Rock Health’s mid-year report: 2015 investment leveling off

July 10, 2015 | by

Rock Health‘s 2015 report is revealing in one aspect–that the authors try to put a game face on what is a flat situation in digital health investment for first half. Not even the most optimistic of the digerati expected a lift of 16 percent as we saw in 2014 versus 2013 [TTA 2 July 14], but the 8.7 percent fall off from 2014’s blistering $2.3 billion to $2.1 billion in 2015 year-to-date was unexpected. StartUp Health’s report indicated a slower start to 2015, though slightly less, so the reports correspond. Digital health still is growing faster than software, biotech and medical device.

Other highlights:

* The top six categories accounted for 50 percent of investment funding: wearables, analytics, consumer engagement, telemedicine, enterprise wellness, EHR/clinical workflow

*  In M&A action, this year’s first half has almost matched 2014’s full year total, but with only 13 percent of the investment. Most are digital health companies acquiring others for small amounts. (more…)

Novartis extends ViaOpta app for visually impaired to smartwatches

July 7, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/07/ViaOpta-Nav-Apple-Watch.jpg” thumb_width=”200″ /]New to this Editor (and I suspect our Readers) in assistive technologies for wearables are Novartis’ ViaOpta apps to aid the visually impaired and facilitate their independence as well as safety. Now available for smartwatches as well as smartphones, its features are primarily centered on assisting with navigation, including (new) points of interest and worldwide maps. Another new feature, recognizing and ‘reading’ both scenes and objects, is for smartphone only because it is dependent on the phone’s camera. Cues are both audio, vibration and visual (see left). Novartis claims this is the first wearable app designed specifically for the visually impaired and blind, now estimated at 285 million worldwide. It’s available in 11 languages and best of all, it’s a free download. Smartwatch demo is on YouTube. Novartis release. Mobihealthnews.

Breaking (holiday weekend) news: Aetna does the ‘deal deal’ with Humana

July 3, 2015 | by

Crap Game (Don Rickles): Ya make a DEAL!
Big Joe (Telly Savalas): What kind of a deal?
Crap Game: A DEAL DEAL.

—Kelly’s Heroes (1970), on getting the German Tiger tank and commander to help them in their bank heist

A $37 bn deal, that is. Announced on the Friday before the US Independence Day holiday (a day which may define media ‘black hole’), Aetna and Humana announced either their merger or the acquisition by the former of the latter, depending on what account you read. If approved by the Feds, the combination of #3 and #4 insurers (by revenue) respectively will exceed 33 million insured, making the combined entity #3 in insured individuals (after UHG and Anthem) and #2 in revenue. The announcement also stated that Louisville, Kentucky, Humana’s current headquarters, will continue to manage the Medicare, Medicaid and military Tricare businesses. Both are in Medicare Advantage, which is problematic due to market share and anti-trust considerations in at least four states, according to Reuters. (Humana has about 20 percent of national Medicare Advantage private policies.) We’ve previously noted the unfavorable comparison to the end stages of airline deregulation–consolidation reducing competition and consumer-favorable pricing. No word on the future of the Humana brand and marketing, which has always been executed well.

As to the outlook for digital health support–the prognosis by this Editor of this combination is, in the Magic 8 Ball’s answer, ‘reply hazy, ask later’.

  • Humana was known in the industry for being fairly open to opportunities and backed them with funding (Healthsense, Vitality, what remained of Healthrageous) under business such as Humana Cares. Humana at Home also owns a home care management company, SeniorBridge. Will this be of interest to Aetna in population health management, or an early ‘For Sale’?
  • Aetna, by contrast, has pivoted several times. CarePass consumer apps was a patient engagement experiment that proved the point that policyholders don’t want apps from insurers. Healthagen (an acquisition) was first positioned as an ’emerging businesses’ skunkworks of sorts umbrella-ing over iTriage (now integrated into the parent), ActiveHealth, Medicity and other digital health/analytics related businesses, then scaled back in early 2014 [TTA 28 Feb 14]. Repositioned as ‘population health management, the ACO business dominates.

Various reports: Daily Mail, Forbes (which likes it not at all and sees none of the touted ‘economies of scale’) and the WSJ.

Onward the 76 Hundred! Healthcare M&A, funding jam the news

July 3, 2015 | by

Healthcare mergers, acquistions, investments and joint ventures are doing their own Charge of the Light Brigade as we cross the mid-year bar.

* Onward the 76 Hundred! 7,600 startups around the world are developing solutions in digital health, according to accelerator/investor StartUp Health’s 2015 mid-year report. It also notes that ‘personalized solutions’ are the It Girl of digital health, and that data analytics/big data has fallen to third in investor interest after wellness/benefits (largely skewed by Zenefits) and patient/consumer 
experience received large funding rounds. Cheering news is that StartUp Health notes that investment in 50+ health companies is remaining steady. But the rest might be a bit frothy. The Gimlet Eye’s tut-tut: “whatever Zenefits is, it can’t produce enough Employee Wellness and manage enough HR to be worth an investment of $500 million”. For our Readers, we give you a direct link to their 2015 Midyear Funding Insights Report. (We await RockHealth’s take on the the Year to Date.)

* Onward with an IPO! Telemedicine darling Teladoc (TDOC, NYSE) is even more so with a smashing initial public offering, targeted to open at $19 which closed on Wednesday at $28 and today (Thursday) at same. Rosy forecasts abound despite those annoying losses ($12.7 million in 1st quarter ’14) and court action (Dallas News, TTA 9 June) . We at TTA are sticklers on terminology; still, we were happily surprised to see USA Today in our corner chiding Mr Gorevic on his misapplication of telehealth for telemedicine.

* Onward to Invest in Each Other! The new Allscripts-NantHealth deal gives new meaning to swap. EHR Allscripts bought a $200m, 10 percent equity stake in NantHealth, the health informatics chunk of Dr. Patrick Soon-Shiong’s NantWorks mini-conglomerate. Meanwhile another Soon-Shiong company bought stock valued at $100m in Allscripts. Neil Versel in MedCity News

* Onward from Amsterdam to Tel Aviv! MedCity News and Reuters also report that Teva Pharmaceuticals and Philips Healthcare have inked a joint investment (more…)

Nortek Security acquires Numera (Updated)

July 3, 2015 | by

Updated. Numera, which those of us with long memories remember as iMetrikus (before 2011, and also a Grizzled Telehealth Pioneer), announced late on Tuesday that it has been acquired by Carlsbad, California-based Nortek Security & Control. Nortek is known for security and home controls/automation (2GIG), with a significant holding in generally white-labeled traditional PERS units mostly under the Linear brand. Numera’s Libris and Libris+ PERS with telehealth connectivity will be sold under the Numera brand and be fitted into Nortek’s existing health-related business and home controls, according to the press release. The EverThere telehealth/activity/location reporting platform, according to Nortek’s FAQs, is especially important as this cloud-based health and wellness software platform can integrate into their home controls area. The transaction, according to Nortek, is valued at $12 million and they disclosed that the acquired businesses recorded unaudited net sales of approximately $5 million in 2014. It does not include the Numera Social behavior change/social engagement business which will be “rebranded”.

Upcoming international telehealth events

July 3, 2015 | by

In summer, the mind does turn to attending conferences in more interesting places. Here are three of interest:

27-29 July: 2nd International Conference on Health Informatics and Technology, Valencia, Spain at the Melia Valencia Palacio De Congresos. Information and registration

Their sister conference is the Global Conference on Telemedicine and eHealth at the Crowne Plaza Houston River Oaks. As it’s 17-19 August, in Houston, pack a personal air conditioner and dehumidifier. Otherwise, it’s a nice city with much to recommend it. Information. Both are organized by the OMICS Group.

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/07/guanoLogo.jpg” thumb_width=”125″ /]Finally, if you are looking for a startup boot camp and something truly different, here’s one with real ambiance. At M.E.S.H.–Medical Entrepreneur Startup Hospital–you’ll be camping in tents and sleeping in cots in a forest just outside of Berlin, Germany. 9-10 September. They invite investors as well–no information on if they get better tents. The objective? The fusion of humans and technology, including what gets under your skin.  Organizer is the interestingly named (and logoed) DocCheck Guano AG (above) along with KPMG and Grants4Apps.

Worcestershire County Council seeking vendors for ‘Future Lives: New Technology’ (UK)

July 3, 2015 | by

Susanne Woodman of the WCC was kind enough to inform this Editor that they are seeking up to five businesses to create a technology-based social care solution. They are inviting interested companies to meet with them for a presentation and informal discussions on Wednesday 22nd July 2015 at 10.30am County Hall, Spetchley Road, Worcester WR5 2NP. More tender details and how to apply for Future Lives is here.

“The data security fault, dear Brutus, is not China, but in the company org chart”

June 30, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/06/Org-chart1.jpg” thumb_width=”150″ /]Mansur Habib, PhD and cybersecurity strategist, formerly CIO for the Baltimore City Health Department, proposes that any data breach analysis should start first with a hard look at the organizational chart. If the CIO or the chief information security officer (CISO) doesn’t report directly to the CEO, the executive clearly does not place priority on IT and data security, treating it as a cost center to be restricted; in his words, they do not ’embrace cybersecurity risk as business risk’. In his 2013 doctoral research in 2013 and subsequently, Dr Habib observed that about half of US HIT and cybersecurity heads report to the chief financial officer (CFO) or some other executive like a CAO (administrative). His withering take on most CEOs are that they are more concerned with stock price (more…)

Seven safeguards for your mHealth app

June 29, 2015 | by

With cyberattacks from all sources on the rise, and mHealth apps being used by providers in care coordination, telehealth, patient engagement and PHRs, Practice Unite, which has some experience in this area through designing customized app platforms for healthcare organizations’ patient and clinician communications, in its blog notes seven points for developers to keep in mind:

1. Access control– unique IDs assigned to each user, remote wiping of the mHealth app from any user’s device.
2. Audit controls
3. Authentication
4. Integrity controls, such as compartmentalization, to ensure that electronically transmitted PHI is not prematurely altered or corrupted
5. Transmission security: data encryption at rest, in transit, and on independently secured servers protects PHI at each stage of transmission
6. Third party app integration–must fully comply with HIPAA safeguards
7. Proprietary data encryption

But all seven points need backing from the top on down in a healthcare organization. (More in the article above)

Two-thirds of US insured not interested in payer health apps: survey

June 27, 2015 | by

A survey of over 1,200 insured (individual and employer plans) sponsored by research firm HealthMine and conducted by Survey Sampling International shows that only 30 percent of this group would participate in a payer-provided mobile app, despite 89 percent using a smartphone and/or tablet. Even worse, only 18 percent liked to learn health, wellness, and lifestyle information from a mobile app. It demonstrates that current apps are not compelling or engaging–and the huge paradox of payers make them less, not more, attractive. Perhaps this Editor goes out on a limb, but US insurers have a trust problem on multiple levels (as claim deniers, as impossible to deal with); apps they provide are perceived as capturing information an individual doesn’t really want them to see. Overall, users are not using their smartphones for health reference at all–well below 20 percent. The leading use is for tracking fitness (21 percent) and calorie counting (16 percent). Is it that real research on health is the province of the desktop PC, where it’s easier to find and read? They also aren’t using mobile to find their doctors, despite all the hype from ZocDoc and Vitals: 8 percent had used a doctor finder app in the past six months. Mobihealthnews, HealthITOutcomes

Google X develops health tracker–for research and clinical trials only

June 27, 2015 | by

And it’s not for sale. The life sciences group within Google X is testing on small groups a wrist-worn device which can sense with high accuracy pulse, heart rhythm, skin temperature and environmental information like light exposure and noise levels. Bloomberg News, which appears to have broken the story, quotes Andy Conrad, head of the life sciences team at Google: “Our intended use is for this to become a medical device that’s prescribed to patients or used for clinical trials.” Obviously it will be more accurate both in hardware and in back end algorithms than what’s currently marketed via Android Wear for smartwatches. Perhaps this is meant for the ‘superusers’ of healthcare services at the top 5 percent using 50 percent of spend, the new ‘It Girls’ of healthcare, TTA 28 May)? However, he’s also projecting out 20-30 years, so health systems and researchers, do not hold your breath waiting for this to become reality. (This is also a counter to Apple’s ResearchKit.) Also Yahoo Finance and The Verge, which has a gigantic photo of a smartwatch but no caption attribution. The Verge also mentions their research in MS. Gizmodo also adds that Mr Conrad is directing the Google X Baseline project, which is doing human testing and crunching data to develop a baseline of normal human health.

More about Google X in this video interview on Tested with Astro Teller (for real), ‘captain of moonshots’ for the company, on ‘thinking big and failing quickly’. (24 minutes)

The pileup of Federal ‘titanic serial IT disasters’ (US)

June 26, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/06/keep-calm-and-secure-your-data-4.png” thumb_width=”150″ /]Don’t feel bad, HIT execs–the Feds are even worse. Complementary to our coverage of the increased danger of hacked health IT systems and data breaches (the trail of tears is here and here) is the oddly muted press clamor around the 4 June hacking report of the Federal Office of Personnel Management (OPM). Chinese hackers roamed around two OPM databases–personnel and security clearances–for nearly a year, according to CNN’s Senate briefing coverage. The breach likely exceeded 18 million records, though the real number may never be known. Privacy Rights Clearinghouse summarizes it and provides an interesting link to a timeline by Brian Krebs, whose independent reporting beat is IT security. Megan McArdle, a reformed IT consultant writing for Bloomberg News and independently, points at the Federal lack of urgency around having adequate IT that doesn’t fail. Example–the much chronicled failure around Healthcare.gov and the so-called health exchanges, which appear to be functioning better, but reports say they are nearly porous and hackable as they were in 2013. She notes that it’s all about ‘scorched-earth determination’ and that the direction has to come from the top, meaning the President. And ‘voters have never held Obama responsible for his administration’s appalling IT record’. A thought that should give those in telehealth and telemedicine who are working with CMS value-based program ACOs a great deal of pause. NY Post editorial via Press Reader.

Breaking news report: Charterhouse evaluating £700 m sale of Tunstall Healthcare (UPDATED)

June 24, 2015 | by

Breaking News

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /]Reuters reports as an exclusive that its sources indicate that UK private equity firm Charterhouse is considering a sale of Tunstall Healthcare Group for a possible valuation of £700 m ($1.1 bn) or more. According to this report, Charterhouse is working with JP Morgan on an exploration for a Tunstall sale in late 2015 or 2016. All three companies declined to comment.

Today, Tunstall also announced their Connected Healthcare 2020 strategy with a £100 m investment over the next five years, which we reported only a few hours ago.

Tunstall has gone through multiple hands in the past ten years. Charterhouse bought Tunstall Group in 2008 for £514m from Bridgepoint Capital, which acquired it from Hg Capital in 2005 for £225 m.

An exit for Charterhouse has long been rumored in UK healthcare circles. In the dark before the Christmas 2014 holiday, Tunstall reported disappointing results for 2014 (close 30 Sept): a YOY £6 m drop in revenue and a £9.7 m drop in EBITDA.  [TTA 24 Dec 14] According to CompanyCheck, which posts financial reports for UK companies, Tunstall Group’s net worth as of that date exceeded a negative £1 bn–a steadily declining position since 2010, though with stronger cash and reduced liabilities (see Accounts page).

We’ll post updates as they’re available.

Update 25 June with some quotes from a Tunstall spokesperson from their ‘hometown paper’, the Yorkshire Post.

Tunstall invests £100 m in ‘Connected Healthcare 2020’ strategy

June 23, 2015 | by

Tunstall Healthcare Group in UK outlined today their five-year public, global strategic vision, along with a fresh investment of £100 million during this timeframe (~£20 m per year) to transition their connected care systems over to IP and cloud technology. The initiative, dubbed Connected Healthcare 2020, is centered on:

  1. Leading the switch to IP infrastructure–transitioning away from analogue (analog) services and devices to connected digital and mobile (cellular, Wi-Fi, Bluetooth)
  2. Extending managed services–offering a wide variety of services end-to-end including full outsourcing
  3. Developing new consumer propositions through innovation–tapping into demand, often private pay, for high quality home care not provided by carers (caregivers)
  4. Developing new models of care in the home through integration–coordination of social care and healthcare

The Yorkshire Post article also points out, through their separate comments with CEO Paul Stobart, that prospective markets include developing nations with aging populations such as Mexico, South Korea and Turkey. Tunstall claims market leadership in UK, Germany, France, Spain, the Netherlands, Belgium, Sweden, Denmark, Finland and Australia, as well as fourth position in the US. The TECS (technology enabled care services) initiative will create about a dozen jobs per year at the Whitley HQ, adding to their present 650 there and their total globally of 3,500. Tunstall release

We wonder if in the US we will see more of Tunstall at events like the mHealth Summit. Tunstall Americas has a refreshed website and communications as ‘The voice of connected health’, is more strongly promoting their call/contact services and its HQ location in New York City. We’ve previously noted their recent home care acquisitions and partnership with QMedic.

Kickstarting the 1st week of summer: news from all over

June 23, 2015 | by

No deal yet between insurer giants. Cigna turned down a $53.8 billion bid from Anthem. According to Healthcare Finance, concerns ranged from corporate governance problems, their membership in the Blue Cross Blue Shield Association, the probable chairman’s (from the Anthem side) qualifications and data security (ahem!). Given that Anthem’s 60 million record breach was an inadvertent inside job [TTA 11 Feb], the last is perfectly understandable. But the door appears to be open for the emollient of additional money (to mix a metaphor). Extra: a tart take on this from the WSJ…..Jaguar is looking to increase driving safety by reading your brain waves to detect if you are distracted or daydreaming, via sensors embedded into the steering wheel. It’s based on technology used by NASA and the US bobsled team. They are also working on mood enhancing lighting and a predictive system to speed your interactions with the dashboard to minimize eyes off the road. But will these detect if you feel good to be bad, as their adverts say? Gizmag….The FT gets into digital health via business, profiling startups such as Lyra Health, Genomics England and Heartflow, as well as 23andme and Google X (including the glucose-detecting contact lens we profiled 18 months ago. Hat tips to Eric Topol and David Doherty (mHealth Insight) via Twitter….The NY Times looks at the dark side of ‘senior independence’ with a group of NYC homebound seniors, but other than tut-tutting the desire of older mainly limited income New Yorkers to remain in familiar surroundings, our ‘national celebration of independence’ (!) and not to be institutionalized (their words), the article doesn’t offer much in the way of solutions. And solutions are badly needed for the nearly 2 million over 65 who rarely or never leave their homes, because not all of them will be in assisted living. Hat tip to Joseph Coughlin of MIT AgeLab via Twitter…. But in Australia, they’re exploring ‘future proofing’ and ‘dignity enabling’ homes for an aging population to make them more livable and accessible, via landscaped ramps, larger bathrooms, and sensor rich floors that connect to gait tracking and analysis. Smart Homes 2.0. Sydney Morning Herald…..Neil Versel over at his new MedCityNews stand reports on Doctor On Demand‘s test of tablet-based medical kiosks adjacent to the pharmacy department at four Wegman’s grocery stores here in the Northeast. Is Weis Market far behind?….And Fitbit has a bit part in ‘Law and Order’…well, not the TV show in perpetual reruns, but in a real-life case in Lancaster County, Pennsylvania which is not all Amish farms, black carriages and the so-called Amish Mafia. The police used Fitbit activity data to determine that a local resident (and Fitbit wearer), who claimed she was raped by a stranger, staged the crime scene with overturned furniture, a knife, and a bottle of vodka in her home. ABC27 News via David Lee Scher.

Guilt and money: the manipulative side of fitness tracking

June 23, 2015 | by

Show me the money! The bottom line of fitness apps can now be cash rewards, much like many credit cards. There’s FitCoins that exchange into bitcoins, the digital currency much in the news and recognized by some legitimate (and non legitimate) retailers; Pact which makes you invest in your goals with a pool of others, rewarding you if you make them, deducting from your account if you do not; GOODcoins which rewards you only with ‘positive things’ (no chocolate or anything that contributes to, say, global warming). But after all, you should only bask in the glow of doing GoodThings for yourself, eh? Getting paid to stay fit (Ozy)

But then there’s always guilt. Fitness tracking is on the way of becoming so omnipresent that it becomes a part of you. Beyond the wrist, fitness clothes, implants and digital tattoos or bandages will be tattling (via your smartphone or directly) on your vital signs, activity and weight gain from too much to eat at dinner. On one hand this can be a good thing in shaping behavior. A study by two researchers associated with University College London and Ashfield Business School, Berkhamsted found many positives in Fitbits shaping female wearers’ behaviors, with 76 percent self-reporting healthier eating habits (more…)