Unintended consequences: American Well loses, loses patent, to Teladoc

June 18, 2016 | by

On Tuesday, the Federal District Court of Massachusetts not only dismissed the American Well patent infringement lawsuit against Teladoc, but also invalidated American Well‘s patent, held by co-founder Dr. Roy Schoenberg since 2009. It was invalidated on the grounds that the claims in the patent were “too abstract” to be patentable and do not “amount to an inventive concept.” American Well is appealing the court decision.

Teladoc started this call-and-response in March 2015 by petitioning the USPTO (US Patent and Trademark Office) to invalidate several American Well patents. (AW claims to hold 28 patents and 22 pending applications). Shortly before Teladoc’s IPO on the New York Stock Exchange last June, American Well sued Teladoc on patent infringement. Those in the industry saw an effort to scupper the IPO. Our Editor Chrys at the time took a decidedly jaundiced view of American Well’s grounds for infringement:
This author is wondering who thought this was such a novel technology as to warrant a patent? What were they thinking? Having worked on developing unified messaging systems for a mobile phone operator at the turn of the century (now that’s a scary 15 years ago) I am just picking myself off the floor after reading this.
Surely all these functions are no more than what is in every instant messaging program, dating back to 1990s? Replace the words “medical service provider” by “friends” or “contacts” and “consultation” by “chat” or “call” it seems to me you get … Skype and Face Time and more! [TTA 9 June 15]
No matter, the result was yesterday’s double shot of a decision. In addition, three Teladoc complaints against American Well‘s patents to invalidate them are still in progress with the USPTO. A triple, anyone? MedCityNews, Teladoc press release, American Well press release
All this is despite the sobering facts that telemedicine has been unprofitable to date–and that IP wars have unintended consequences. (more…)

Your weekly robot fix: ingestible robot fetches swallowed button batteries, more

June 15, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/06/mit-microsurgeon-2.jpg” thumb_width=”150″ /]A research team drawn from MIT, the University of Sheffield and the Tokyo Institute of Technology has developed an ‘origami’ robot to aid in the location and fetching the result of a common and potentially fatal incident–swallowed button batteries or other foreign objects. The robot is swallowed in a capsule which dissolves. It then unfolds its dried pig intestine appendages and is directed by external magnetic fields towards the battery, attaches to it and safely moves through the digestive system. Another potential use is to patch wounds or deliver medicine to a specific location. Unlike other robots, it is untethered and moves freely, propelling itself through a ‘stick-slip’ motion, and is resistant to acidic gastric fluids. Next steps for the team are to equip it with sensors and to perform animal and human in vivo testing. ZDNet

Nosocomial hospital infections may also get a good zapping by disinfecting robots. In an 18 month test at Lowell (Massachusetts) General Hospital, robots with pulsing xenon high-dose ultraviolet light from Xenex Disinfection Services disinfected the Lowell Hospital ORs nightly in addition to routine chemical disinfection. The study estimated that they avoided an estimated 23 infections at a cost savings of one life and $478,000. MedCityNews.

Robotics in healthcare will also be part of the five tracks centered on informatics available to attendees of HEALTHINFO 2016, August 21 – 25, 2016 in Rome’s H10 ROMA CITTA,  organized by IARIA (International Academy, Research, and Industry Association). More information here.

And if you wonder if humans will be able to find work when robots take over everything (maybe we just go to conferences and have a guaranteed income?), take comfort (or not) in this interview with one of the two authors of Only Humans Need Apply: Winners and Losers in the Age of Smart Machines, a new book by Thomas Hayes Davenport and Julia Kirby. “One is to work alongside smart machines, and complement their activity. The other is to dip into what smart machines are unlikely to be able to do any time soon.” The emphasis on STEM education may be misplaced as many of these jobs will be replaced by AI. In healthcare, they predict that automation will displace specialists and empower GPs, leaving room for ultra specialization in combinations not thought of today. Robots beware: Humans will still be bosses of machines (TechRepublic)

The difficulty in differentiating telemedicine and telehealth

June 15, 2016 | by

Our Editors have always tried to cleanly define the differences between telemedicine, telehealth and telecare, even as they blur in industry use. (See our Definitions sidebar for the latter two.) But telemedicine, at least on this side of the Atlantic, has lost linguistic ground to telehealth, which has become the umbrella term that eHealth wanted to be only two or three years ago. Similarly, digital health, connected health and mHealth have lost ground to health tech, since most devices now connect and incorporate mobility. And there are sub-genres, such as wearables, fitness trackers and aging tech.

Poor telehealth grows ever fuzzier emanations and penumbra! Now bearing the burden of virtual visits between doctor and patient, doctor-to-doctor professional consults, video conferencing (synchronous and asynchronous), remote patient monitoring of vital signs and qualitative information (ditto), and distance health monitoring to treat patients, it also begins to embrace its data: outcome-based analytics, population health and care modeling. Eric Wicklund accumulates a pile of studies from initial-heavy organizations: WHO, HIMSS, HHS, Center for Connected Health Policy (CCHP), ATA, TRC Network. All of which shows, perhaps contrary to Mr Wicklund’s intentions, how confusing simple concepts have become. mHealth Intelligence

Unhappy endings? HealthSpot’s remains to Rite Aid, Theranos’ story to Hollywood

June 14, 2016 | by

HealthSpot Station’s assets to Rite Aid, minus the ‘froth’. On Monday, drug store chain Rite Aid won the US Bankruptcy Court in Columbus, Ohio’s mandated auction for the inventory, most assets and IP for its entry bid of $1.15 million. According to Columbus Business First (subscription only), a touted second bid by a central Ohio investor group was $1 million–and stayed right there with no second bid. This group had invested $650,000 before HealthSpot entered Chapter 7. A dark horse third bidder, which came in at the last minute, never put money on the line.

The Ohio business group leader, local assisted living facility owner Paul Gross, interestingly maintained his faith in the kiosk concept to Columbus Business First in an earlier interview, rapping the prior management for squandering approximately $47 million (more, given Xerox‘s never-disclosed investment) on office furniture, lavish executive salaries and misbegotten marketing (quoted in MedCityNews). 25 of the kiosks were in Rite Aid locations in Ohio and others with Cleveland Clinic, but there are 137 still ‘in the box’. Perhaps ‘misbegotten’ should be applied to the concept (kiosks too big, expensive) and not the marketing communications, which in this Editor’s professional judgment were strong and appealing, but ran into the ‘lipstick on a pig’ wall.

One wonders what Rite Aid, in the throes of its own difficult merger with Walgreen Boots Alliance, will do with the assets. TTA’s earlier stories on HealthSpot.

Theranos the Movie, starring Jennifer Lawrence. Co-starring Walgreens? ‘Hunger Games’ star Jennifer Lawrence has reportedly agreed to star in ‘The Big Short’ director Adam McKay’s adaptation of the story. (Fortune) Certainly there is a resemblance to CEO Elizabeth Holmes Frogeyed Sprite (‘Bugeyed’ to us Yanks–Ed.) crossed with Steve Jobs. Ms Lawrence has already played a young, aggressive, come-from-nada inventor of household gadgets in ‘Joy’. The Theranos story is appearing to be the ‘Joy’ story in reverse. Suggested title: ‘The Royal Scam’? (credit Steely Dan, circa 1974). ‘Less Than Zero’ (Bret Easton Ellis) is taken, now describing Ms Holmes’ net worth according to Forbes.

Mr McKay will be ripping from the headlines in progress, should the movie actually be made. (more…)

Tunstall’s Innovation Centre virtual tour

June 8, 2016 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /]Tunstall Healthcare Group’s release for 1 June’s Telecare Awareness Day was a virtual tour of their Innovation Centre physically located at their Whitley, Yorkshire head office. It’s divided into five TECS-related ‘zones’: integrated care, connected home, development room, app bar and workshop. There are explanatory comments below, which help because the virtual tour has a measure of clunkiness. The marketing purpose of the Innovation Centre? It “provides a unique, dedicated space to define the challenge and help accelerate the development and design process to evolve the next generation of digital connected healthcare, create new innovations and service models that genuinely meet the needs of commissioners and consumers.” (Whew!) It’s also kind of a cool space to get feedback from customers, users and partners, which this Editor suspects is the real reason why it was developed. But overall, both the Centre and the virtual tour are good ‘showcase’ ideas that demonstrate both product and thought leadership.

Worthing MarketPlace Wednesday 8th June 2016 (UK)

June 8, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/06/Worthing-Marketplace-flyer-712×1024.png” thumb_width=”120″ /]Fresh from last week’s National Telecare Awareness Day on 1 June, UK Telehealthcare is sponsoring a bonus MarketPlace today (8 June) in conjunction with the West Sussex County Council at the Charmandian in Worthing, West Sussex. 36 companies including Tynetec, CAIR, Doro, Tunstall and others we mention are listed for five hours of exhibition and activities starting at 10 am. UK Telehealthcare information and flyer at left above.

Stop the Internet of Things Monster!

June 1, 2016 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/06/robottoy-1.jpg” thumb_width=”150″ /]A cry from the heart (or aching head) indeed! The overhyped, overheated and overblown Internet of Things (IoT) gets a good and deserved lampooning from tech writer Joanna Stern. If you take seriously a egg tray that tells you when the hen ova are getting few or old, an umbrella that signals you when it’s left home, a connected toilet seat and a juicer that only works when it’s on Wi-Fi, you’ll think the writer is a Luddite. But if you think 95 percent of IoT is ridiculous (save a Few Good Apps) and Overload Reigns in Solving Problems Which Aren’t, you’ll enjoy The Internet of Every Single Thing Must Be Stopped (Wall Street Journal). (Ms Stern would be undoubtedly appreciative of the ‘‘Uninvited Guests’ that nag and spy. And she doesn’t even get into the hackable dangers of Interconnected Everything.)

Falling Walls Lab NY–application deadline June 22

June 1, 2016 | by

Falling Walls Lab New York, German Center for Research and Innovation, August 30, 6 PM

The New York City edition of the international Falling Walls Lab, which invites scientists and innovators to present research that answers the question, “Which are the next walls to fall?”, this year is hosted by GCRI.

Each year, the Falling Walls Lab Finale is held in Berlin, this year on November 8, and is closely connected to the annual and internationally renowned Falling Walls Conference the next day. The Conference hosts 20 top-class scientists from around the world to present their current breakthrough research.

The New York deadline is June 22. To submit an application, go to the Falling Walls website. Separately, a 3-minute video preview of the presentation must be sent to events@germaninnovation.org. Apart from their round-trip travel to the Falling Walls Lab New York, participants will not incur additional travel costs. According to the event listing on the website, the most intriguing presenter will qualify directly for the Falling Walls Lab Finale in Berlin. The Falling Walls Foundation will cover accommodation costs for November 8-9 in Berlin. All participants in the Finale will receive a ticket for the Falling Walls Conference.

The Falling Walls Lab is a non-profit series of scientific conferences, which aims to build and foster interdisciplinary connections between scientists, innovators, and entrepreneurs. Contact the Falling Walls Foundation at labs@falling-walls.com. Also coming up: Falling Walls Tokyo 29 August, Falling Walls Lab UAlberta 29 September. Main website. Hat tip to GCRI (listing here)

Congressional investigation confirms NFL attempted to influence concussion, CTE research

May 25, 2016 | by

Not shocking to our Readers. In December, sports network ESPN reported that the National Football League (NFL) refused to fund research on detecting in vivo chronic traumatic encephalopathy (CTE) from a long-term $30 million unrestricted grant to the National Institutes of Health (NIH) [TTA 23 Dec 15]. A 91-page report by Democratic members of the House Committee on Energy and Commerce, which started after the December reports, confirmed that the NFL improperly attempted to shape the research after the grant, violating NIH peer-review process policies that stipulated no grantor interference. The NFL specifically objected to the objectivity of Boston University’s Robert Stern, MD heading up the $16 million project before the award in 2015, then tried to redirect the money, so to speak, in-house–to a group including Dr. Richard Ellenbogen, a member of the league’s panel on brain injuries and their bid for the project. Ultimately, the NFL withdrew the funding from the NIH, which went ahead with it. The project was awarded to BU, the Cleveland Clinic, Banner Alzheimer’s Institute (Arizona) and Brigham and Women’s Hospital in Boston.

The Congressional report’s six major conclusions were highly critical of the NFL in several ways and also scored the Foundation for the NIH for not acting as a ‘buffer’:

  1. The NFL improperly attempted to influence the grant selection process at NIH.
  2. The NFL’s Head, Neck and Spine Committee members played an inappropriate role in attempting to influence the outcome of the grant selection process.
  3. The NFL’s rationalization that the Boston University study did not match their request for a longitudinal study is unfounded.
  4. FNIH (Foundation for the NIH) did not adequately fulfill its role of serving as an intermediary betweenNIH and the NFL.
  5. NIH leadership maintained the integrity of the science and the grant review process.
  6. The NFL did not carry out its commitment to respect the science and prioritize health and safety.

When the grants were announced in September 2012 [TTA 7 Sept 12], there was great cheer that finally the NFL had decided that denial was, to use the old joke, a river in Egypt, and to do something about it. This also followed Army research on TBI being supported by the NFL. The first indicator that the funds were going elsewhere, as we noted a year later, was that a year later the Sports and Health Research Program (SHRP) funds were going to other medical problems like joint diseases and sickle cell anemia. While worthy, it had not been the prime publicized objective of the funds. The Congressional committee report also details how the NFL tried to steer the research away from Dr Stern, one of the leading researchers in the field, citing his support of players who refused to accept the CTE settlement in 2014. Beyond the NFL, research on CTE and concussion will impact any contact sports as well as the military and other head traumas. This Editor has previously reported on Dr Stern’s CTE research presentations in NYC and from other researchers in the field; search on NFL and Dr Stern both in current index and the back file. Congressional report, ESPN.com, New York Times.

6th Global mHealth App Developer Economics Study–closing soon!

May 25, 2016 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/05/surveybannerv10.jpg” thumb_width=”200″ /]research2guidance’s 6th Global mHealth App Developer Economics Study is still open (closing end of May) and interested in the opinions of those in the health tech field. Take 15 minutes or so and take the survey (link here). You’ll also receive a free copy of the survey once completed, and a chance to win either an Apple Watch or a Samsung Gear. Last year, over 5,000 industry experts did, including our TTA readers. Our article on the survey’s preliminary results in April. TTA and DHACA (Editor Charles, Managing Director) are media partners for this study. Hat tip to r2g’s Ralf Jahns.

ATA meeting abstracts now online

May 25, 2016 | by

Even if you did attend the American Telemedicine Association’s annual meeting, you will likely be very interested in the extensive abstracts from the meeting’s presentations given from Sunday to last Tuesday. They range from the usual matched cohort studies in chronic disease to specialized areas such as teleICU, pediatrics, mental health (including telepsychiatry in California prisons), emergency responder and digital health approaches for brain injury/TBI. International is also represented in abstracts from Canada, Chile, Israel, Panama, Bolivia, Brazil, France, South Africa (delivered by Drs Maurice Mars and Richard Scott of ISfTeH) and Colombia. Telemedicine and e-Health (Liebert), free and sponsored by USF Health and the ATA. TTA was a media partner of ATA 2016.

Nail in the coffin hammers home: Theranos voids, corrects 2 years of test results

May 19, 2016 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/04/Yak_52__G-CBSS_FLAT_SPIN.jpg” thumb_width=”150″ /]Tens of thousands of lab results 2013-2015 voided, “corrections” sent. L’affaire Theranos continues, with the not-so-surprising action of Theranos to void all of its Edison machine testing results, from all labs, as well as many processed on conventional equipment during those years.

According to the Wall Street Journal, Theranos told CMS during its lab inspections that they ran 890,000 tests a year, so we are between 1.5 and 2 million tests being, at minimum, voided. The Edison was used for 12 out of 200 tests, at least initially, with conventional machines performing the rest.

The voiding was verified by John Carreyrou of the WSJ by cross-checking his sources with Phoenix-area medical practices (the Walgreens marketing area), which confirmed receiving corrected test reports. One doctor reported that many of the voided results were for calcium, estrogen and testosterone tests. Here is where it cuts to danger levels: “The doctor said one corrected report is for a patient she sent to the emergency room after receiving abnormally elevated test results from Theranos in late 2014. The corrected report from Theranos now shows normal values for those tests, according to the doctor.”

But how can you send corrected results, which would require a rerun, of samples at least a year and perhaps two years old? It’s not clear if this pertains to standard tests run on miscalibrated machines (see below on Siemens) or somehow Edison tests were re-evaluated.

This reads like a last ditch effort to stay out of the Alphabet Monster’s clutches (CMS, FDA, DOJ, SEC), or at least survive their squeeze. COO Sunny Balwani was bid adieu last week, along with the company adding three members with scientific expertise to one of its many boards. Of course, as we previously noted, these boards are Silicon Valley Sock Puppets. The one to watch is legal Attack Dog David Boies (to whom the First Amendment and a free press are so much tissue paper to be ripped) who also sits on the governing board–politically well wired and the kind of bully attorney you call in when you are facing Big Trouble and need Big Defense–or Offense.

Walgreens Boots–reportedly fit to be tied, because Theranos won’t disclose the extent of the corrections, and surely assessing its legal options. Siemens must be equally unhappy that its equipment was 1) miscalibrated by Theranos and 2) Theranos didn’t monitor test water purity; thus they have become inadvertently tainted.

One must wonder if founder Ms Holmes is considering the fit and finish of orange turtlenecks, or residency in a country with no US extradition treaty. For the company, the flat spin above is likely non-recoverable. Sadly, Clipper Theranos will crash down on other, far more honest innovative companies lined up on the runway. Wall Street Journal (if paywalled, copy and search on the headline); Forbes, Ars Technica. Our Theranos dossier here.

Can expanding telehealth help VA solve veteran access crisis?

May 18, 2016 | by | 1 Comment

The Department of Veterans Affairs (VA) has been both one of the largest US users of telehealth in various forms–and widely criticized for practices including veteran patient wait lists for care, a lack of accountability, a scheduling system full of problems, an ancient EHR (VistA), and an inability to meet interoperability and modernization goals set over years. Telehealth is, in fact, one of VA’s bright spots with store-and-forward imaging, clinical video telemedicine and home telehealth.

At the American Telemedicine Association ATA 2016 meeting Monday, Under Secretary for Health and VA Chief Executive Dr. David Shulkin noted that the crisis has pushed VA into other options for achieving the goals set for the end of year: every VA medical center provides same day primary care services and same day mental health services. One area of focus is telemental health. Dr Shulkin announced in his plenary speech the opening of five new Mental Health Telehealth Clinical Resource Centers this summer, located in Charleston, Salt Lake City, Pittsburgh, and a consortium of facilities in Boise, Seattle, and Portland, Oregon. West Haven, Connecticut is already open as a specialty hub focused on the most severe and complex mental health issues, such as chronic depression and bipolar disorder. Other VA telemedicine initiatives include kiosks and text messaging to help with medication adherence and chronic condition management. (We’ve reported on their partnering with nhssimple to develop ANNIE, a sister of NHS’ Flo in text messaging to encourage patients in their health monitoring, TTA 2 Dec 15.)

VA delivered 2.1 million episodes of telehealth care last year (FY 2015), in 45 specialty areas of care, including 400,000 telemental health visits. They also reduced bed days by 56 percent, reduced readmissions by 32 percent, and decreased total psychiatric admissions by 35 percent, maintaining high user satisfaction scores at 89 percent.

Dr Shulkin also noted that four generations of veterans are served by VA–WWII, Korea, Vietnam and Desert Shield through current Iraq/Afghanistan–and all four have different delivery requirements. He closed with what is, for VA which has been very proud of their ‘home grown’ solutions from the time of Dr Adam Darkins in the early 2000s on, something unusual: “We’re looking to learn, we’re looking to work with all of you who are innovating to help take better care of veterans.” (Next on tap: the award of the next five-year round of home telehealth providers, which is presently down to two Grizzled Pioneers, Medtronic (Cardiocom) and Viterion.) Mobihealthnews, VA press release

Philips ACT(s)@Scale with three-year research study (UK/EU)

May 18, 2016 | by

Philips is expanding their just-concluded three-year ACT program with ACT@Scale, a three-year research study which will track up to 75,000 chronic disease patients on health outcomes and economic impact data. They are working with specific EU regions (Northern Ireland, Spain’s Catalonia and Basque Country, southern Denmark and northern Netherlands) which are already innovating care/coordination services and use of technology in specific areas. A major university consortium is also joining with Philips to conduct the study: University Medical Center Groningen (The Netherlands), Aristotle University of Thessaloniki (Greece), City University London (UK), Universitätsklinikum Würzburg/Klinikum der Bayerischen Julius-Maximilians-Universität (Germany), University of Hull (UK), Kronikgune-Centre for Research Excellence in Chronicity (Basque Country, Spain) and Hospital Clinic of Barcelona (Spain). ACT@Scale is part of the European Innovation Partnership on Active and Healthy Ageing (EIP-AHA), an initiative from the European Commission under its Innovation Union strategy that aims to increase the average healthy lifespan by two years by 2020. More will be presented at eHealth Week, 8-10 June, Beurs van Berlage, Amsterdam, The Netherlands. Philips release.

Are virtual visits consistent and effective? JAMA-published study raises doubts.

May 13, 2016 | by

A medical/health policy team from University of California-San Francisco (UCSF) studied virtual telemedicine visits and found a “significant variation in quality.” Over a year, 67 trained standardized patients over 599 visits presented their symptoms to the eight largest telemedicine (video and phone) providers (not named in the abstract). Their illnesses were common and acute: ankle pain, streptococcal pharyngitis, viral pharyngitis, acute rhinosinusitis, low back pain and recurrent female urinary tract infection. Based on their metrics, histories and physical exams were completed only 70 percent of the time; key management decisions adhered to accepted guidelines 54 percent of the time. Rates of guideline-adherent care (best practices) ranged from 206 visits (34.4 percent) to 396 visits (66.1 percent) across the eight websites. Wide variations were also found in diagnosis of pharyngitis and acute rhinosinusitis, with clinicians adhering to guidelines anywhere from 12.8 percent to 82.1 percent of the time. JAMA Internal Medicine, May issue, published online 4 April: Variation in Quality of Urgent Health Care Provided During Commercial Virtual Visits (abstract only without subscription)

The type of telemedicine they studied were the typical live, real-time video appointments. Another ‘virtual care platform’ provider, Zipnosis, offers a contrasting way. They claim that the live simulacrum of the in-person appointment is lacking, and what’s needed is an asynchronous approach–‘store-and-forward’ information in what they call an “online structured, adaptive interview” integrated with health systems’ services.

In preview information released to press and as a letter to JAMA just prior to the start of the American Telemedicine Association’s (ATA) annual meeting, Zipnosis offered its own, far more positive study. Their review of 1,760 patient encounters (more…)

Is the clock at the funding pub pointing to ‘last call’? (Updated)

May 11, 2016 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2012/12/crystal-ball.jpg” thumb_width=”150″ /]And we were having such a good time! UPDATED Having ridden a few hype curves (in health tech and out–remember airline deregulation?) and with the bruises to prove it, this Editor believes that she can spot a Cracking Market at forty paces. The hands on the clock appear to be near closing time, even as we party on. After all, DTC telehealth is forecast to be $25 bn in the US by 2025 (GrandView Research), if we make it that far!

Where are the sharp noises coming from?

  • The continuing fail of unicorns like Theranos [TTA 4 May and prior], now resorting to bullying the Wall Street Journal and negotiating with the alphabet (SEC, DOJ, FDA, CMS…), and the troubles of Zenefits. 
  • Another notable unicorn, the doctor booking site ZocDoc, being called out at last on their customer churn, low margins, and high customer acquisition costs. (As well as an irritant to doctors and office managers) New York Business Journal
  • Extremely high and perhaps insane rounds of funding to young companies with a lot of competition or a questionable niche. Higi is an odd little kiosk + consumer engagement program located in primarily Rite Aid drugstores–odd enough to score $40 million in its first venture round. (Ed. note: I shop at Rite Aid–and have never seen one.)This is after the failure of HealthSpot Station, which burned through approximately $43 million through its entire short but showy life. The low-cost, largely exchange plan insurer Oscar Health raised $400 million this February  ($727 million total) while UnitedHealth and others are dropping money-losing plans in most states. Over 50 percent of exchange co-ops went out of business in 2015, leaving doctors, health systems and patients holding their baggage. Again, low margins, high cost and high customer acquisition costs.
  • We’ve previously noted that funders are seeking ‘validation in similarity’–that a few targeted niches are piling up funding, such as doctor appointment setting, sleep trackers and wellness engagement [TTA 30 Dec 15]
  • Tunstall’s continuing difficulty in a sale or additional financing, which influence the UK and EU markets.
  • NEW More patent fights with the aim of draining or knocking out competition. We’re presently seeing it with American Well litigating Teladoc over patent infringement starting last year, which is only now (March) reaching court. It didn’t stop Teladoc’s IPO, but it publicly revealed the cost: $5 million in previously unplanned lobbying and legal costs, which include their fight with the Texas Medical Board on practicing telemedicine–which is beneficial for the entire industry. (But I would not want to be the one in the legal department explaining this budget line.) Politico, scroll down. But these lawsuits have unintended consequences–just ask the no-longer-extant Bosch Healthcare about the price of losing one. (more…)