US Department of Justice decides additional scrutiny needed of $13bn Optum acquisition of Change Healthcare

March 30, 2021 | by

Change, so to speak, will not be fast for Optum. On Friday, Change Healthcare filed with the Securities and Exchange Commission (SEC) a Form 8-K (PDF link) that confirms that the Department of Justice (DOJ) has asked for additional information pertinent to their proposed acquisition by UnitedHealthcare Group and integration into their Optum unit. On 24 March, both received a request from the DOJ for additional information and documentary materials (called a “Second Request”) as part of DOJ’s review of the merger under the Hart-Scott-Rodino Antitrust Act (HSR). The Second Request extends the waiting period for 30 days after UHG and Change comply with the review, unless either the DOJ shortens it or it is extended by the two companies (para. 3).

The integration of Change Healthcare into Optum already had significant competitive concerns for DOJ to consider. OptumInsight, Optum’s data analytics unit, and Change provide a similar range of services in health IT and revenue cycle management (RCM). However, Change is one of the largest independent companies providing these services to major providers, with access to the data of 1 out of 3 patients. Optum’s parent, UnitedHealthcare, is the largest US payer. These were the factors that made those represented by the American Hospital Association (AHA) very nervous indeed [TTA 25 Mar] regarding pricing of these services–and they expressed their misgivings cogently in a seven-page letter (PDF link) to DOJ on 17 March. In their view, Change integrated into OptumInsight would reduce competition and increase pricing in RCM, claims clearinghouse and payment accuracy services, and clinical decision support services.

Why it’s important. The closing of the $13 bn deal, originally forecast as second half 2021, now has a decent likelihood of being postponed. As CVS and Aetna found between 2017 and 2019, once the objections start in the flashpoint called US Healthcare, they tend to snowball into delays, even if it can be managed to a successful conclusion. (Extreme examples: the doomed to fail Aetna-Humana and Anthem-Cigna mergers) While RCM and data analytics are not as high profile as health plans and retail health, industry groups have a lot of clout in the DC Swamp when the cause is higher cost and DOJ, in this administration, is likely to be more activist. Another reason: if UHG or Change have to divest themselves of too much (UHG set a boundary of $650 million), they may Call The Whole Thing Off. Also Healthcare Dive and FierceHealthcare. 

Deals and news roundup: Ginger’s $100M, myNEXUS to Anthem, Everlywell snaps up PWN, Amwell’s banner year for revenue–and loss, VA reviews Cerner rollout, voice visits for MA, GE’s vScan goes wireless, uBiome founders indicted

March 27, 2021 | by

Deals–and news–are piling up like Easter eggs before the hunt. Mental health and cognitive digital therapy scored another raise with Ginger‘s $100 million Series E to fund expansion into health plan and government partnerships. Blackstone Growth led the round. Total funding to date is $220 million. It’s entered unicorn status with a valuation just north of $1 bn. Ginger to date has concentrated on corporate mental healthcare. From being an ugly duckling only a few years ago, digital mental therapies are this year’s ‘it’. But competition is fierce: the traditional telehealth companies such as Teladoc, Doctor on Demand, and Amwell are closing in on the early entrants such as AbleTo. Direct-to-consumer models like Talkspace; UK/Ireland’s SilverCloud Health; and Lyra, Spring Health, and Happify, which just closed a $73 million Series D, all step out with slightly different ‘differentiators’ but target the same companies, health plans, and health systems. FierceHealthcare, Ginger release. 

Home health is also another former ugly duckling transformed into a swan. Anthem is acquiring home health/nursing management company myNEXUS, which manages home-based nursing services for 1.7 million Medicare Advantage members across 20 states. Their digital authorization and visit management couples with a nationwide network of providers and nursing agencies for local care. Exiting myNEXUS are private equity investors led by New York’s WindRose Health Investors, after four rounds and a conservative $31 million in funding (Crunchbase). Neither terms nor management transitions were disclosed. myNEXUS will join Anthem’s Diversified Business Group. FierceHealthcare, release.

Home testing+telehealth company Everlywell (not connected with the Everly Brothers) has a different take on home health. They are now integrating their self-test kits with fully owned lab testing. New acquisitions PWNHealth and its subsidiary Home Access Health Corporation will join Everlywell in Everly Group. PWN was Everlywell’s main telehealth partner and diagnostic testing partner since 2016. It will become Everly Health Solutions with their testing data kept separate from Everlywell’s. Home Access was PWN’s self-collected lab test company. Everly Health now will support more than 20 million people annually in all 50 U.S. states, Canada, and Puerto Rico. Acquisition terms were not disclosed. PWN’s CEO will take a seat on the Everly Group board to assist integration. Valuation is now estimated at $2.9 bn.  Mobihealthnews, Everly release, Bloomberg News

And in other news…

Amwell reported a Very Good Year in their telehealth services, with visits growing to 5.9 million from 2019’s 1.1 million. Total revenue was up over 65 percent to $245.3 million. However, profitability continues to be elusive, with net loss almost equaling revenue. Release

The Department of Veterans Affairs (VA) finally announced a review of the Cerner-Leidos EHR integration. Back in February, VA was hanging tough on the rollout after the GAO report questioning its wisdom and recommending postponement until high severity issues were corrected. Secretary Denis McDonough, new VA head, has directed the undertaking of a 12 week strategic review without pausing the project. Taking bets on that 12 weeks! Healthcare Dive

Payers and their lobbyists are supporting a newly reintroduced House bill that would permit telephonic-only telehealth visits to be reimbursed for their Medicare Advantage plans after HHS closes the pandemic period. There is considerable information that video/audio virtual visits still have limitations with the 65+ group, clustered around high-speed internet or good data connections, smartphones, and computers with cameras, making video visits difficult or impossible. Which begs the question about continuing coverage for those on Original Medicare. Healthcare Dive

Those readers with long memories will recall GE Healthcare’s heralded introduction of the VScan handheld clinical-grade ultrasound device–back in 2010, complete with Eric Topol rave and demo. Not much has been heard from GEHC since till this month, and other competitors, such as the Butterfly IQ from 4Catalyzer, have made handheld ultrasound common and affordable. GEHC announced Vscan Air, a fully wireless version that connects to iOS or Android. It was FDA cleared in November 2020 and will be shipping its dual-headed probe and accessories starting 1 April for a US-listed target price of $4,495. GEHC page (with the cute domain vscan.rocks), Mobihealthnews

And in our Scandal Sheet section, a Federal grand jury in the Northern District of California has indicted the founders of now-bankrupt uBiome on 40-odd counts encompassing conspiracy to commit securities fraud, conspiracy to commit health care fraud, money laundering, and identity theft. Separately, the Securities and Exchange Commission (SEC) also filed charges. Between 2016 and 2018, uBiome had raised $100 million through a Series C, and was likened to Theranos, after its fall, in the Big Claim (‘inventing the microbiome industry’). Its business was analyzing the DNA of fecal and other biological matter to sequence the bacteria of the body’s microbiome. Starting with low-cost, limited data comparison for at-home tests, the founders progressed to claiming to doctors that their diagnostic tests were clinical-quality and would be reimbursed by payers. Payers did–for awhile–and the investors piled in. By 2019, the wheels fell off their scheme and the FBI came knocking at their Silicon Valley offices after the founders cashed in. Chapter 7 followed in late 2019. The Register reports that the two married founders are on the run, whereabouts unknown. US Attorney’s Office release, SEC filing (PDF)

 

UK short news takes: Tunstall names new chair, Alcidion patient safety software partners with East Lancashire NHS Trust

March 27, 2021 | by

Tunstall Healthcare named Peter Nicklin as Chairman of the Board. Mr. Nicklin has had a varied career in healthcare, including stints at companies such as Baxter International, Bayer Healthcare, Novartis, and Bristol-Myers Squibb. Before joining Tunstall, he was Chairman of Versantis, a Swiss pharmaceutical company, as well as Chairman of the Board of Healthcare at Home a leading pharma services company, focused on chronic, rare disease and oncology medicine management services. Prior to that, he was CEO and board member of Amann Girrbach AG of Koblach, Austria. Mr. Nicklin and his impressive background arrives at an interesting time for Tunstall, some months past a reorganization, purchase by a Jersey-based group [TTA 30 Oct 20], and a blistering market for health tech and associated in the US which hasn’t quite spread to the UK. Tunstall release 

Alcidion‘s Patientrack, a patient status monitoring software used to track patient conditions, particularly safety and deteriorating vital signs needing immediate attention, at bedside and remotely, announced a five-year, five hospital deal with East Lancashire Hospitals NHS Trust. Patientrack will integrate with East Lancashire’s Cerner Millenium EHR. Alcidion markets in the UK, Australia, and New Zealand, and was founded and remains HQ’d in Australia in 2000. Unusually for software, the chair and the group managing director are women.  Release

Propel@YH’s Demo Day for participants next Wednesday 31 March

March 26, 2021 | by

Propel@YH, the Yorkshire and Humber Academic Health Science Network (Yorkshire & Humber AHSN) program organized to support digital health companies, will have a virtual Demo Day this coming Wednesday 31 March. The 2020-2021 cohort presenting could be called the ‘COVID Class’, as the program starting last October was focused on supporting the healthcare sector during the ongoing pandemic.  

Here are the finalists presenting on Wednesday:

  • Co-Opts ltd; a smart speaker for automated recording, transcription and summarisation of therapy sessions
  • CyberLiver Ltd; remote monitoring of at-risk cirrhosis patients using wearables and an app
  • I.M.M.E; a VR experience created to support Williams syndrome, supporting isolation, rehab mobility and mental health
  • Liria Digital Health; a technological solution addressing the health and wellbeing of perimenopausal, menopausal, and postmenopausal people.
  • My Food 24; an online food diary system which automates the diet tracking and analysis process
  • SeeAI; a platform that supports early fracture diagnosis through x-ray images
  • Ufonia Ltd; an AI-enabled accessible clinical assistant called Dora that can conduct an intelligent clinical conversation via a regular voice telephone call
  • Vastmindz; an AI face analysis app to measure real-time heart and respiration rates, oxygen saturation, stress level, blood pressure and atrial fibrillation risk
  • Warner Patch; a non-invasive, wearable wireless (using 2G network) sensor that predicts tissue health disease evolution using AI for clinicians to give preventive care, improve patient outcome and save care costs
  • Written Medicine; a pharmacy label and discharge summary translation system, that works across 11 different languages

The 15 AHSNs like Yorkshire & Humber function as innovation arms of the NHS and act as a bridge between health care providers, commissioners, academia, and industry. Joining the AHSN are the University of Leeds’ innovation hub, Nexus (academic and SME support); Barclays Eagle Labs (incubator network); law firm Hill Dickinson LLP; and Leeds City Council.

Register for the presentation via Eventbrite here. (Time 0900-1130 GMT)  Hat tip to Ellis Noble of KC Communications

Breaking: Sarah Wilkinson, CEO of NHS Digital, resigns, to depart by summer

March 26, 2021 | by

Breaking News. NHS Digital announced Friday afternoon (UK time) that Sarah Wilkinson, CEO of NHS Digital since August 2017, has resigned and will be departing her post this summer. The rationale given in the release is to carry forward the work of NHS Digital after the COVID pandemic:

“As the work associated with the pandemic starts to stabilise, and planning commences for the ambitious program of transformation over the next few years, I have come to the conclusion that it would be better for a new CEO to step into the role now so that they can provide continuous leadership over the programs of that post-Covid agenda, and now is an appropriate time for me to leave the organisation. That new CEO will be able to build upon strong foundations in an organisation that knows what it can do, and I will work closely with them to ensure a smooth transition to new leadership for our programmes, products, and people.”

NHS Digital is seeking an interim CEO to transition the position from Ms. Wilkinson. The NHS Digital Board will start the open search for candidates to permanently fill the position later this year. NHS Digital provides and supervises information, data, and IT systems for the UK’s Department of Health and Social Care.

Ms. Wilkinson came to NHS Digital from the chief information officer (CIO) position at the Home Office (2015-2017) and previously from the banking sector with technology titles at Credit Suisse, HSBC, and UBS. Her board positions include NatWest Markets and King’s College London.

Certainly more to come from this!

News and deals roundup: AHA opposes Optum buy of Change Healthcare; big raises by Komodo Health, Evidation Health, Ro’s $500M; Appriss acquires PatientPing

March 25, 2021 | by

Sometimes $13bn Mega Deals run into powerful opposition. The nearly 5,000 member American Hospital Association (AHA) is opposing UnitedHealth Group’s Optum‘s acquisition of software/analytics/revenue cycle management (RCM) company Change Healthcare. The AHA is urging that the Antitrust Division of the Department of Justice (DOJ) review it on anti-competitive grounds. Their position is that the OptumInsight integration of Change, planned for Q2, will drastically reduce competition for health care information technology (IT) services to hospitals and other health care providers, driving up costs to hospitals and patients. Optum is already one of the largest in this sector. It would also shift data from a third-party company to a subsidiary of the US’ largest payer. Change is the largest independent provider of health IT services for payments and RCM. Though substantial divestitures are part of the deal, the AHA opposition may kick off the same from other healthcare groups and successfully force DOJ to take action. FierceHealthcare, AHA letter to DOJ (PDF link).

Dizzy Digital Health Deals Continue This Week. Data analytics companies haven’t been as hot as other areas of digital health closer to telehealth and behavioral health, but Komodo Health just completed a big Series E of $220 million. This follows their snack-sized January Series D of $44 million (Crunchbase). Komodo feeds their 325 million patient encounter database drawn from EHR, pharma, lab, and government data into their proprietary software for analytics to drive better health outcomes across therapeutic areas. Their primary markets are life sciences and pharma for R&D, clinical trials, and medical affairs. The Series E was led by Tiger Global Management, which earlier this month invested in Tyto Care and Dispatch Health [TTA 4 March], with Casdin Capital plus existing investors ICONIQ Growth, Andreessen Horowitz, and SVB Capital. Release 

Evidation Health, another data aggregation and analytics company, raised $153 million in a Series E led by OMERS Growth Equity and Kaiser Permanente Group Trust for a total funding since 2012 of $259 million. This will be used for building out their virtual health analytics and research platform, Achievement. Release

In direct-to-consumer healthcare, integration gets tighter. For those who can stand their tacky commercials for Roman, you’ll be seeing many more of them because parent DTC/telehealth company Ro just raised $500 million in a Series D round, led by General Catalyst, FirstMark Capital, and TQ Ventures. The intent of co-founder Zachariah Reitano is to combine a nationwide telemedicine, pharmacy distribution, and in-home care network. Their total funding since 2017 is $876 million. According to the TechCrunch article, Ro is building out a patient-centric ‘vertical optimization’ model with 10 pharmacies scheduled for 2021 and the ability to provide 500 common drugs at $5 per month. Earlier this year, Ro acquired Workpath, a software platform that enables healthcare companies to offer on-demand, in-home care, and diagnostic services. Look for Ro to make another acquisition or two this year to bolster their telehealth capabilities. Release

PatientPing, a care coordination software that connects providers to create continuity of patient care to notify them of patient events, is in an agreement to be acquired by Appriss Health, a 25-year-old SaaS software company primarily known for behavioral health care coordination and data analytics solutions to identify and mitigate substance use disorders. The combined company will cover 1 million professionals, 2,500 hospitals, 7,500 post-acute facilities, 25,000 pharmacies including every national pharmacy chain, and 43 state governments. Terms of the transaction were not disclosed, nor valuation or management transition, but closing is expected in Q2. Release

CareCentrix files ‘corporate espionage’ on trade secrets lawsuit against Signify Health, former employee

March 18, 2021 | by

Usually, laundry like this is not aired or dried in public, but it’s on the line nevertheless in a lawsuit. CareCentrix, a post-acute care/transitions of care management company, has sued in US Federal Court for the District of Delaware both Signify Health, a diversified home care company overlapping the same line of business, and CareCentrix’s former general manager, VP post-acute care Marcus Lanznar.  Initial charges were filed on 23 December and motions are piling up fast based on what is listed (paywalled, unfortunately) on PacerMonitor.

The Federal charge is covered under the Defend Trade Secrets Act of 2016 (DTSA), Cause 18:1836(a) Injunction against Misappropriation of Trade Secrets. The basics are that Mr. Lanznar was a senior executive of CareCentrix, had access to proprietary information, and had a restrictive covenant that would not allow him to go to a competitor for nine months. Yet he was engaged in interviews starting in July 2020, by August-September was having regular meetings with his counterpart, chief product officer Peter Boumenot, and passed CareCentrix information not only to his personal email but also to Signify into October, when Mr. Lanznar resigned. He joined Signify Health in November 2020 and is listed on LinkedIn as SVP product, though not on their management page. 

The lawsuit claims that Signify “targeted, recruited, and hired former CareCentrix executive Marcus Lanznar in a covert scheme that succeeded in providing access to CareCentrix’s confidential information and trade secrets” and also was aware of the conflict presented by the restrictive covenant. It seeks to prevent Mr. Lanznar and Signify Health from using its trade secrets and to award it damages and attorneys’ fees. 

This is a David versus Goliath matchup. Signify Health in February had a highly successful IPO gaining over $560 million and is valued with a market cap of over $7 bn. CareCentrix to date is most definitely the David in this scenario in terms of size, having raised all private equity funding via Summit Partners starting in 2011. However, it has made two acquisitions of its own recently: Vesta Healthcare at $30 million and Turnkey Health for an undisclosed amount (Crunchbase). The stakes are piled high in this hot segment of healthcare. 

There are a number of high-powered law firms dueling in this lawsuit, which also includes CareCentrix’s parent, NDES Holdings. Note: this article is based on both reporting in Healthcare IT News, which initially filed the story, and FierceHealthcare’s close on follow-up.

News and deals roundup: Strive Health’s $140M for kidney care, coalition lobbies for more home telehealth, codes removed from PFS, Hinge Health buys Enso, HelloSelf £5M raise, Tyto Care adds

March 18, 2021 | by

Strive Health, which is integrating digital health and analytics into the much-needed area of chronic kidney disease management, secured a $140 million Series B round of funding led by CapitalG, Alphabet’s independent growth fund. Another new investor, Redpoint, joins current investors NEA, Town Hall Ventures, Ascension Ventures, and Echo Ventures. Strive’s total funding at this point is over $223 million. Strive’s model is the improvement of renal disease through managing specialized patient care delivery with payers and providers, with data analytics integrated into a patient care model focused on the home, e.g. telehealth and home dialysis. Financially, they take risk on chronic kidney disease (CKD) and end-stage renal disease (ESRD) patients. Current contracts are with Humana, Blue Cross and Blue Shield of North Carolina, Independence Blue Cross, SSM Health, and Conviva Care Centers.   Release, FierceHealthcare

Speaking of home telehealth, the Moving Health Home coalition, formed by lobbyist Sirona Strategies, has onboard a founding group of companies that are generally competitive with each other: Amazon Care, Amwell, hospital systems Ascension Health and Intermountain Health, risk-based senior care group Landmark Health, Signify Health, and big Series D winner Dispatch Health [TTA 4 March]. Their stated intent is to influence policy to expand reimbursed home health care and advance the usage of home-based health based on evidence of effectiveness and cost savings. STAT,  MHH release

Meanwhile, back in DC, CMS says “oops!” on four telehealth codes inadvertently included in the Medicare Physician Fee Schedule (PFS) [TTA 3 Dec 20]. The 3 March Federal Register notice removes four codes listed in the temporary Category 3, which will remain in place through the end of the year as the pandemic public health emergency (PHE) has gone into 2021. Becker’s Hospital Review:

1. 96121: Neurobehavioral status exam by physician or other qualified health professional
2. 99221: Initial hospital care
3. 99222: Initial hospital care
4. 99223: Initial hospital care

Hinge Health acquires Enso. Enso developed a high-frequency pulsed, non-invasive, drug-free musculoskeletal (MSK) pain therapy which has been branded and added to Hinge Health’s MSK offerings. Product website. In January, Hinge Health raised $300 million in a Series D [TTA 14 Jan] as a rumored prelude to an IPO and made some management changes in preparation for same [TTA 27 Feb]. Terms and management alignments were not disclosed. Release

UK’s HelloSelf has raised a £5.5 million Series A funding round from OMERS Ventures. HelloSelf provides digital therapy and access to “the UK’s best clinical psychologists”. HelloSelf enters a crowded field of behavioral therapy providers, with SilverCloud Health dominant in the UK with the NHS. HelloSelf is concentrating on the B2B segment with employers. This Editor notes the much lower raises UK companies enjoy even in this hot area. Mobihealthnews

Tyto Care added Spectrum Health, a western Michigan health system, for live 24/7 video consults using Tyto Care’s exam kit. Release

Two major moves and what they mean: Doctor on Demand, Grand Rounds to merge; Amazon Care will go national by summer (updated)

March 18, 2021 | by

This week’s Digital Health Big Deal (as of Wednesday!) is the merger agreement between telehealth/virtual visit provider Doctor on Demand and employer health navigator Grand Rounds. Terms were not disclosed. It’s important because it extends Grand Rounds’ care coordination capabilities beyond provider network navigation and employee clinical/financial tools for six million employees into an extensive telehealth network with 98 million patients in commercial, Federal, and state health plans.

Both companies had big recent raises–$175 million for Grand Rounds in a September 2020 Series E (Crunchbase) and Doctor on Demand with a $75 million Series D last July (Crunchbase). The transaction is a stock swap with no cash involved (FierceHealthcare, CNBC), and the announcement states that the two companies will operate under their own brands for the time being. Owen Tripp, co-founder and CEO of Grand Rounds, will run the combined company, while Doctor on Demand CEO Hill Ferguson runs DOD and joins the board. The combined company is well into Double Unicorn status with over $2 bn in valuation. Also Mobihealthnews.

What it means. Smaller (than Teladoc and Amwell) telehealth companies have been running towards M&A, with the most recent MDLive joining Optum’s Evernorth [TTA 27 Feb] creating interstate juggernauts with major leverage. Doctor on Demand was looking at their options for expansion or acquisition and decided 1) the time and the $ were right and 2) with Grand Rounds, they could keep a modicum of independence as a separate line while enjoying integration with a larger company. The trend is profound enough to raise alarms in the august pages of Kaiser Health News, which decries interstate telehealth providers competing with small and often specialized in-state providers, and in general the loosening of telehealth requirements, including some providers still only taking virtual visits. Contra this, but not in the KHN article, this Editor has previously noted that white-labeled telehealth providers such as Zipnosis and Bluestream Health have found a niche in supplying large health systems and provider groups with customized telehealth and triage systems.

UPDATED. In the Shoe Dropping department, Amazon Care goes national with virtual primary care (VPC). To no one’s surprise after Haven’s demise, Amazon’s pilot among their employees providing telehealth plus in-person for those in the Seattle area [TTA 17 Dec 20] is rolling out nationally in stages. First, the website is now live and positions the company as a total care management service for both urgent and primary care. Starting Wednesday, Amazon opened the full service (Video and Mobile Care) to other Washington state companies. The in-person service will expand to Washington, DC, Baltimore, and other cities in the next few months. Video Care will be available nationally to companies and all Amazon employees by the summer.

Notably, and buried way down in the glowing articles, Amazon is not engaging with payers on filing reimbursements for patient care. Video Care and Care Medical services will be billed directly to the individual who must then send for reimbursement to their insurance provider. The convenience is compromised by additional work on the patient’s part, something that those of us on the rare PPO plans were accustomed to doing back in the Paper Age but not common now. It also tends to shut out over 65’s on Medicare and those on low-income plans through Medicaid. It is doubtful that Amazon really wants this group anyway. Not exactly inclusive healthcare.

TechCrunch, FierceHealthcare. Jailendra Singh’s Credit Suisse team has a POV here which opines that Amazon continues to have a weak case for disruption in VPC, along with their other healthcare efforts, and an uphill battle against the current telehealth players who have already allied themselves with employers and integrating with payers.

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.

Healthcare ad/patient ed network PatientPoint combining with once-hot Outcome Health

March 13, 2021 | by

Can’t retreat from advertising in a doctor’s office, at least in the US. Point of care ad/patient education ad network giant PatientPoint is combining with one-time unicorn Outcome Health. The combined company, called PatientPoint Health Technologies, will operate under the PatientPoint brand. The transaction is effective immediately and the company will be headquartered in Cincinnati. Financials are not disclosed, but claimed to reach 150,000 providers and 750 million patient visits a year.

Management of the combined company, and all the senior leadership, is from PatientPoint: CEO Mike Collette, Chief Client Officer Linda Ruschau, CFO Pat O’Brien, and Chief Provider Officer Chris Martini. The only two carry-overs from Outcome Health mentioned in the announcement are tech executives Glenn Keighley and Sean Barden. CEO Matt McNally and COO Nandini Ramani, who stabilized the company after Outcome’s 2017 advertiser fraud scandal, are thanked but not remaining with the company. The Outcome Health website has no leadership page and popups on every page announcing the new company. 

PatientPoint is now majority-owned by a group of investors, including funds managed by L Catterton and Littlejohn & Co., LLC. Both funds also backed Outcome Health, so one can assume their role in engineering the combination; the word ‘acquisition’ is nowhere to be found.

One-time $5.5bn unicorn Outcome Health lost its horn, rainbow sparkle, and its Chicago high-rise office building in autumn 2017 when Big Pharma/Biotech companies like Pfizer, Sanofi SA, and Biogen Inc. discovered that their advertising exposure was wildly inflated, affecting tens of millions in ad revenue, embarrassing investors like Goldman Sachs and Alphabet. By 2019, their principals were in Federal District Court in Chicago: former Chief Executive Rishi Shah, former President Shradha Agarwal, and former executives Brad Purdy (COO/CFO), and Executive VP Ashik Desai. Mr. Desai cooperated with the prosecution, leaving the rest to their tender mercies. The trial, now classified as a $1bn fraud, is still pending. PatientPoint release, MM&M, Chicago Tribune. TTA’s back file on Outcome Health here.

BETTEReHEALTH project initiated to support eHealth solutions, improved outcomes in low-income African nations

March 9, 2021 | by

The BETTEReHEALTH initiative has kicked off with partners in both Europe and Africa, with the objective of coordinating and supporting the deployment of what they term “sustainable eHealth solutions” in low and lower middle income countries (LLMICs) in Africa. The group of 11 project partners from Norway, Belgium, Netherlands, Malawi, Tunisia, Ghana, and Ethiopia aim to create better health outcomes through better healthcare accessibility and higher quality, leveraging eHealth and healthcare technology.

The initiative will map and identify various human, technical, and public policy factors in eHealth implementation, and from there derive strategies and policies for successful eHealth leading to improved population health. Another objective is to develop new and existing strategic partnerships in Africa, plus European and African stakeholders in healthcare, research, education, business, and government. It is also creating open access registries on eHealth policies and solution information to identify best practices.

BETTEReHEALTH received funding from the European Union’s Horizon 2020 research and innovation program under grant agreement No 101017450, going to December 2022.

Organized around “Better eHealth is Better Health,” project coordinator partner spokesperson Morten Dalsmo, Executive Vice President at SINTEF and Head of SINTEF Digital, one of Europe’s largest independent research organizations, said: “BETTEReHEALTH is an important contribution to improve the quality of health services and increase access to health for underserved populations in Africa. This project is very much in line with SINTEF’s vision “technology for a better society” and our commitment to the sustainable development goals. SINTEF has valuable experience from projects in eHealth and digital health and in addition to coordinating BETTEReHEALTH, we aim to share these experiences with the consortium and the health authorities in African countries. Furthermore, SINTEF and our partners have an extensive network in Africa. BETTEReHEALTH aims for stakeholders in Africa and Europe to connect and make new partnerships with the overall purpose of better health outcomes.” 

The initiative is setting up four regional hubs in Tunisia, Ghana, Ethiopia, and Malawi, endorsed by each country’s Ministry of Health, an important factor in their effectiveness.  The four host countries will implement policies, roadmaps, and strategic plans first to serve as models for all other African countries in the project.  Release.  Hat tip to Frederic Lievens of Ets. Lievens-Lanckman, Belgium, and the International Society for Telemedicine & eHealth (ISfTeH).

Marketing alert! Age-positive image library launched by Centre for Ageing Better–and free to use

March 5, 2021 | by

The UK non-profit Centre for Ageing Better has launched a much-needed resource for companies, healthcare organizations, and press–a photo library of hundreds of positive, realistic, and diverse images of older people in everyday life. It is free for use for non-commercial and commercial purposes, UK and internationally, with only a few restrictions on use such as crediting and non-alteration, which are clearly outlined in their short guide (downloadable PDF). They also provide information on how to search and guidelines for creating your own images. Link to the Centre’s information page on the photo library.

Categories on ResourceSpace are work, health, housing, communities, digital inclusion, finance, and planning. There are also icons free for use. At present, there are about 300 images which the Centre is adding to.

Sign up also for their newsletter, not only for updates on the library but also information on the Centre’s activities and policy updates.

Editor’s note: As a marketer (marketing director/head of marketing/consultant) in the past 15 years for several health care companies in the older adult market, including a payer, I can testify at length at the scarcity of images of older people in everyday activities including work and play. Searching stock libraries for photos that don’t depict infirmity, a medical setting, aloneness or sadness, or to represent diverse cultures and social groups, is wearying indeed. There aren’t many, which leads to overuse of the few royalty-free/single payment images that meet these needs. Is there lack of demand? (I don’t think so!) Larger organizations can and should set up photo shoots for their needs, but not all organizations or companies have that opportunity nor the resources. See these three images from the library at left/above for a sample (these are lower res suitable for PowerPoint). Easy to download and select. Another plus: there are relatively few that are identifiable as the UK or Europe, so this is a boon for marketers in many countries. 

Hat tip to Emily Wilson, Communications Assistant, at the Centre for Ageing Better.

Weekend reading: ISfTeH’s ‘A Century of Telemedicine’, featuring the UK

March 5, 2021 | by

The International Society for Telemedicine and eHealth (ISfTeH) recently published “A Century of Telemedicine – A World Wide Overview, Part IV”. This edition includes the UK. The author is our occasional contributor Malcolm ​Fisk, Professor of Ageing and Digital Health at the Centre for Computing and Social Responsibility at De Montfort University in Leicester. The UK history starts before the Great War and moves towards the UK’s future in just under 100 pages. In addition to the UK, this compendium of telemedicine and eHealth initiatives also includes Armenia, Côte D’Ivoire, Pakistan, and Tunisia. The full text is a PDF download located here.

Three earlier overviews, plus Part IV, are indexed on ISfTeH’s Telemedicine and eHealth History page in their Media section. The introductory volume reviews the global history of telemedicine starting about 1859 when doctors and engineers fixed heart pulse as a curve and sent the data via a telegraph. Part I starts the history by country series with Australia, Brazil, Czech Republic, India, Nigeria, and Russia. Part II covers Chile, Finland, Georgia, Japan, Peru, and the US. Part III includes Bolivia, Denmark, Iran, and Poland. Two additional histories on the page are on telehealth in the state of Rio de Janeiro, Brazil plus 25 years of telemedicine in northern Norway.

These are extensive studies, but well worth your time. Hat tip to Malcolm Fisk.

News and deal roundup, 5 March: Oscar Health’s $1.4 billion IPO, telehealth expansion in Congress, what people *really* do during a telehealth visit

March 5, 2021 | by

What a difference a month makes in a blazing healthcare market. ‘Neoinsurer’ Oscar Health went public on Tuesday, selling over 37 million shares at $39 each, reaping an eyeblinking $1.44 bn. While shares took a tumble on Wednesday and Thursday, closing at just above $32, the valuation of the company could be anywhere between $7.92 and $9.5 bn (calculating in options and the like). Quite a difference from the estimate in early February, which was a modest–and as now we know, totally sandbagged–$100 million [TTA 9 Feb]. A lovely payday for their backers and all at Oscar who had stock grants, indeed.

As we’ve seen from recent IPOs, they have all been underestimated (e.g. Signify Health’s $100 million filing transubstantiated into $561 million). The downward glide slope in share price is typical. Whether it will rise will depend very much on strong results for this quarter, half year, and full year as Oscar presses harder into the competitive Medicare Advantage, exchange, and small group markets. How they, and all the other payers do, will be dependent on health policy permutations and emanations from the DC Swamp. CNBC, TechCrunch, FierceHealthcare

Speaking of the DC Swamp, telehealth expansion is enjoying real traction in Congress and with Health and Human Services (HHS). The chair of the House Health Subcommittee, Rep. Anna Eshoo (D-Calif.) has called for many of the flexibilities on payments and locations granted temporarily during the pandemic’s liberalization of coverage to be made permanent. These affect Medicare and other types of Federal payments. [Review of the 2021 Medicare Physician Fee Schedule re telehealth here]  They expire after the public health emergency (PHE), extended in January to end of April, so a clock is ticking, quickly.

The basics are that Congress must pass legislation that removes restrictions on geography (currently rural only) and permits the patient home to be used as a ‘distant site’. Advocates also want to add to Medicare telehealth coverage hospice and home dialysis care, more types of eligible care providers such as physical therapists and other allied health professionals, and audio-only (telephonic) consults. Others are pushing for reinstating HIPAA compliance for telehealth platforms.

The Telehealth Modernization Bill that covers most of the above was introduced on 23 February in both the Senate and House, in a rare show of both bipartisanship and bicamerality. (Excluded: telephonic consults, HIPAA compliance) Rep. Eshoo’s remarks were made during last Tuesday’s Committee on Energy and Commerce Health Subcommittee hearing.

HHS is also backing this, based on HHS’ Office of the Inspector General’s recent statement praising the expansion of telehealth. Recognizing that concerns have been raised about ‘telefraud’, IG Christi Grimm noted that they have been vigorously prosecuting fraudulent claims [TTA 2 Oct 20] with telehealth being used in a broad sense for billing other goods and services such as medications and durable medical equipment. FierceHealthcare, Healthcare Dive, ATA News 26 Feb

Speaking of telehealth visits, what do the patients do during them? This Editor had filed away, waiting for an opportune moment to share it, a surprising study by DrFirst, a mobile telehealth and communications platform. It was conducted online during the Pits of the Pandemic (June 2020). It may not surprise you that most patients weren’t fully engaged in the process. Bored, isolated, mostly male patients–73 percent men, 39 percent women–multitasked and distracted themselves during the virtual visit by: 

Surfing web, checking email, texting – 24.5%
Watching the news, TV, or movie – 24%
Scrolling through social media – 21%
Eating a snack or a meal – 21%
Playing a video game – 19%
Exercising – 18%
Smoking a cigarette – 11%
Driving a car – 10% (!!!!)

And the best….Having a “quarantini” cocktail or other alcoholic beverage – 9.4%

Reasons for consults were unsurprising: annual checkup – 38%, mental health therapy – 25%, and specialist visits (e.g., dermatologist, hematologist, or oncologist) – 21%.  N=1,002 US consumers. 44% of Americans Have Used Telehealth Services During Coronavirus Pandemic but Some Admit Not Paying Attention. Also Advisory Board blog.