The Theranos Story, ch. 73: the defense tries to stack the jury deck in Holmes’ favor, prosecutors say. And Theranos swag and memes are hot!

June 10, 2021 | by

Law and Order Proceeds. For those of us who follow US trials, or have served on a local or county jury, smart attorneys do a fair amount of ruling jurors in–and out. The voir dire process in high-profile trials is critical. Jury consultants make comfortable livings creating profiles of their ‘ideal juror’.

Thus it should not be a surprise that Elizabeth Holmes’ spare-no-expense-or-strategem defense would file in May with the court an over-the-top 41-page, 112 question jury document. Their rationale is to screen jurors for issues related to the extensive news coverage around la scandale Theranos, Holmes herself, and even the pandemic (!).

In the prosecution’s view, questions such as “Do you have investments?”, “Do you have health insurance?”, and inquiries about social media use, were “untethered” from pretrial publicity and the coronavirus pandemic.

By comparison, the prosecution presented to Judge Edward Davila a modestly sized nine-page questionnaire with a scant 51 questions. Typically, many of these questions are routine, such as reading about the case and if they had any pre-existing opinions which would prevent that person from a fair judgment of the facts presented in the case. On pandemic issues, the prosecution drew from previously used questionnaires that addressed them, though this Editor cannot see how the pandemic is pertinent to this case.

Holmes is facing 12 felony fraud charges. The trial will start 31 August and will be held on Tuesdays, Thursdays, and Fridays through 17 December, according to a filing last week by Holmes’ legal team. She faces maximum penalties of 20 years in prison and a $2.75 million fine, plus possible restitution. East Bay Times

Attention eBay Shoppers!  According to CNBC, original Theranos-labeled items are fetching real coin on auction sites like eBay and Poshmark. An original Theranos lab coat is supposedly listed for $17,000. Over at Etsy and Redbubble, which sell artist-created items, logo-printed t-shirts and masks, including those with Holmes’ face and the Silicon Valley meme, ‘Fake It Till You Make It’, “Girl Boss” signs, throws, posters (left), and greeting cards. (Good things? Yeesh!) are all over. The funniest is a sweatshirt with ‘Theranos Testing–A Guaranteed Result’. Over on Etsy, a merchant’s most popular Theranos item is a mug emblazoned ‘Theranos Early Investor’. (Is it cracked?) Perhaps Holmes could put her Theranos trinkets and trash online to defray a few costs. Or copyright her image like Bogart?

OnePerspective: How the shift from analogue to digital telephone services affects telecare provisioning

June 10, 2021 | by

TTA has an open invitation to industry leaders to provide a personal perspective on issues of importance to readers. This week, Charlotte Rathbone, Product Account Manager for CareUnity Digital, Chubb, examines the ongoing transformation of the UK telecommunications industry and how the shift to digital technology will affect telecare provision.

Interested contributors should contact Editor Donna. (Pictures and graphs/infographics are welcome)

According to the Technology Services Association (TSA), the representative body for technology-enabled care, more than 1.8 million vulnerable people* rely on telecare in the UK. In most cases, telecare consists of a care alarm in a person’s home, which when triggered by pressing a button or an automated sensor, sends data via the Public Switched Telephone Network (PSTN) to a monitoring centre, where an operator will give advice or seek help.

The UK telecommunications industry however is undergoing rapid change. By 2025* all analogue telephone services across the UK will be switched off as infrastructure is upgraded to digital connectivity. This approaching switch highlights the need for dedicated digital telecare solutions. 

So how will this affect telecare services in the UK?
As early as 2023*, British Telecom (BT) customers may not be able to buy an analogue phone line. Instead, BT will move its customers to a digital Internet Protocol network in readiness for the shutdown of traditional telephone lines in 2025. It’s then that we’ll see the PSTN and all Integrated Services Digital Network lines switched off. These lines are currently used by many telecare services to feed alarm data into their monitoring centres.

While the digital migration is underway, analogue telecare alarm services are reporting a rise in the number of failed alarm call attempts – with one service provider reporting a failure rate of 11.5% for the first alarm attempt*. This is concerning.

Another concern is failed care alarms through loss of power. When analogue alarms run on a digital network, they require a router to be plugged in at home. In the event of a power failure, this router will stop working, so if a vulnerable person triggered their alarm, it would duly fail.

It’s little surprise that telecommunication providers and Ofcom are all recommending a shift away from traditional analogue devices to digital devices to ensure consistency of access to care*. Some countries including Sweden are ahead of the curve when it comes to switching to digital. More than 95% of Swedish digital alarm installations now use mobile network connections*. There is some way to go in the UK.

Currently, there are approximately 1.6 million analogue telecare devices** across the UK that need to be changed to digital-dispersed alarm units so it’s going to be a gradual process. There are, however, benefits for telecare service providers that make the change sooner rather than later. 

Why switch now?
As we approach the switchover date, the time to replace analogue units in the field reduces. This will likely result in significant resource pressures for customers to complete the transition; by switching early, this can be completely avoided.

References
*TSA, 10 Facts about Analogue to Digital: How it will affect telecare.   ** TSA survey of service provider members, May 2021.

Hat tip to Kathryn Ranger of PRG Marketing Communications

Tunstall Group acquires Secuvita (NL)

June 2, 2021 | by

Breaking news. Tunstall Healthcare announced today (2 June) the acquisition of Dutch alarm/home automation company Secuvita, Financial terms, integration, timing, and management going forward were not disclosed. In the announcement, Tunstall Group CEO Gordon Sutherland referred to Secuvita’s technology  integration with Tunstall Cognitive Care’s proactive care model. Benelux is one of Tunstall’s six key regions. The acquisition adds to Tunstall’s customer base 70,000 Secuvita users.

Secuvita’s director and owner is Patrick Gaasbeek. It was founded in 2006 as a brand independent service provider for social alarm systems. Today, their significant sectors are care alarms (standard and mobile), healthcare home automation (smart home), and remote care for home care, housing, and emergency centers. Featured clients on their website are Florence, Aafie, and Vérian. The company is based in Apeldoorn, Netherlands. 

NHS Digital GPDPR medical database plans criticized by Royal College of GPs, privacy advocates (updated 8 June)

June 2, 2021 | by | 2 Comments

What our UK Readers may have missed on the long bank holiday weekend. And why this matters outside the UK.  NHS Digital is being roundly criticized by privacy advocates, the Royal College of GPs (RCGP), the Doctors’ Association UK (DAUK), and individual GP surgeries on plans for creation of the General Practice Data for Planning and Research (GPDPR).

The GPDPR will compile information on 55 million patients–every patient in England registered with a GP surgery–into a database available to academic and commercial third parties for research and planning purposes. NHS has been collecting patient data on patients in a database, the General Practice Extraction Service (GPES), for the past decade. The GPDPR will replace it. Data collection on patients in England starts 1 July. What will be collected is at the end of this article as background.

The objections center on the sensitivity of the data, the short window of notification to patients, the lack of a clearly notified opt-out with sufficient time, and how it will be used.

  • The data apparently can include mental and sexual health data, criminal records (!), and other sensitive information. 
  • The short time–six weeks–between the announcement in late April (a low key affair with Matt Hancock-signed blog posts on the NHS Digital website, YouTube videos, and flyers at GP surgeries), and the start of data collection from the surgeries
  • How many patients are actually aware that this is happening and of their options is debatable. (See next two bullets)
    • If a patient didn’t pick up on it in the six-week window ending on 23 June (and go to the page with the Type 1 Opt-Out), a patient can opt out for data going forward, but cannot withdraw any data collected into the database prior to that date.
    • If a patient is in the National Data Opt-out program, their medical data will be collected anyway, since it applies to only identifiable and confidential patient information.
  • Many GPs are concerned about further erosion of the physician-patient relationship and the lack of communication to patients on how the data will be used, the ethical questions around the organizations to which it will be sold, and how patient privacy will be preserved.

The blackest mark here on NHS Digital is that the groups ostensibly involved in the development of the database–the RCGP and the British Medical Association (BMA)–are the ones sounding the alarm, along with the aforementioned DAUK and privacy groups such as MedConfidential and Foxglove. There is also a rebellion starting among London GPs. Reportedly, 36 doctors’ surgeries in Tower Hamlets, east London, will withhold data. An email is circulating to about 100 surgeries in north London questioning the legitimacy of the NHS data collection. This is despite penalties if they don’t submit.

Why does this matter if you’re not in England? Medical data–collecting, manipulating it, connecting it, finding insights, and selling it–is the Gold Rush of the 2020s. Pharma and payers as markets are just the start. Nearly every Roundup or deal this Editor covers has companies with a chunk of this gold rush. Why are telehealth companies worth their IPO/SPAC/funding prices? Why is McKesson ‘big banging’ four separate businesses into one division? Why do we follow ‘data warehouses’ like Sensyne [TTA 26 May],  Mayo Clinic’s big bet on a multi-line Remote Diagnostics and Management Platform [TTA 23 Apr], and virtual pharmacies like Capsule?  Why are insurtechs like Oscar and Bright Health hot? Why is it the #1 target of hackers?

It’s not altruistic. Services can be duplicated. Companies can be a hair away from failure. But ah, their data…the data has huge market value, even if its potential is not fully understood yet. Ask any data analytics person. Ask China, probably the most aggressive nation in collecting the health and personal data of its citizens, with Chinese capital for years now leading investment in global health tech companies.

In an article back in October 2015, this Editor described the many ways that deidentified patient data, in this case genomic data, can be identified by researchers through cross-checking via research database “beacons”, a network of servers. Referring to the 23andme and Ancestry.com collection of innocently given genomic data from consumers, this Editor proposed a Genomic Bill of Rights in 2018 and again in 2020. If this Editor, no data geek, can deduce it (hat tip to Toni Bunting back in 2015), this information has to be well known to researchers and to privacy advocates.

The controversy is just starting to ramp up. And it should. It’s about time there was a reckoning. The Guardian 30 May, 1 June

More background. According to the NHS Digital page on the GPDPR, patients will be anonymized by a process where de-identification software will replace their NHS Number, date of birth, and full postcode with unique codes produced by de-identification software. The data collected from GPs in England starting 1 July will be on: (more…)

Babylon Health going the SPAC route with Alkuri Global for $4.2 billion value (updated for 3 June announcement)

June 1, 2021 | by

Another big SPAC on the boards. Telemedicine/symptom checking app Babylon Health has closed a deal to go public via a SPAC (special purpose acquisition company) via Nashville-based Alkuri Global Acquisition Corp.  The deal with Alkuri, run by two former Groupon Inc. execs, was reported of 28 May and was imminent, according to the usual “people familiar with the matter” speaking with Bloomberg News (may be paywalled). 

If the Babylon-Alkuri SPAC comes to pass (it did–see below), the company valuation was reported to top $3.5 billion. Alkuri also is lining up investors for $270 million of private investment in public equity (PIPE) funding, the sources said. Alkuri is led by Groupon’s ex-CEO Rich Williams and former COO Steve Krenzer, The money connection is likely Sultan Almaadeed, a former executive at the Qatar Investment Authority, who is Alkuri’s chairman.

This isn’t the first time Babylon has talked SPAC. Back in April, Babylon almost went into a SPAC backed by financier Alec Gore. Other SPACs in prior talks with Babylon were Freedom Acquisition I Corp., backed by former Credit Suisse Group AG CEO Tidjane Thiam, as well as a vehicle from Klaus Kleinfeld, the former head of Arconic. Yahoo!Finance, 

Babylon’s last big raise was a $550 million Series C in 2019, led by Saudi Arabia’s Public Investment Fund with prior investors Kinnevik AB and Munich Re AB. Their total funding since 2015 is $631.1 million. Crunchbase.

Updated. And so it came to pass that on Thursday 3 June, two days after our article published (and while this Editor was on assignment), it was formally announced. Reuters reported that Babylon’s pro-forma equity valuation is up to $4.2 billion. Babylon will enjoy $575 million in gross proceeds. This includes a PIPE of $230 million, a little lower than earlier reports, from investors such as AMF Pensionsförsäkring and Palantir Technologies Inc. Existing Babylon shareholders will roll 100% of their equity into the combined company and will own approximately 84% of the pro forma company at closing sometime in the second half of the year. It will trade on NASDAQ under BBLN. Ali Parsa, Babylon’s founder, CEO, and face of the business, will remain chairman and CEO. Babylon’s release has the financial details, including the investor presentation. FierceHealthcare