made.)

What is the largest divergence from reality? The longer term faltering of health tech/telecare/telehealth companies with real books of business. Two failures readily come to mind: Viterion (founded in 2003–disclosure, a former employer of this Editor) and 3rings (2015). Healthsense (2001) and Lively were bought by GreatCall for their IP, though Healthsense had a LTC business. Withings was bought back by the founder after Nokia failed to make a go of it. Canary Care was sold out of administration and reorganized. Even with larger companies, the well-publicized financial and management problems of publicly traded, highly valued, and dominant US telemed company Teladoc (since 2015 losing $239 million) and worldwide, Tunstall Healthcare’s doldrums (and lack of sale by Charterhouse) feed into this. 

All too many companies apparently cannot get funding or the fresh business guidance to develop. It is rare to see an RPM survivor of the early ’00s like GrandCare (2005). There are other long-term companies reportedly on the verge–names which this Editor cannot mention.

The reasons why are many. Some have lurched back and forth from the abyss or have made strategic errors a/k/a bad bets. Others like 3rings fall into the ‘running out of road and time’ category in a constrained NHS healthcare system. Beyond the Rock Health list and the eternal optimism of new companies, business duration correlates negatively with success. Perhaps it is that healthcare technology acceptance and profitability largely rests on stony, arid ground, no matter what side of the Atlantic. All that money moves on to the next shiny object.(Babylon Health?) There are of course some exceptions like Legrand which has bought several strong UK companies such as Tynetec (a long-time TTA supporter) and Jontek.

Debate welcomed in Comments.

Related: Becker’s Hospital Review has a list of seven highly valued early stage companies that failed in 2018–including the Theranos fraud. Bubble photo by Marc Sendra martorell on Unsplash

It’s Official: CES is now a health tech event (updated)

January 17, 2019 | by

CES is now, officially, a health tech event. It’s not just the timing before CES of the flashy but apparently cratering JP Morgan annual healthcare investment conference in the absurdly pricey venue of San Francisco (FierceBiotech on the #MoveJPM backlash; the general disillusion with it expressed well here). It’s the fact that whatever mainstreaming health tech has actually accomplished, it’s far better represented in Las Vegas. Always a place of beginnings, endings, fun, gambles taken, lack of sleep, and sore feet, health tech fits right in, big or small.

CES reported that 2019 boasted an increase of 25 percent health-related exhibitors and a 15 percent increase in the amount of floor space dedicated to health tech. One winner was a big gamble by a small company–Living in Digital Times, which organizes and stages the Digital Health Summit. Ten years later, it turned out to be right place, right time for the founders who work hard to keep it on trend. Lifestyle, robotics, self-care, assistive tech (even exoskeletons), wearables, cosmetic “wellness” devices like P&G’s Opté, and Alexa-type home assistants/robots all now fit into the CES purview. Trial balloons by young companies, AI-powered concept devices from big companies, watches (including the Apple-beater Move ECG from the revitalized Withings TTA 10 Oct 18 and Omron’s HeartGuide), and robots all appeared. Samsung again brought out a brace of concept robots. Last year’s Best of CES ElliQ is finally available for pre-order after three years at a measly $1,500. The humanoid Sophia brought a kid sister, the equally creepy Little Sophia, both of whom failed during this CNET video. Yes, Pepper from Softbank made its appearance and apparently didn’t wilt as it did last year.

Sleep tech was another hot item, with a spin on sleep diagnostics or improvement from many products. A brainwave product, Urgonight from France, claims to be able to train your brain to sleep better. (Send one to Rick Astley who was a poster child for not Sleeping.)  Mental health is a natural crossover into sleep tech and robots, with a $5,000 Japanese robot, Lovot, capable of responsive cuddling and comfort.

Best of the coverage:

  • CNET has probably the best coverage and articles on health which stick to the facts (slim in some cases as they are); anyone who wants to catch up with the feel and flavor of this three-ring circus can start and stay there. Their full show coverage is here.
  • Dr. Jayne at HISTalk also did an excellent health-related product roundup in her Curbside Consult column.
  • Mobihealthnews also has a very long running list of health tech pictures and announcements as part of its limited coverage, including the mea culpas and promised transparency of onetime health ed unicorn Outcome Health [TTA 29 Jan 18].

Beyond the plethora of products encouraging ever more to come forward, what ones will even make it to market, far more be winners? Aside from the Samsungs and P&Gs, which of these young companies planting their stake at CES will be there next year?  As in past CES, the wheel goes round and round, and where it stops, nobody knows–not even the JPM investors. 

Withings returns to international markets with Steel HR Sport and a new Go

October 10, 2018 | by

Withings, bought back earlier this year from Nokia by founder Eric Carreel [TTA 3 May, release 31 May], reentered the market last month with most of the Nokia Health line and its new Steel HR Sport, a multisport hybrid smartwatch with heart rate monitoring, connected GPS tracking and fitness level analytics that analyzes VO2 max (release). Like Withings products before the acquisition, it is a pleasure to look at–well designed and more watch-like than smartwatchy–and surprisingly priced at $200. But on the budget side, reports indicate that Withings is reviving the Withings Go, famous for its eInk face. According to Wareable, they found a listing with the FCC for a successor model number to the previous Go (WAM03) containing information about a fresh design and new sensors for this basic fitness tracker. No price or release date is listed, but the 2016 model was about $70 retail.

Withings’ HQ has returned to Paris and is selling in the US, Canada, Mexico, Europe, Asia, and New Zealand.

Nokia throws in towel on digital health, negotiates Withings sale to co-founder Eric Carreel

May 3, 2018 | by

Nokia finally gave up on consumer health tech, confirming February reports that they were reviewing strategic options for its Digital Health business. Digital Health was a tiny part of Nokia Technologies and an even tinier part of overall revenue (under .2 percent at €52 million of revenues). The prospective buyer in the exclusive talks is Withings co-founder and former chairman Éric Carreel. “Nokia and Éric Carreel recognize that as an original Co-Founder of Withings, he is best positioned to carry the company forward into its next phase,” a Nokia spokesperson wrote to Mobihealthnews.

Withings sold itself to diversifying Nokia in 2016 for a hefty €170 million, becoming Nokia Digital Health in February 2017. The Withings purchase was positioned as a reverse takeover, with Withings staff taking over Nokia’s fledgling efforts in digital health. But the promised results and impact never took place and Withings faded from view, at least in the Americas.

According to their statement, “The planned sale is part of Nokia’s honed focus on becoming a business-to-business and licensing company.” Other interested buyers include Google’s Nest division and Samsung. The company may also head back to France.  TechCrunch, Mobihealthnews

Was 2016 a great or off year for digital health funding, M&A, IPOs? (updated)

January 10, 2017 | by

It depends on the study you read and how jaundiced your view is. If you believe the StartUp Health Insights 2016 ‘Health Moonshots’ report, 2016 digital health funding has hit a zenith of $8.18 bn (up 38 percent from 2015), with 500 companies enjoying funding from over 900 individual investors. Yet over at fellow funder Rock Health, the forecast is far more circumspect. They tracked only half the funding–$4.2 bn in funding–with 296 deals and 451 investors, down from the $4.6 bn over 276 deals in 2015.

There are significant differences in methodology. Rock Health tracks deals only over $2 million in value, while StartUp Health seems to have no minimum or maximum; the latter includes early stage deals at a lower value (their cross-section of ~$1 million deals has 15). StartUp Health gathers in international deals at all levels (pages 11-12),  whereas Rock Health only includes US-funded ventures. Another observation is that StartUp Health defines ‘digital health’ differently than Rock Health, most notably in ‘patient/consumer experience’, ‘wellness’ and ‘personalized health’. This can be seen by comparing their top 10 categories and total funding: (more…)

Philips dives into global consumer health tech with new wearables ‘ecosystem’

August 3, 2016 | by

Philips has made another substantial, if traditionally risky, move into the direct to consumer (DTC) health monitoring segment with a limited wearables ‘ecosystem’ under a new Personal Health Solutions division. It contains five FDA-cleared products for monitoring vital signs. Four peripherals download via a watch to iPhone/Android phone apps which run on version 2.0 of the Philips HealthSuite (with Salesforce1) mobile app. Earlier the apps were marketed in NL and BE.

While the release states they are globally available, initially it appears they are being marketed direct to consumer for the US only. Purchase is direct on the site. All devices are Bluetooth LE and sync with the watch and smartphone app/dashboard (available on Google Play and the Apple Store). The watch/app also tracks exercise with activity recognition, calorie tracking and sleep patterning, with the app providing some education content.

  • Watch $249
  • Body Analysis Scale (weight, body fat, BMI) $100
  • BP/pulse (upper arm) $100, (wrist) $90
  • Ear Thermometer $60

Interestingly, their existing DTC PERS enterprise, Lifeline, is not linked to or mentioned.

Prices are mid-range to high, making this a prima facie tough sell. (more…)