Funding update, 4 March: big Series Ds for new unicorn Dispatch Health and Tyto Care; USDA’s $42M for rural telehealth; UK’s Perfect Ward hospital inspection app secures £4m

Once upon a time for health tech companies, Series D funding and unicorn status were rare, especially when the tech relates to the under-the-radar, formerly unsexy area of home health. 

  • DispatchHealth, an in-home mobile care provider based in Denver, just closed a $200 million Series D led by Tiger Global with additional participation from Alta Partners, Echo Health Ventures, Humana, Oak HC/FT, and Questa Capital. This comes less than a year after a $135.8 million Series C led by Optum Ventures, The new total of $417 million in funding brings its valuation to a unicorn level of $1.7 bn. DispatchHealth is in the desirable, high potential cost-saving areas of care that replaces ER visits or hospital stays. The platform integrates in-home care services booked through a call, their app, or online by patients, care providers, payers, EMS, senior living, and health systems. The objectives of care are to substitute for ER visits, hospital stays, and to coordinate ancillary services. Currently serving 19 markets across 12 states with care to more than 170,000 patients in 2020, the new funding will be used for expansion to 100 national markets. DispatchHealth recently announced partnering with Humana for advanced hospital-level care for their Medicare Advantage members in several cities. Release, FierceHealthcare
  • More on the health tech side is Tyto Care’s remote diagnostic exam platform. Today they are announcing an additional raise of $50 million, doubling the earlier Series D and now totaling $100 million. Leading the extension is Insight Partners, with participation by Tiger Global (see DispatchHealth), Qumra Capital, Qualcomm Ventures LLC, Olive Tree Ventures, and Shenzhen Capital Group Company. Tyto’s funding is now $155 million and claims a doubling of its valuation. Release.

The US Department of Agriculture (USDA) is surprisingly now an investor in rural telehealth, in part courtesy of the CARES Act from March 2020. (Yes, there were considerable funds left over from that $2.2 trillion pandemic relief bill and now some of them are being used.) USDA is funding projects with a total of $42.3 million, including $24 million from the CARES Act, to improve infrastructure for telemedicine and distance learning infrastructure. Approved to go are 86 projects through the Distance Learning and Telemedicine grant program, to help rural education and healthcare organizations remotely reach students, patients, and outside expertise. USDA’s study found that due to population health, lack of insurance, and lower access to health facilities, there are higher rates of COVID-19 related deaths in rural areas. Healthcare IT News

A UK company that’s in an unusual area of health tech is Perfect Ward, which is designed to put on a laptop and mobile app the complicated process of health inspections of hospitals, care homes, and other health and social care organizations in the UK and internationally. Their £4 million round comes from Octopus Investments (Octopus Group). Current clients include King’s College, Barts Health, The Royal Free and London Ambulance Service. Release (Business Cloud)

Rock Health/Stanford U Digital Health Adoption Report: high gear for telemedicine, digital health, but little broadening of demographics

It’s good news–and an antidote to the bubble at the same time. Rock Health and Stanford University Medicine-Center for Digital Health’s just-released report found that, unsurprisingly, that telemedicine/telehealth use rocketed during the pandemic and gained ground that would not have been true for years otherwise, as of September 2020. However, the growth was not largely from new demographics, but largely among the adopters of telehealth in 2019 and prior. It also rolled back to about 6 percent of visits. Wearable use also boosted, especially for better sleep, as did self-tracking. But overall healthcare utilization cratered from March onward, barely reviving in the late summer, and telemedicine use declined to a steady state of about 6 percent of all visits–far more than the near-zero it was pre-pandemic. Here’s our rundown of the highlights.

Telemedicine user demographics haven’t changed significantly. It accelerated among those in the 2019 and prior (through 2015) profile: higher-income earners ($150K+), middle-aged adults aged 35-54, highly educated (masters degree and higher), urban residents, slightly male skewed (74 percent men/66 percent women/67 percent non-binary)and those with one or more chronic conditions (78 percent) and high utilizers (87 percent with 6+ visits/year). This profile apparently sustains across racial and ethnicity lines. (page 15) The non-user profile tends to be female, over 55, lower-income, rural, not on a prescription, and Hispanic. (page 23)

More usage of live virtual video visits than before–11 points up from 32 to 43 percent. These reduced reliance on non-video communications: telephonic, text, asynchronous pictures/video, and email. (page 12) And respondents largely accessed live video and phone visits through their doctor, indicating a pivot on practices’ parts: 70 percent of live video telemedicine users and 60 percent of live phone telemedicine users. (page 17) But the reasons why were more acute than this Editor expected: 33 percent for medical emergency, then minor illness (25 percent), then chronic condition (19 percent). (page 16)

Barriers to use remain significant in telemedicine and have not changed year to year except for awareness of options. (page 22-23)

  • Prefer to discuss health in-person (52 percent)
  • Not aware of options (much less this year)
  • Provider didn’t recommend
  • Cost
  • Poor cellular or broadband connection is minimal (3 percent). There is also no barrier of ‘inability to use’, though this may be skewed by the survey group being online (see methodology).

Wearables and digital information tracking accelerated, but ‘churn’ continued. 54 percent of respondents adopted wearables, up 10 points, while information tracking increased by 12 points.  (page 11) Unpacking this:

  • The populations with the highest rate of digital tracking were those with heart disease, diabetes, and obesity as chronic conditions
  • The leading reasons for wearables remained fitness training and weight loss. However, right behind these were major year-to-year spikes in better sleep (27 to 52 percent), managing a diagnosed condition (28 to 51 percent), and managing stress (24 to 44 percent).
  • The surprise uses of wearables? Managing fertility tracking and menstrual cycle.
  • Yet wearables churn continues. From the study: 55 percent of respondents who owned a wearable in 2020 stopped using it for one or more purposes (though they may continue using it for another purpose). The demographics tend to mirror telemedicine users for adoption and stopping use. (pages 24-28)

Healthcare utilization overall, telemedicine or not, has barely revived versus the March baseline, using the Commonwealth Fund data TTA profiled here. The report usefully digs into the groups that delayed care: 50 percent of 35-54-year-olds, women, Northeast residents, chronic conditions, and mental health. (page 34)

Yet trust in health information remains with the person’s physician, family, hospital, payer, and pharmacy. Overall, there is a reluctance to share data with entities beyond these. Health tech and tech companies aren’t trusted sources, along with social media, and lag to less than 25 percent, along with less willingness to share data with them. COVID-19 data is broken out in sharing, generally following these trends except for more willingness to share this data with governmental entities and research. (pages 29-31) 

The report recommends that for telemedicine to go deeper into adoption, refocusing is in order: (page 21)

  • Shift from a transactional model to a continuous virtual care or ‘full-stack’ model
  • Seek a different kind of customer. One-third of telemedicine visits were for emergencies. A more sustainable model would concentrate on chronic condition management and lower-acuity care.
  • Accept that new care models are disintermediating the patient-provider relationship especially in the younger age groups

The methodology of the survey: N=7,980 US adults, matched to US demographics; dates conducted 4 September-2 October 2020; online survey in English only. Rock Health summary, link to free survey report download, Mobihealthnews article.