Breaking news confirmed: Bosch exiting healthcare and telehealth in US–UPDATED

June 19, 2015 | by

Breaking News–UPDATED with Bosch response

Bosch has confirmed they are closing their telehealth business in the US. Please see their statement at the end of this article.

A home care industry newsletter, along with our own reliable industry sources, have confirmed the recent industry discussion that Bosch Healthcare, since January a solely US operation, is winding down its business without a definite turnover to a buyer. This Editor, in calling various departments in their Palo Alto, California offices for confirmation on Thursday, was (when she reached a human being) forwarded to HR where she could leave only voice mail. An email to marketing also received no response. All sources indicate that staff layoffs took place last Monday.

Editor’s Note: Bosch’s official press response follows this article. We have also made certain corrections to this article (see in red).

  1. The Home Care Technology Report, published by industry consultant Tim Rowan, on Wednesday posted two articles stating that Bosch laid off nearly all of its staff on Monday (15 June) save for customer service and some key operating areas. His information indicated that Health Buddy sales–new and existing orders–have been terminated. This includes orders placed through its McKesson partnership. Non-VA service will be terminated in 60 to 90 days.
  2. Home Care Technology also reported that Bosch’s business with the Veterans Health Administration (VA) will be maintained through April 2016, which is near to the contract end in May, but no new units will be delivered. The original contract was with Health Buddy hub developer Health Hero Network, sold to Bosch in 2008. With the later acquisition of ViTel Net, Bosch developed into one of the two leading VA Home Telehealth remote monitoring hub suppliers–the other being Cardiocom. VA Home Telehealth is the largest telehealth program in the US with over 156,000 patients (Federal Year 2014) (Ed. Note: VA has a third authorized and active VA supplier, Viterion).

As Mr Rowan did, this Editor will speculate on the reasons why there is this reported exit without a sale or spinoff, despite the substantial VA and other healthcare placements of Health Buddy. Our take is somewhat different than his: (more…)

Fitbit and Teladoc: big IPOs, big questions

June 19, 2015 | by

This week’s big news (so far) of Fitbit’s $732 million initial public offering–the largest consumer electronics IPO ever–comes despite the Jawbone IP lawsuits [TTA 11 June]. Count us among those who question this ‘vote of confidence’ as raising unrealistic expectations for health tech by a fitness tracker not truly part of real digital health. Telemedicine provider Teladoc appears headed on the same track with an IPO estimated to come in at $137 million, probably by next week. This generous pricing (~$20/share) comes despite never being profitable in 13 years. Like Fitbit, Teladoc is facing lawsuits from its major competitor American Well on IP [TTA 9 June], with Teladoc asking the US Patent and Trademark Office to review the validity of several American Well patents. Both IPOs are on the New York Stock Exchange (NYSE). MedCityNews examines Fitbit and Teladoc.

Your Friday robot fix: the final DARPA Robotics Challenge

June 19, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/Overrun-by-Robots1-183×108.jpg” thumb_width=”150″ /]They’re Still Puppets! The final DARPA Robotics Challenge took place last week at the Fairplex racetrack in Pomona, California. 10,000 spectators viewed 24 teams’ robots going through their disaster-response paces to win a share of $3.5 million in prize money in this final stage of the DARPA three-year program. Many of the robots were custom, but several teams fielded adaptations of the Boston Dynamics Atlas robot as a common platform. The engineering teams were sequestered in a ‘garage’ offsite and linked to their robot charges by a deliberately degraded communication system (to simulate field conditions). The robots had no cords (unlike 2013) and were given eight tasks: driving a car down a dirt road, getting out of the car, opening a door and entering a building, turning a valve, cutting a hole in a wall with a drill, completing a surprise task (flipping a switch or unplugging a tube and plugging it into another hole), navigating a pile of rubble, (more…)

3rings smart plug fundraising on Kickstarter

June 19, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/06/3rings.gif” thumb_width=”150″ /]A note from founder and chairman Steve Purdham brings the news that the 3rings smart plug [TTA 11 Mar], which tracks an older one’s activity through everyday actions such as turning on an electric tea kettle or TV and radio on, is raising funds on Kickstarter through 13 July. Their goal is $30,709 (£20,000) of which $10,306 (£6,712) has been raised with 24 days to go. With product design and testing complete, the funds will go towards facilitating production. Pledges start at £2 and go up to £5,000 for practically everything listed in the lower donation levels, a special evening in Oxford for two and an autographed, personalized picture and autobiography of Manchester United and Scotland legend Willie Morgan. Note: the 3rings plug and service is only available in the UK, but if the service is available later in your country, any subscription pledges will be honored. Best of luck to Steve and the 3rings team! Release.

A ‘Game of Thrones’ analogy to potential health insurer mergers

June 18, 2015 | by

The Wall Street Journal has likened the merger action pending among America’s largest insurers to the series ‘Game of Thrones’, said thrones occupied by Aetna, Cigna, Humana, UnitedHealthcare and Anthem. These more aptly remind this Editor of the final stages of airline deregulation, except that none are in a non-medieval bankruptcy court. Their actions reflects the payers’ urgent concerns that now is the time to reinforce a national presence, that revenues in a Obamacare environment (well, we’ll see the effect of that US Supreme Court subsidy decision due imminently) can do nothing but go down and that Medicare Advantage, commercial accounts, health system relationships (ACOs) and health IT systems are the place to be. What is missing: the fate of those independent, state and regional Blue Cross-Blue Shield (collectively, the ‘Blues’) which are not part of Anthem, many of which are ‘non-profit’ (note the quotes); the positive effect of competition on pricing and a fair consideration of the negative effects of monopoly. Ah, but there are no flung axes, regicide or poisonings to be found here. The real theme of ‘Game of Thrones’ is the effect of the powerful on the powerless (we the insured), which the WSJ writer doesn’t address…..Insurers Playing a Game of Thrones (if you hit a paywall, search on the title)

Telemedicine, telehealth follow up to reduce emergency room revisits

June 18, 2015 | by

A great deal of importance has been placed on reducing same-cause hospital readmissions, but what about emergency room (ER, Emergency Department=A&E in UK) revisits? Sometimes they are needed–for increased pain, further testing or medication checks when the staff is doubtful the patient will follow up on their own–but often not. Two telemedicine/telehealth programs in Pennsylvania aims to cut these high rates of return–up to 20 percent in a month. Thomas Jefferson University Hospital is piloting video call follow up plus a call center to phone patients at risk of revisit to help with needed appointments. A group of insurers and providers, the HealthShare Exchange of Southeastern Pennsylvania, will also share patient information among local ERs when the insurance number is entered, a measure that may prevent unneeded testing. Modern Healthcare Hat tip to our readers at Practice Unite

Tunstall Americas gets active with QMedic

June 18, 2015 | by | 1 Comment

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /]Tunstall Americas’ monitoring providers will have something new to distribute: the QMedic activity tracker. The QMedic bracelet (alternatively pendant) has an alert button and a base station like a conventional PERS, but also tracks sleep quality and activity levels. It has two way monitoring and also generates alerts and texts to loved ones if the bracelet isn’t worn or no wake-up is detected, plus recurring wellness reports on activity, sleep, and safety in the home. Fall detection presumably is inferred Tunstall’s reseller agreement includes all its local healthcare service providers. This Editor also observes that after a very long period of quiet, Tunstall in the US is demonstrating its own activity. Release. Earlier in TTA: Tunstall Goes Hawaiian with Kupuna Monitoring acquisition

Tunstall Goes Hawaiian with Kupuna Monitoring acquisition

June 11, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /] Tunstall Americas is acquiring Kupuna Monitoring Systems of Aiea (northwest of Honolulu), Hawaii, a medical alarm and medication manager provider. In the press release, CEO Casey Pittock confirmed that Tunstall Americas’ strategy is to acquire regional monitoring services, as we noted in their Mountain Home (Denver) purchase last year. Locally owned (kama’aina) and serving the four major islands, Kupuna (‘elder’) is currently using Philips Lifeline monitors and Philips med dispensers. We hope they are welcomed with warmest aloha. (Hawaii as a market and culture is like no other in the US, and in this Editor’s experience in a totally different industry, can be fiercely local.)

What’s news at the end of the week

June 11, 2015 | by

Care Innovations harmonizes seniors, Panasonic adds diabetes, Jawbone and Fitbit bite, the first EHR/PHR Hack and Concussion in Cleveland. Converging its interests in remote patient monitoring with its long-time footprint in senior housing resident monitoring (QuietCare), Intel-GE Care Innovations is testing its Health Harmony remote patient monitoring system, partnering with two California-located Front Porch communities and the Front Porch Center for Innovation and Wellbeing. The residents selected have poor chronic condition management or have returned after a discharge from a skilled nursing facility. No disclosure on projected number or duration–and it doesn’t appear that QuietCare is part of the monitoring. Release….Panasonic just bought Bayer Healthcare’s diabetes/blood glucose monitoring device unit for $1.13 billion as Bayer continues to shed non-life science businesses. While old-school prick-and-bleed monitors are being eclipsed by continuous glucose monitors (CGMs) and mobile-based devices such as Telcare in the US and in Europe, there’s plenty of market remaining in the West, and new ones in Asia and the Middle East for simple devices. It joins Panasonic’s existing blood pressure monitors. MedCityNews….Jawbone and Fitbit continue to snap at each other in court, with the former on Wednesday filing a second lawsuit on patent infringement, specifically “a wellness application using data from a data-capable band”, with the added fillip of going to the International Trade Commission, which could ban the import of Fitbit products or component parts. The 28 May lawsuit was about Fitbit’s hiring of five former Jawbone employees who allegedly stole IP. The companies between them have hundreds of patents, and as this Editor has noted in previous IP and patent troll articles, the US Patent and Trademark Office (USPTO) is not especially rigorous in ensuring that patents are not overbroad. Wonderful for the IP attorneys, but not exactly what Fitbit wants as a runup to their expected IPO next week. Wall Street Journal….Now an EHR and PHR join Hackermania Running Wild. Medical Informatics Engineering reported Tuesday that in May their server was cyberattacked, exposing PHI of patients in five clients and separately information contained in the NoMoreClipboard PHR subsidiary. POLITICO reports that this is the first recorded instance of an EHR compromise. MIE Release, POLITICO Morning eHealth….If you are in the Cleveland, Ohio area and have an interest, Concussion: A National Challenge is a free, two-day event on detection and diagnosis sponsored by the National Academy of Engineering, the Institute of Medicine, Case Western Reserve University, Metro Health and Taipei Medical University. Advance registration required.

Health Datapalooza 2015: more data, better health

June 10, 2015 | by

Guest columnist and data analytics whiz Sarianne Gruber (@subtleimpact) sat in on the Health Data Consortium’s 2015 edition of Health Datapalooza last week in Washington, DC. It was all about the data that Medicare has been diligently harvesting. Also see the US-UK connection on obesity.

Health Datapalooza 2015, now in its sixth year, welcomed more than 2,000 innovators, healthcare industry executives, policymakers, venture capitalists, startups, developers, researchers, providers, consumers and patient advocates. Health Datapalooza brings together stakeholders to discuss how best to work the advance health and healthcare,” said Susan Dentzer, senior policy adviser to the Robert Wood Johnson Foundation and a member of the Health Data Consortium. The Consortium promotes health data best practices and information sharing; and works with businesses, entrepreneurs, and academia to help them understand how to use data to develop new products, services, apps and research insights. This year’s conference was held on May 31 through June 3 in Washington, DC. And how best to celebrate is with the gift of more data!

New Medicare Data Means More Transparency
The Centers of Medicare and Medicaid Services (CMS) released its third annual update to the Medicare hospital inpatient and outpatient charge data on June 1, 2013. (more…)

Medtronic favoring early-stage acquisitions, diabetes; American Well and Teva

June 4, 2015 | by

Medtronic plc, now firmly planted in the Auld Sod of Ireland, reported a tidy $7.304 bn in its 4th quarter global revenue closing 24 April versus a prior year of $7.257 bn, with a net loss of $1 million. Their report yesterday (2 June) was primarily centered around the integration of Covidien and the foreign currency loss. Results were especially strong in the US with an 8 percent gain in fourth quarter. Earlier speculation that the major Covidien acquisition in addition to Corventis, Zephyr Technologies (through Covidien) and telehealth provider Cardiocom would slow future investments seems to be the direction CEO Omar Ishrak is taking, based on his comments during the analyst call. The Covidien strategy of making early-stage company acquisitions is to his liking and with new revenues from Covidien (and a more favorable tax domicile) certainly there is not a lack of funds despite a small loss in fourth quarter revenues. Another change from being a cardiac-centric device company is apparent in the growth area of global diabetes, shifting from pumps to diabetes management. They have a minority investment in diabetes manager Glooko, a partnership with IBM Watson Health for diabetes management, and acquired a Dutch clinic and research center, Diabeter. Jonah Comstock at Mobihealthnews has more on that call.

In a surprising move, Israel’s Teva Pharmaceuticals is putting a reported ‘tens of millions of dollars’ into American Well and their telemedicine (virtual consult) platform. The pharma interest at once may be narrow in utilizing these consults in clinical trials, but as we have seen with Merck’s telemedicine clinics in Kenya, there’s also a focus on monitoring critical medication at long distances. Late last year American Well completed an $81 million Series C, but it is not clear whether Teva is a part of this and the news is just now catching up. MedCityNews, Globes (Israeli business website)

The leaky roof of healthcare data (in)security–DARPA to the rescue?

June 4, 2015 | by

This week’s priceless quote:

“A lot of the response was, ‘We live in a cornfield in the middle of Minnesota,’” he said. “’Who wants to hurt us? Who can even find us here?’”–Jim Nelms, Mayo Clinic’s first chief information security officer, 

We know where you are and what you do! The precarious state of healthcare data security at facilities and with insurers, plus increased external threats from hacking has been getting noticed by Congress–when you see it in POLITICO, you know finally it’s made it into the Rotunda. It was over the horizon late last summer with the FBI alert and legislators in high dudgeon over the Community Health Systems China hack [TTA 22 Aug 14]. It’s a roof that leaks, that costs a lot to fix, doesn’t have immediate benefit (cost avoidance never does) but when it does leak it’s disastrous.

This article rounds up much of what these pages have pointed out for several years, including the Ponemon Institute/IBM study from earlier this week, the Chinese/Russian connections behind Big Hacks not only for selling data, but also IP [TTA 26 Aug 14] and how decidedly easy it is to hack devices and equipment [TTA 10 May 14]. Acknowledgement that healthcare data security is about 20 years behind finance and defense deserves a ‘hooray!’, but when you realize that on average only 3 percent of HIT spend is on security when it should be a minimum of 10 percent (HIMSS) or higher…yet the choice may be better security or uncompensated patient care particularly in rural areas, what will it be for many healthcare organizations?

The article also doesn’t go far enough in the devil’s dilemma–that the Federal Government with Medicare, HITECH, meaningful use, rural telehealth and programs like Medicare Shared Savings demand more and more data tracking, sharing and response mechanisms, stretching HIT 15 ways from sundown. At the cutely named Health Datapalooza presently going on in Washington DC, data sharing is It for Quality Care, or else. Yet the costs to smaller healthcare providers to prevent that ER readmission scenario through new care models such as PCMHs and ACOs is stunning. And the consequences may be more consolidated, less available healthcare. We are already seeing merger rumors in the insurer area and scaledowns/shutdowns/buyouts of community health organizations including smaller hospitals and clinics. Also iHealthBeat.

DARPA to the rescue? The folks who brought you the Internet may develop a solution, but it won’t be tomorrow or even the day after. The Brandeis Program is a several stage project over 4.5 years to determine how “to enable information systems that would allow individuals, enterprises and U.S. government agencies to keep personal and/or proprietary information private.” It discards the current methodology of filtering data (de-identification) or trusting third-parties to secure. Armed With Science  FedBizOpps has the broad agency announcement in addition to vendor solicitation information.

Healthcare vulnerability in a concatenation of data breaches

June 2, 2015 | by

Concatenation is one of those lovely English words that express far more than its simpler synonyms: sequence, series or chain of events. Perhaps we have experienced that concatenation of data breaches which connect and demonstrate a critical mass that motivate healthcare organizations, including insurers, to ensure that data security and privacy gets primacy in HIT. Our Readers know we’ve been on the case since 2010; we’ve been noting Ponemon Institute and ID Experts studies since then.

While simple, straightforward theft can be the cause of smaller breaches and not part of a Big Hack, it’s not as Three Stooges or Benny Hill-esque as perhaps the JAMA study earlier this year made it out to be, especially if it’s your personal record, or your patient’s, which is breached, identity and financials damaged. (See this Security Intelligence article on a minor health breach and how it affected an individual who happens to be in IBM’s security arm.)

Just in the past few weeks, in the US we have experienced the following major and minor breaches:

  • CareFirst BlueCross BlueShield in Maryland–an insurer, not a hospital or practice–had a Big Hack of 1.1 million health records, with names, birth dates, email addresses and insurance identification numbers (but not SSI or credit card numbers) revealed.
  • Beacon Health Systems (Indiana) had a phishing attack into employee email boxes dating back to 2013. This was a Medium Hack that affected about 220,000 patients. Data taken included SSI and driver’s license. Health Data Management today.
  • Advantage Dental in Redmond, Washington had a 152,000 patient hack during three days in February.
  • Also in February, a New York City Health and Hospitals Corporation employee transferred patient files to her personal and new work email. 90,000 patients may have compromised data as a result. Becker’s

More breaches are listed today in iHealthBeat and the ever-growing list on Privacy Rights Clearinghouse.

Ponemon Institute’s 2015 Cost of a Data Breach Study: Global Analysis, with IBM, was published last week. (more…)

Tunstall adds services for Australian veterans, upgrades US call centers

May 29, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /]Tunstall has been quiet on the newsfront lately, so these two items from Australia and the US are to be noted. In Australia, the Department of Veterans Affairs (DVA) rehabilitation appliances program (RAP), which provides subsidized personal response systems to veterans, now includes Tunstall’s PERS, iVi fall detector pendant, PIR movement sensor and GPS watch. The program requires that veterans be evaluated for need by a qualified health provider. Tunstall has participated in the RAP program since 2002. Pulse+IT (Australasia) In the US, a significant part of Tunstall’s purchase of AMAC were medical answering service operations in Long Island City, NY, Pawtucket, RI, and Newington, CT. A $10 million upgrade of their 24/7 service includes CRM for healthcare providers for after-hours, overflow support, appointment reminders, insurance verification and help desk services. Release

Telehealth reimbursement makes legislative progress in Texas, US House

May 29, 2015 | by

In Texas, telehealth reimbursement as part of the state Medicaid program passed their House resoundingly (120 to 5!) and moved to the state Senate. (In Texas, if your bill makes it through the scrum that is their House, the Senate moves expeditiously.)  HB (House Bill) 2641 would authorize Texas’ Health & Human Services Commission (HHSC) to extend reimbursement for home telemonitoring (telehealth) services under the state Medicaid program from September this year for four years. Health care providers in Medicaid would be reimbursed for review and transmission of electronic health information. The caveat of course is that it is ‘feasible and cost effective’–it is designed to be expenditure neutral. The bill also includes extensive stipulations on health information exchanges based on national standards (ANSI) as well as amending the health and safety code for immunizations and other health conditions. The ‘criminal offense’ pertains to protected health information breaches as a misdemeanor. Telehealth inclusion in Medicaid is positive as this state insurance plan serves the poorest and often sickest, as well as many federal Medicare ‘dual eligibles’. Texas, being a large state, also sets trends (including the most reluctant to adopt cross-state telemedicine licensure.)  Text of HB2641

Would that telehealth reimbursement have the same chance in that large, exceedingly deliberative body called the US House of Representatives. HR2066, the Telehealth Enhancement Act of 2015, is similar to a bill that expired in committee in the last session. It was introduced (more…)

Home telehealth now focused on the ‘superusers’ of healthcare

May 28, 2015 | by

A noticeable trend in telehealth has to do with focusing less on the generic virtues of at-home vital signs monitoring for routine patient care and more on managing specific high-cost populations to avoid or reduce costs. Some of the impetus in the US has come from new regulations by CMS (Center for Medicare and Medicaid Services) intended to move Medicare fee-for-service (FFS) patients into a reimbursed chronic care management (CCM) model. Banner Health is Arizona’s largest private employer (which does say something about Arizona as a retirement haven) and since 2006 has been experimenting with remote monitoring since 2006. Starting in 2013 Banner piloted Philips‘ post-discharge program now called ‘Hospital to Home’ as Banner iCare, combined with Philips Lifeline PERS, but made it available to those only with a stunning five+ chronic conditions–the top 5 percent that is reputed to account for 50 percent of healthcare spend. Banner combined the tech with intense support by a multi-layered care team. At ATA they announced the following results with the initial cohort of 135 patients, now up to 500:

  • 27% reduction in cost of care
  • 32% reduction in acute and long term care costs
  • 45% reduction in hospitalizations

The article in Forbes is a bit breathless in profiling the program and the ‘superusers’ of healthcare (with a windy but false analogy from John Sculley) but provides a level of detail in the program that most articles do not. One wonders how Philips makes money on supplying what is at least $2,500 worth of kit, with peripherals that must all be Bluetooth LE. It’s also not stated, but the TeleICU and TeleAcute programs also appear to be Philips’. Video