The Theranos Story, ch. 68: the texts told the tech failure–and please omit Holmes’ ‘luxurious lifestyle’ and profane meeting language from trial

November 26, 2020 | by

The trials of Elizabeth Holmes and ‘Sunny’ Balwani churn on towards a March 2021 court date. Two major revelations have entered the record from last Friday 20 November’s flurry of filings on both sides. 

  • The prosecution introduced panicky Holmes/Balwani texts, iMessages, and Skype messages indicating that Theranos was having major trouble with validating its lab technology from 2014 on. One text from Balwani described a lab as a ‘disaster zone’. “The spreadsheets are replete with admissions by defendant and Balwani that demonstrate their knowledge that their statements to investors were false and misleading and that Theranos’s testing was beset with problems.”  CMS in 2015 concluded that their California lab posed an “immediate jeopardy to health and safety.” The messages were from previous civil cases and collected by securities regulators, with many still under seal from those cases.
  • The defense for Holmes moved to prohibit prosecutors as ‘unfairly prejudicial’ evidence of Holmes’ wealth, spending, and lifestyle,  citing Federal rules of evidence and that this information is not relevant to Holmes’ guilt or innocence on the fraud charges. In 2015, Holmes was worth an estimated (by Forbes) $4.5 bn despite what is claimed as a moderate salary and not selling equity. The government has detailed her company-paid perks such as a luxury SUV, a rented luxury house, and luxury-level travel, in addition to a ‘substantial salary’. 
  • The defense is also seeking to omit any references to Theranos employees making claims about the technology, including Theranos sales representatives falsely claiming that the FDA approved the company’s lab machines. The grounds to omit are that Holmes could not be responsible for their false statements.
  • The defense also seeks to omit transcripts of a company meeting that used profane language to refer to reporting in the Wall Street Journal investigating the company and a competitor at that time, on the grounds that such language is par for the course in High-Tech-Land. Mercury News (may be paywalled)

Fox Business 23 November, 24 November. BNNBloomberg.

In a separate case, a former Theranos lab scientist, Diana Dupuy, has claimed that she was wrongfully terminated from her job with medical testing company DiaSorin nine days after receiving a subpoena to testify at the Theranos trial. DiaSorin is claiming the reason is unrelated to Theranos. The suit has been filed in US District Court in San Francisco. Anecdotally, many former Theranos employees have reported that Theranos has been a glaring black mark in their resumes that make them close to unhireable. Mercury News

Flow depression treatment headset/app addresses UK ‘lockdown loneliness’ of as high as 27% (UK/EU)

November 26, 2020 | by

A depression treatment headset and app called Flow is being marketed in the UK and Europe by a Malmö-based company to help treat depression through brain stimulation. The user applies the headset to the forehead area and operates it through the smartphone app. The brain stimulation uses transcranial Direct Current Stimulation (tDCS) to restore brain activity in the frontal lobe to decrease depressive symptoms in as little as three weeks. tDCS has been found in randomized controlled trials to have a similar effect to anti-depressant drugs, but without the side effects. The treatment and company were formed by Daniel Mansson, a clinical psychologist, and neuroscientist Erik Rehn. The system is available for purchase for €45/monthly or outright purchase for €459. (Not available in the US)

‘Lockdown loneliness’ is a renewed concern as the pandemic won’t go away and we are both being advised to restrict our movements, physically distance, normal gathering places are closed or restricted, and in many areas, we are being asked to isolate again from family, friends, and co-workers. A study published in PLOS One from a 1,900+ sample of UK adults 18-87 years of age in March-April indicated the prevalence of self-reported loneliness was very high–27 percent. 49 to 70 percent of respondents reported feeling isolated Reported risk was higher in the younger age group, among those who are separated or divorced, or already meeting clinical criteria for depression or emotion regulation difficulty. Loneliness was measured using the Three-Item Loneliness Scale. With holidays coming up soon, this initial report does not bode well for the rest of the year. 

Health tech M&A moves: Well Health’s $45M Series C, GigHealth2/UpHealth’s $1.35 bn ‘blank check’ acquisition

November 26, 2020 | by

Santa Barbara, California-based Well Health, a patient communication platform that connects patients and providers through the care experience including the home, earlier this week announced a $45 million Series C funding round, bringing total funds raised to $75 million since its founding in 2015. The lead investor is Lead Edge Capital, with Martin Ventures plus previous funders Jackson Square Ventures, Health Velocity Capital, Summation Health Ventures, Structure Capital and Freestyle Capital. Their target markets are providers, payers, and accountable care organizations (ACOs). Well Health’s CEO/founder Guillaume de Zwirek, claimed that annually 200,000 healthcare providers use the platform to send more than 1 billion messages with 30+ million patients.

Well Health also announced Dana Gelb Safran, Sc.D. as Senior Vice President, Value Based Care and Population Health. She was previously with Blue Cross Blue Shield of Massachusetts. Well Health release, Mobihealthnews

GigCapital2 Inc., a publicly-traded US special purpose acquisition company (SPAC) or ‘blank check’ company, has agreed to merge with UpHealth Holdings Inc and Cloudbreak Health LLC to create a digital healthcare company valued at $1.35 billion. According to their release, UpHealth is expected to generate over $190M in revenue and $24M in EBITDA next year; 69% of the 2021 incremental revenue growth is already contracted. The combined company will be named UpHealth, Inc. and trade on the NYSE under UPH.

The new company will be organized in four lines across population health management and telehealth: Integrated Care Management, Global Telehealth, Digital Pharmacy, and Tech-enabled Behavioral Health. Global Telehealth under the Cloudbreak brand claims 100,000 encounters per month on over 14,000 video endpoints at over 1,800 healthcare venues nationwide, with telepsychiatry, telestroke, tele-urology, and other specialties.

GigCapital2 previously raised $150 million in an IPO in June 2019. It will raise an additional $160 million as a private investment in a public equity, or PIPE, transaction. GigCapital is located in Palo Alto and is led by CEO/President Dr. Raluca Dinu and Executive Chairman Dr. Avi Katz. The roots of the company are interestingly in the companies ultimately rolled up into GigPeak, which was sold to Newark NJ-based telecom company IDT Corporation in 2017.

‘Blank check’ acquisition companies are becoming a popular way for digital health companies to go public without the fuss and bother of the necessary and expensive filings, SEC review, financing, etc. of an IPO. In August, SOC Telemed went this route in the other direction, acquiring a SPAC [TTA 4 August]. Hims, Augmedix, and Clover Health also went public through SPACs.The former principals of Livongo, post-Teladoc, are also forming a SPAC [TTA 30 Oct]. Reuters, Fierce Healthcare

Thank and Praise thanking wall adopted by United Lincolnshire Hospitals NHS Trust

November 26, 2020 | by

As in the US we celebrate Thanksgiving Day, when Plymouth Rock landed on the Pilgrims, this is appropriate. Thank and Praise Ltd., a social thanking platform that sets up digital ‘thanking walls’ and thanking books, announced that they were selected by United Lincolnshire Hospitals NHS Trust to set up a digital thanking wall for their staff. The objective is to boost staff wellbeing and morale, especially with the continuance of the COVID pandemic. Patients, staff friends and relatives, and local people can post, using a simple online form, messages of thanks and cheer such as this (left).

 

United Lincolnshire is a hospital Trust composed of four acute care hospitals – Lincoln County Hospital, Grantham and District Hospital, Pilgrim Hospital Boston, and County Hospital Louth, serving a population of 720,000. Hat tip to James McLoughlin of Thank and Praise for keeping our Readers posted.

CVS Aetna testing social determinants of health with Medicaid HealthTag pilot

November 26, 2020 | by

The meshing of payer, retail, and service enhancements to improve health outcomes is the aim of CVS Aetna’s HealthTag pilot in Louisiana and West Virginia. It’s not terribly complicated. Aetna Medicaid (state health program) members picking up their prescriptions at CVS pharmacies will receive tucked into their prescription bag information on social and community services that may be useful to them, services such as food, housing, and transportation. An outside organization, Unite Us, is the resource for these social care programs. 

HealthTag is part of a broader and older ongoing program, Destination: Health [TTA 27 July 19] with Unite Us and a five-year affordable housing initiative. Unite Us’ community organizations had to do quite a bit of adjusting to virtual assistance from in-person after the pandemic hit. R.J. Briscione, senior director for social determinants of health (SDOH) strategy at CVS Health, told Fierce Healthcare that the objective of the “program is designed to identify Aetna Medicaid members who could use additional interventions to address their social needs, but who might otherwise not receive those potential services.” The pharmacy is a logical place as the members may have frequent interactions with their pharmacists for medications. (What is not said that frequent medication use is a leading indicator of multiple chronic conditions which may be mitigated by improvements in food sources, housing, and transportation to work and doctors, and possibly reducing cost.) 

Unite Us is also working with Lyft car service to provide non-emergency patient transportation to referred health appointments [TTA 13 Mar].

SDOH is not new to US payers, but the CVS Aetna integration and delivery is much more seamless than distribution through a practice office or mailers.  (This Editor worked on a WellCare program delivered through participating practices in their Maryland accountable care organization unit, and it was hard to get traction.)

Short Takes 20 Nov: Doro Eliza social alarm in UK, R2G diabetes market study, KOMPAÏ Robotics update, Bluestream Health integrates LanguageLine translation, and Optum’s 18

November 20, 2020 | by

Why does this whole year feel like we are Pauline in Peril, all tied-up, with an Evil Man menacing us while the Train barrels down the tracks? Nonetheless, there are bites of news to be consumed, even though this year’s Thanksgiving in the US will be at best a muted one, and the Grinch may be stealing Christmas.

Doro remains ‘on a tear’ with new product introductions for the UK. The Doro Eliza (right) is a 4G/digital IP compatible social alarm/”smartcare” hub, with a modern design that connects to telecare accessories. The modern design has HD audio on the speaker for personal alarms, and also connects to smoke detectors, fall sensors, security cameras, and pill dispensers. Already introduced in Europe, its timing is part of the transition from analogue to digital telecare for 1.7 million UK telecare users as telecom moves to full digital by 2025. Release.

If your business is in diabetes care and the apps that assist them, Research2Guidance’s study and forecast, “The Global Digital Diabetes Care Market 2020: Going Beyond Diabetes Management” will be of interest. The 91-page report covers a global picture of growth from 2008 projecting out to 2024, as well as digital solutions, their segmentation, and competition. For instance, from 2019 to 2024, the number of diagnosed diabetics with access to smart devices is set to increase from 109 million to 180 million. It includes profiles of 10 countries. Priced from €3,290, so it will set you back a bit. More information here. 

We missed updating you on KOMPAÏ Robotics, which Editor Emeritus Steve Hards first covered in 2011. Their latest developments were earlier this year as their assistance/companion robot finally debuted for sale–right in the middle of the pandemic. This Pulse article recounts the road for CEO Vincent Dupourqué from 1975 to the third version of KOMPAÏ.

LanguageLine, which is a long-time provider of language translation services live to in-patient and acute care settings, announced an integration with Bluestream Health’s virtual visits. With a single click, a Bluestream user can access audio and video interpretation in 240 languages and over 13,000 interpreters. LanguageLine also assists with deaf and hard-of-hearing users. Bluestream provides whitelabeled telehealth services to approximately 50,000 providers. LanguageLine has headquarters in California, with offices in Taiwan and London.  Release

And finally, Optum’s 18. Optum Ventures, the funding arm of UnitedHealth Group’s Optum, has invested in a large number of healthcare ventures this year, nearly all with a health tech or AI spin. It’s neatly distributed internationally and between Series A through C, with UK companies like Oxford VR (VR used for therapies, no connection to Oxford Medical Simulations) as part of a $12.5 million Series A, Germany’s Kaia Health with a $26 million Series B tranche, and US companies like LetsGetChecked as part of a $71 million Series C. Not quite Ocean’s 11, but Optum’s bet a lot more than Danny Ocean got from those casinos in 1960. Becker’s Health IT.

Weekend reading: HISTalk’s interview with Spirion’s CEO on healthcare data security

November 20, 2020 | by

A short but must-read if you care about data security and your customers/patients/residents. Where this HISTalk interview with Kevin Coppins, CEO of Spirion, excels is leading the reader through areas that are usually filled with fog and IT jargon. The view is from his company and a healthcare organization sitting in a conference room and scoping the problem without ‘paralysis by analysis’ or a turnkey ‘solution’ that may not be one. What’s different here is the clear, and few, logic steps, particularly the first three listed, that Mr. Coppins takes to get the ball rolling rather than befogging the discussion with too many factors or the punitive consequences of regulatory non-compliance.

“The concept of data and sensitive data is at the core of both security and privacy.”

  1. How much data do you have? (Nobody really knows, admit it)
  2. Of that data, what would you consider ‘sensitive’, and how do you define ‘sensitive’? Not only by regulation/compliance directives, but what your patients, clients and the board would consider ‘sensitive’.
  3. How much of that data is actually critical? 
  4. What’s the impact? How personal is it to your organization, not just in a compliance way but in your community, etc.
  5. How do I reduce the risk of loss?
  6. If I lost the data due to hacking or ransomware, what’s the backup? How fast can this happen?

This Editor notes that these points (quantity, definition, risk of loss and recovery, and community impact) can be applied to other situation analyses.

The litany of ransomware attacks that have ramped up during the pandemic waves has pushed data security issues to the ‘gotta tackle’ list. According to Emsisoft, a security company, there were 41 attacks on healthcare organizations in first half 2020. This didn’t stop during the summer, with a rash of them at end of October and a hit list of 400 hospitals, according to Becker’s.) Hacking attacks persist but aren’t getting the headlines.

And his conclusion is pertinent: “When it comes to security and privacy and all the drama and all the noise that you hear about it and read about it, just boil it down to this — am I doing everything I can today to protect what matters most to the constituents I serve?”

Early detection of Parkinson’s via AI (and a surprising medium); Ed Marx on the digital transformation (or not) of health systems and COVID treatment at home

November 20, 2020 | by

Somewhat off our normal beat….but of interest.

Ardigen and The BioCollective are collaborating on early detection research for Parkinson’s Disease, based on a microbiome-based biomarker. Ardigen has developed an Artificial Intelligence (AI) Microbiome Translational Platform. The BioCollective has a bank of metagenomic and patient metadata generated from an unexpected source: Parkinson’s patients’ stool samples. Release

The BioCollective is headed by Martha Carlin, who came from well outside of healthcare and pulled together a research group to address her husband’s diagnosis. A visit to this website is worth an examination on how these samples are collected for microbiome extraction. An interesting twist is the marketing of a probiotic mix developed using their BioFlux metabolic model for ‘gut health’.

Ed Marx, the former CIO of the Cleveland Clinic, has written a new book, ‘Healthcare Digital Transformation: How Consumerism, Technology, and the Pandemic are Accelerating the Future’. It’s billed as a wake-up call for healthcare systems and hospitals under challenge by Big Retail, Big Pharma, and Big Tech. This Editor met Mr. Marx when he premiered his entertaining memoir, ‘Extraordinary Tales from a Rather Ordinary Guy’, a few years ago. On treatment for COVID patients, except for the very sickest, he advocates it being done from home. From the release: “When the pandemic hit, a lot of progressive organizations would send most of their Covid patients home with monitoring equipment hooked up to phones unless they needed a ventilator. It’s a lot cheaper than staying in the hospital.”

News roundup: Amazon Pharmacy–retail, GoodRx threat, 81% of healthcare workers have remote IT issues, Epicor installs in Australia care homes, GrandCare for developmentally disabled adults

November 19, 2020 | by

Rounding up lots of dogies here!

Amazon, to no one’s surprise, has formally entered the US pharmacy business with Amazon Pharmacy which can fill prescriptions for most common medications. There is a whole process of course to sign up (at right), and a separate program for Amazon Prime customers with discounts on Amazon Pharmacy with two-day delivery, PillPack, and at 50,000 pharmacies in 45 states. The Prime program is administered by Inside Rx, a subsidiary of Evernorth/Cigna.

Mr. Market downgraded pharmacy retailers CVS and Walgreens Boots stocks, again unsurprisingly. It isn’t just brick ‘n’ mortars feeling the heat; heavily advertised drug price comparison platform (lumped into ‘digital health’) and recent IPO winner GoodRx took a 20 percent hit as Amazon Prime also discounts, comparable to GoodRx Gold. The GoodRx network is about 70,000 pharmacies, including the largest retailers. Fierce Healthcare. Big hat tip to Jailendra Singh at Credit Suisse Equity Research for these analyses on Amazon Pharmacy and GoodRx.

81 percent of healthcare workers experience issues with systems and technology used in external care, out visiting and caring for patients, according to a ‘State of Mobility in Healthcare’ multi-national study (email signup required) by business mobility development company SOTI. 64 percent of UK healthcare workers (63 percent overall) are ripping out what is left of their hair due to IT/technology glitches leading to system failures within a normal working week. Only a quarter of respondents said that their systems were able to cope with COVID-19. Based on the Healthcare IT News EMEA edition article, UK respondents apparently reported a higher level of IT problems affecting their work. The bright spot is that 68 percent of UK healthcare workers/55 percent overall agree that investment in new or better technology could help save lives. The study had respondents in the US, Canada, UK, Germany, Sweden, France, and Australia.

Speaking of software, Epicor, a US-based software company, is providing to two Australian care home groups their Community Care workflow and information platform: Finncare, which is associated with services to the Finnish and Scandinavian communities, and MannaCare in the Victoria area. Healthcare IT News Australia

One of the Ur-companies (2005!) in the senior health monitoring sector, GrandCare Systems, announced that they are working with LADD, a Cincinnati Ohio-based non-profit that supports adults with developmental disabilities. LADD’s project, the Heidt Smart Living Home, will incorporate GrandCare’s communication, cognitive assists, telehealth, and social engagement tools, as well as innovations in accessibility, lighting, and sensory control, for residents. Release Hat tip to CEO Laura Mitchell via LinkedIn.

News roundup: Pfizer’s COVID-19 vaccine on horizon, CVS’ new CEO, Vodafone UK 5G health survey, Centene acquires Apixio AI, Doro’s 24/7 Response

November 14, 2020 | by

As infection rates continue to rise, Pfizer’s and German partner BioNTech SE’s COVID-19 vaccine was the top of the news this undecided post-US election week. It was found to be “more than 90 percent effective in preventing COVID-19 in participants without evidence of prior SARS-CoV-2 infection in the first interim efficacy analysis” of the Phase 3 clinical study. They exceeded their evaluable case count (total was 94). Protection was achieved 28 days after the initiation of the 2-dose vaccination. Pfizer release. Chain and independent pharmacies have already signed on for distribution at no cost to patients, covering about 60 percent of pharmacies through the US, Puerto Rico, and the USVI. It’s expected that FDA approval will be by end of year with availability early next year. HHS release. Work on 10 other vaccines goes on. The NHS is lining up for distribution with Health Secretary Matt Hancock promising that they’ll be ready from December as coronavirus diagnoses and deaths climb up from summer levels. BBC News

CVS’ CEO Larry Merlo announces 1 Feb 2021 retirement, Aetna head Karen Lynch to take the helm. Ms. Lynch will also join the board of directors. Mr. Merlo will depart after the shareholder meeting and serve as a strategic adviser until 31 May, which is typical of CEO phased departures. He leaves CVS in excellent shape having conducted during his 10-year tenure the acquisition of Aetna in 2018 and the growth of CVS to almost 10,000 store locations, initiating 1,500 HealthHUBs, and over $199 bn in earnings through Q3 this year. Ms. Lynch joined Aetna in 2012 from Magellan Health Services, a specialty/behavioral managed health company, and Cigna. She hit a home run with vitalizing Aetna’s Medicare Advantage business to 2.5 million members from under 1 million in 2013 and became Aetna’s president in 2015. Mark Bertolini, Aetna’s CEO during the merger in 2018 (but not Federally approved till September 2019), lost his spot on the board in an apparent spat/downsizing last February.  FierceHealthcare, Healthcare Dive, Fortune

Vodafone UK’s new survey on 5G and Internet of Things (IoT) devices in UK health and social care has been issued. A key finding is the comfort level of some telehealth consults well past 50 percent, and over 60 percent in the 18-34 and 35-54 age groups. There is 60-70+ agreement with Government investment in digital technology to ‘future proof the UK healthcare sector’ and to pay for care homes’ high-quality broadband and mobile. More in Vodafone’s study here.

Healthcare payer Centene Corporation is acquiring healthcare analytics company Apixio. Apixio’s AI platform analyzes large amounts of unstructured patient data in physician notes and medical charts. It then creates algorithms to extract high-quality insights to support payers’ and providers’ administrative activities. Acquisition cost is not disclosed and close is expected by end of year. It will be an ‘operationally independent entity’ in an Enterprise group, but complement other in-house technologies such as Interpreta. A bit of catch up here as larger plans Anthem, UnitedHealth/Optum, and Humana all have either substantial in-house AI analytics or have contracted with outside vendors (e.g. Microsoft) for this capability. Release. (Disclosure: This Editor was formerly with Centene, via their WellCare Health Plans acquisition)

Doro Mobile UK and Ireland is introducing ‘Response by Doro’, a touch button service to summon help if needed. The alert button is on the back of the phone versus on the screen, which differs it from most mobile systems. The standard level connects to family and friends, with the Response Premium level connecting to a 24/7 service. For BT Mobile and EE mobile customers with a Doro mobile phone, their first month’s access to Response Premium is free. Release (PDF)

Shock news: a very muted HIMSS 2021 set for 9-13 August, Las Vegas

November 13, 2020 | by

Yes, Virginia, there will be a HIMSS21, of sorts, we think. The news of a HIMSS21 in Las Vegas next August (when it will be 110° in the shade) is like the forecast of rain for this parched-of-business convention city and the parched-of-contact health tech community. The basics, mostly from the FAQ:

  • Registration will open in January (date TBD). If you paid your registration for the canceled 2020 conference, your registration will automatically be carried over to the 2021 conference, with details to come. If you cannot attend, no refunds.
  • Programming, exhibits, and events will be held at the Venetian-Sands Expo Center, Caesars Forum Conference Center, and Wynn 
  • The program and topics are sketched in (see the website dropdowns).
  • Proposals for the education track are closed, but open till mid-January for the optional events.  

Exhibitor registrations and paid badges will be carried over (unless you don’t plan on exhibiting, then again, no refunds). For whatever reason, the exhibit floor will be worthy of a Woman’s Christian Temperance Union (WCTU) convention in Des Moines, based on the published rules:

  • NO SOLICITING OUTSIDE THE CONFINES OF YOUR BOOTH (replicating their capitals, including hotels–what fun is this?)
  • All demos and promo activities must be performed five feet set into your booth space. It’ll get cozy for the small, poor exhibitors in a 10 x 10! In fact, straying outside your booth for anything is apparently prohibited.
  • No megaphones, loudspeakers, or what is quaintly called ‘sideshow’ tactics, for instance, clowns, whistles, or high school marching bands in the aisle. Noise must be less than 75db. If there are speakers, they must face into the booth–and better be small.
  • Tchotchkes must have logos on them, so no running out for brand-name candy needed to fuel a looong floor day
  • You have to stay in your booth during exhibit AND non-exhibit hours. (I guess this means no food, event attendance, bathroom breaks–or scoping out/chatting up the competition, a key activity at any trade show.) And don’t wear lights or signage of any type on your clothes.
  • Speaking of clothes, they’re NOT optional–tops and bottoms required. At all times. Even though it’s HIMSS. And Las Vegas.
  • No cameras or video equipment on the floor. (I guess this means you can’t shoot reference pictures, booths you like, or cute videos to share on your blog, Twitter feed, and LinkedIn. Sounds like a closed shop for HIMSS Media.)
  • Exhibitors must use the official booker (onPeak), or you can lose your badges and booth. No economizing! Rough on the small, poor companies.
  • “Event Participants are expected to behave responsibly and to treat each other – and treat the community – with respect, kindness, and compassion.” If you don’t, you lose Exhibitor Points. (No comment!)

This Editor wonders that with all these restrictions and the mid-summer timing, how many exhibitors will simply walk away from HIMSS21 and its high expense? Or wait till March 2022 in Orlando? After all, 2020 booth expense was in last year’s budget and written off. Is going to HIMSS worth it to you?  Hat tip to HISTalk.

Discovering ways to non-invasively early detect COVID-19 from heart rate, sleep, or a cough sound, even among the asymptomatic

November 6, 2020 | by

Heart rate, sleep quality, daily movement–cough sound frequency? Several studies in the US and UK are attempting to turn up ways to early diagnose mildly symptomatic, asymptomatic, or even pre-symptomatic COVID-19 cases, without the PCR swab or a blood test.

The more obvious of the two comes out of the Scripps Research Translational Institute. The DETECT study started in March (!) with 30,500 participants sending in data in the first six weeks of the study on heart rate, sleep quality, and daily movement. This information was then matched with self-reported symptoms and diagnostic tests taken if any. In this way, new infections and outbreaks could be detected at an earlier stage.  The study is attempting to confirm if changes in those metrics in an individual’s pattern can identify those even at a pre-symptomatic or asymptomatic stage. 3,811 reported symptoms, 54 reported testing positive, and 279 negative for COVID-19. The numbers seem small, but the analysis carries out that the combination of sensor and symptom data performed better in discriminating between positive and negative individuals than symptom reporting alone. The symptom data were taken from Fitbits and any device connected through Apple HealthKit or Google Fit data aggregators, then reported on the research app MyDataHelps. FierceBiotech, Nature Medicine (study)

Also using vital signs, back in August, Fitbit released early data on a 100,000+ study where changes in heart rate and breathing could detect about half of diagnosed cases at least one day to a week before diagnosis. Symptomatic cases were 1,100 in this sample. Heart rate and breathing were detected to become more frequent in the symptomatic, with the variability in time between each heartbeat dropping, resulting in a more steady pulse. The preferred tracking was at night during rest. However, there was a 30 percent false positive rate on the algorithm used, which is extremely high. FierceBiotech Related to this work, Fitbit was selected at the end of October by the US Army Medical Research and Development Command (USAMRDC) to receive nearly $2.5 million from the US Department of Defense through a Medical Technology Enterprise Consortium (MTEC) award to advance a wearable diagnostic capability for the early detection of a COVID-19 infection. Fitbit will be working with Northwell Health’s Feinstein Institutes for Medical Research to validate their early detection algorithm. Business Wire

And what about that ‘Covid Cough’? MIT is researching that this cough is different than other coughs, like from cold or allergy. Their research found that there’s a difference in the sound of an asymptomatic individual’s cough–and that sound frequency difference could not be heard by human ears. (Dog ears perhaps?) MIT researchers created “the largest audio COVID-19 cough balanced dataset reported to date with 5,320 subjects” out of 70,000 cough samples. The algorithm performed well. “When validated with subjects diagnosed using an official test, the model achieves COVID-19 sensitivity of 98.5% with a specificity of 94.2% (AUC: 0.97). For asymptomatic subjects it achieves sensitivity of 100% with a specificity of 83.2%.” This sure sounds like an AI screening tool that is inexpensive and convenient to use with multiple populations even daily. IEEE-EMB  BBC News reports that similar studies are taking place at Cambridge University, Carnegie Mellon University, and UK health start-up Novoic. The Cambridge study used a combination of breath and cough sounds and had an 80 percent success rate in identifying positive coronavirus cases from their base of 30,000 recordings.

All of these will be useful, but still need to be validated–and that takes time, for which this Editor thinks is short as this virus, like others, will eventually 1) mutate out or 2) be effectively treated as we do with normal flus. But down the road, these will serve as a template for new ways for early screening or even diagnosis of other respiratory diseases.

Bexley, Wandsworth Councils onboarding remote monitoring, video calls with COVID-19 the spur (UK)

November 6, 2020 | by

With Round 2 of the pandemic hitting the UK (and rising rates in EU and also parts of the US), it’s timely that borough councils have already stepped up their efforts to extend home monitoring and connectivity to the most vulnerable older adults and disabled. Here’s a short roundup:

  1. The London Borough of Bexley has been working with Docobo to install their DOC@HOME technology to connect residents with their GP to manage their health and well being at home. DOC@HOME connects with the patient via tablet (Android) tablet, computer, Docobo TV, or smartphone to their clinical teams to enroll, set up, and manage their patients using Docobo’s reporting platform. This version of DOC@HOME used two types of question sets: to set up a doctor consult requested by the resident or staff member and to conduct monthly wellness checks. The pilot was completed with one care home with these results (2019 vs 2018 same period): 71 percent fewer visits by GPs to the care home, and 36 percent fewer visits by residents to A&E. Bexley is now rolling out to 20 care homes using an NHS Digital pathfinder grant. Later plans will be rollout to individual homes.
  2. The Bexley Council is also piloting another Docobo product, ARTEMUS, a risk stratification platform, with the Bexley Clinical Commissioning Group (CCG) to create an analytics and decision support platform to support a more holistic approach to health and wellbeing at the individual level. Risk stratification at its most essential level uses data to classify residents or patients at their level of health risk (multiple chronic conditions) with the objective of mitigating long-term escalations in care needs and emergencies and integrate support, particularly to integrate support for those with dementia. 1 and 2 from NHS AI Lab Hat tip to Adrian Flowerday of Docobo for his LinkedIn post.
  3. Wandsworth Council is working with Alcove to provide the Carephone tablet to their residents who receive a care or support package. The Carephone enables them to make video calls with family, friends, care workers, and other approved service providers. Wandsworth Council article.