Perspectives: How robust patient scheduling and intake enable better patient access to cancer care – a UK case study

June 15, 2023 | by

TTA has an open invitation to industry leaders to contribute to our Perspectives non-promotional opinion area. Today’s contribution is from Josif Dishliev, co-founder at Healee, an integrated patient access solution built for the operational complexity of high-performing medical groups. For one of its clients, UK-based Perci Health, Healee helped launch a branded patient access platform that aims to challenge the status quo for those impacted by cancer. Perci Health connects people living with cancer and their caregivers to a team of multidisciplinary cancer experts, tackling the physical, psychological, and practical impacts of cancer with a focus on managing the long-term side effects of treatment which are often overlooked in traditional healthcare. In this article, Mr. Dishliev talks about the role robust patient scheduling and intake capabilities play in improving patient access to cancer care.

When it comes to cancer treatment itself, the UK has one of the most well-developed healthcare systems in the world. With advancements in screenings, diagnostics, and therapy, the cancer survival rate in the country has seen radical improvement. Although 1 in 2 people will be diagnosed with cancer in their lifetime, survival rates have more than doubled, and by 2030 6% of the population will be living with and beyond cancer.  

However, innovation in the aftercare of cancer survivors has significantly lagged. Patients find the healthcare system complicated and confusing, they cannot get the care they need, and continue to suffer from the long-term effects of treatment.

Digital health technology holds immense potential to improve patient access to cancer care and provide people living with or beyond cancer with much-needed support from the physical, psychological, and practical impacts of cancer. 

Perci Health observed several critical requirements when it comes to successfully implementing a patient access solution that enhances cancer care:

Allow for custom digital intake forms

Strong digital patient intake is the first – and one of the most crucial – steps to the success of a virtual-first care model that prioritizes convenience and affordability but not at the expense of high-quality personalized care.

Perci’s Healee-powered platform utilizes digital intake forms by offering an online questionnaire that first determines the person’s demographic profile and then provides the option for two journeys – “supporting someone with cancer” or “living with or beyond cancer.”

  • For people who choose the “supporting someone with cancer” option, the platform asks a set of questions to determine the physical, psychological, and social impact that taking care of a person with cancer has had on them. 
  • For people who choose the “living with or beyond cancer” option, the platform asks several additional questions including type of cancer, year of diagnosis, and treatment stage.

Based on each person’s answers, the platform offers tailored recommendations for the type of care and the healthcare professionals best suited to their needs.

Robust patient access platforms offer custom intake forms, which determine each user’s needs based on their demographics and specific physical and psychological requirements. This method allows users to access personalized treatment plans and match them with the healthcare professional best suited to their needs.

Enable strong patient-provider matching

A well-designed patient access solution allows matching the exact patient need with the best-suited provider in one easy, smooth and real-time provider search experience. Automated patient-provider matching takes into account providers’ characteristics such as provider specialty and considers patient and provider preferences as well as system requirements.

Perci’s platform offers over 20 holistic cancer support types and a list of NHS-qualified healthcare professionals that range from cancer and clinical exercise coaches to psychologists, dieticians, psychosexual therapists, and more. 

Given the many different types of cancer specialists and the varying needs of cancer patients, the access to the right team of healthcare professionals is crucial to improving patient outcomes. (more…)

‘Warning flare’ study: will pandemic-induced digital health solutions get renewed by hospitals in 2023-4, or will they churn?

June 15, 2023 | by

Hospitals and health systems in 2020 and 2021 were desperate for virtual solutions. But comes the reckoning now that they have returned to 1) business as (mostly) usual and 2) even more financial shortfalls. Technology and software contracts typically run three to five years, with new vendor contracts usually three or four. Did these solutions work as implemented? Probably on a spectrum of very well to ‘kinda’. But did they return the desired results in care quality, financially on investment or simply add to the fixed costs which aren’t affordable anymore?

Panda Health, a company that consults with hospitals on digital health adoption, did research via Sage Growth Partners in March 2023 surveying 100 hospital C-suite executives and leaders to assess whether they were satisfied with their current digital health solutions acquired in the pandemic period, whether they would renew with the same vendors, or search for new vendors. While this survey size is small and hedged, the directional prediction is that there will be considerable churn–turnover–among vendors in 2023-25, but not in every one of the 11 areas surveyed have the same risk.

Not unexpectedly, the highest churn risk is projected to be among telemedicine/e-visits and remote patient monitoring (RPM)–the two areas most kickstarted by the pandemic. Lower risk was found in functional areas such as self-service patient scheduling, digital care coordination, patient acquisition/activation, and IT areas such as data lakes and data fabric. Five categories are in the middle.

Telemedicine/E-Visits: 97% of surveyed health executives stated that the pandemic crisis played a role in their acquisition decision. 47% were ‘moderately’ to ‘not satisfied’ with their choices. 30% of these contracts will expire this year and next. In projecting this against a US total of 6,414 hospitals, 1,693 may be changing solutions by the end of 2024.

Remote Patient Monitoring: The pandemic kickstarted RPM adoption by hospitals. 82% of hospitals deployed their solutions since the pandemic began with 19% within the past 12 months. 53% reported that they were ‘moderately’ to ‘not satisfied’ with their choices. With 33% of contracts expiring by 2024, the study estimates that 1,058 hospitals may be changing their solutions.

A different picture–Digital Care Navigator/Website Chatbot: Only 14% of respondents adopted these solutions, all within the past two years. Only 25% of contracts come due during 2024, with 55% coming due in 2025 and the remainder presumably in 2026 and beyond. Yet of all 11 categories, 63% of executives reported some level of dissatisfaction, with 38% ‘not satisfied’–the highest percentage in the study. 197 hospitals are projected to consider changing solutions by the end of 2024. 

Even low/moderate and low churn solution categories have moderate (‘moderately’ to ‘not satisfied’) levels of dissatisfaction that edge close to 50%. Exceptions are the last two categories, Data Lakes and Patient Acquisition. Fair warning to all companies who are selling digital health into hospitals–it’s time for your customer success teams to get busy, find out where their pain points are, and who’s feeling them.

The Great Shakeup (free report, PDF download). Panda release.  Hat tip to HIStalk 14 June

‘The Future of AI and Older Adults 2023’ now published

June 14, 2023 | by

Laurie Orlov of Aging and Technology Watch in her latest paper tackles the latest iterations of AI and ML, tracing their roots back to 2014 to the original smart speakers and voice assistance, technologies that enabled older adults to access services with convenience and at reasonable cost. What will be the impact of AI using tools such as large language models (LLM) like ChatGPT to develop improved search, voice assistance, answers to health questions, and care plans written in understandable and empathetic language? For care facilities and senior housing, will they leverage AI with voice and sensor tech to improve safety monitoring for both residents and caregivers, plus the dream of predictive health for residents or those living at home with limited assistance? Will chatbots get a lot smarter versus obnoxious? Find out what both the short term and long term (5+ year) impact could be. 

Ms. Orlov’s somewhat gimlety view includes Gartner’s infamous Hype Cycle chart on page 5. As of today, most AI technologies reside in the balmy Peak of Inflated Expectations, the place where whatever investment funding is going. There’s lots of innovation and kitchen table hackathoning. Looming about two years out is the inevitable Trough of Disillusionment which has already been kicked off by Big Thinkers such as Steve Wozniak. As this Editor observed last month, it is a double-edged sword, with the bad side in its potential for data misuse, fraud, fakery, and malicious action. It’s already created controversy that this Editor predicts will crest in the next year with demands for regulation. We’re not there yet, however.

Download of the PDF is here and free.

Mid-week roundup: Promising Langone AI/LLM predicts hospital readmits; Huma gains FDA 510(k) Class II clearance; telepsychiatry’s challenges; layoffs/asset buys/losses from 23andMe, Cityblock, Thirty Madison, Butterfly

June 14, 2023 | by

New York University’s Langone Health’s large language model (LLM) accurately predicting hospital readmissions, more. NYU’s academic medical center NYU Langone Health has developed an LLM using medical language, NYUTron, from unstructured clinical notes in patient records, then fine-tuned it across a wide range of clinical and operational predictive tasks. The dataset was immense:  ‘NYU Notes’ covers 7.25 million clinical notes (for example, radiographic reads, history, and physicals) from 387,144 patients across four hospitals, and more. According to their study published in Nature on 7 June, it was tested for predictive ability in five areas: 30-day all-cause readmissions, in-hospital mortality, comorbidity index, length of stay, and insurance denial. The NYUTron system in testing has achieved results improved over conventional structured models’ baselines. From the Nature study:

  • For 30-day readmission prediction, it had a median area under the curve (AUC) of 79.9% ± 0.168% with a 5.36% improvement
  • On in-hospital mortality prediction, NYUTron had a median AUC of 94.9% ± 0.168% with a 7.43% improvement.
  • On comorbidity index imputation, NYUTron had an OVR median AUC of 89.4% ± 0.275%
  • On binned LOS prediction, NYUTron had a median AUC of 78.7% ± 0.179% with a 12.3% improvement 
  • On insurance denial prediction, NYUTron had a median AUC of 87.2% ± 0.246% with a 14.7% improvement.

In a test of the system during January-April 2022, the system analyzed 29,286 discharged encounters, with 3,271 patients (11.17%) returning within 30 days. NYUTron predicted 2,692 of the 3,271 readmissions (82.30% recall) with 20.58% precision. Also HealthcareITNews

London-based Huma (the former Medopad) gained US FDA 510(k) Class II clearance for their Software as a Medical Device (SaMD) platform. This is defined as disease and age-agnostic digital health pathways through which data are collected from patients for self-management or to be assessed remotely by healthcare professionals. Huma also recently obtained EU MDR Class IIb approval and with Health Canada through the FDA’s joint eStar program. Huma’s tech also includes remote patient monitoring (RPM) systems and companion apps to enable disease management, with third-party device integration. For providers, the platform hosts AI algorithms that use automated data analytics to support screening, diagnosis, dosing recommendations, clinical decision making, and prognostication for identification of at-risk patients and early intervention. In 2020, Huma acquired BioBeats and TLT; more recently, last year iPLATO patient engagement and in January clinical trials data specialist Alcedis.   Huma release, Mobihealthnews

The growth of behavioral health has come to a screeching halt with the demonstrated abuse of online prescribing, then the US Drug Enforcement Administration (DEA)’s uncertainty around controlled substance prescribing. This interview with the CEO of Array Behavioral Care, one of the Ur-companies in telepsychiatry (1999, originally InSight Telepsychiatry and Regroup Telehealth), points out how the DEA’s post-Public Health Emergency (PHE) policies around Schedule II and higher teleprescribing disrupted their operations. The flexibilities established during the PHE have been waivered to 11 November, though a final rule must replace the temporary extension rule and comply with the Federal Ryan-Haight Act [TTA 11 May]. Other issues addressed are dealing with medical affairs (clinical licensure, primary source credentialing, facility privileging, and payer enrollment), and the potential for AI to create new tools to aid clinicians in evaluating mental health, such as natural language processing (NLP) in transcribing video sessions and suggesting clinical notes, as well as scanning patient intake stories and analyzing that information for the likelihood of certain diagnoses. HealthcareITNews

The slow drip-drip-drip of layoffs, folded companies’ asset sales, and company losses that started in 2022 continue, though at a diminished pace compared to consumer companies:

  • Genomics and DNA testing company 23andMe announced layoffs of 9% of staff or 75 people. This will take place by the end of their FY 2024, which ends next 31 March. In a 9 June filing, the company claimed that it would reduce annualized payroll and benefit expenses by $12.8 million, which leads one to wonder about the compensation level of those 75 and from what area they are in. South San Francisco-based 23andMe continues to be money-losing, increasing annual net losses from $217 million to $317 million in the 12 months ending in March, according to its May earnings report despite a 10% revenue gain. 23andMe is yet another ‘cracked SPAC’, having gone that route in 2021 with a Virgin-backed SPAC. Once trading at highs of $12-13 on the NYSE, it closed today at $1.96. However, they don’t have debt, are hanging on to a valuation of $924 million, and their cash position is apparently strong enough to hold it for two years.  Becker’s, SF Chronicle, Yahoo Finance, SimplyWallStreet
  • Another well-financed company, Cityblock Health, is laying off 12%, or 155 staff. Spun off from Sidewalk Labs (Alphabet Health-Google) at the end of 2017, their CEO announced the layoffs in a blog post late last week and effective immediately for those affected. Cityblock serves Medicaid and low-income ‘duals’ with both Medicare and Medicare in value-based care models with a heavy reliance on technology. Their CEO who joined the company in March phrased it as a restructuring, using technology to automate processes, and reducing staff layer. In contrast to others, Cityblock has had no trouble raising funding in the past; in December 2020 they raised $160 million in a December 2020 Series C, plus another $192 million in a Series C extension in March 2021, then a reported $400 million Series D in September 2021 with total raises over $890 million. But their cash burn with high-cost operations in six states (HQ New York, Massachusetts, Indiana, North Carolina, Ohio, and Washington DC) is also likely high. FierceHealthcare
  • Thirty Madison buys assets from bankrupt The Pill Club. The assets? Over 100,000 patient files for $32.3 million. The Pill Club entered Chapter 11 in April after being charged by California authorities of defrauding the state Medicaid program. It paid $18.3 million to settle the charges. But that wasn’t all. According to Mobihealthnews, “the settlement came just days after a state court unsealed a whistleblower complaint against the company in which former nurse practitioners alleged it had defrauded private insurers in at least 38 states. According to a statement from their attorneys regarding the settlement, the whistleblowers would receive approximately $5 million.” The patients covered by The Pill Club’s prescriptions will be converted over to another Thirty Madison brand, Nurx, and offered other services such as behavioral health and dermatology services. The Pill Club raised a lot of money from 2016–$51 million in Series B funding in 2019 and another $41.9 million in 2021. Thirty Madison is a private multi-line of consumer-marketed brands such as Keeps (hair), Picnic (allergies), Cove (migraine), and Facet (psoriasis, eczema) and is at a Series C with a total raise of $209 million. Axios, 
  • Butterfly Network, which some years back developed a hand-held ultrasound device (Butterfly iQ) and entered a crowded field with GE HealthCare’s VScan, Mobisante (apparently defunct), and Philips Lumify, reported Q1 revenue of $15.5 million, flat year-over-year compared to Q1 2022 and which missed analyst estimates (again). Somewhat better news was narrowing last year’s loss to a Q1 loss of $33.5 million which was less than Q1 2022’s loss of $44.5 million. It’s another early SPAC that hasn’t had a great time of it. Since its debut on the NYSE in December 2021, the stock has had the typical drop in altitude from $19.79 to $2.42. It has since expanded to enterprise imaging with Blueprint. Mobihealthnews, Yahoo Finance, Zachs

Theranos restitution status: Holmes’ defense claims $250/month repayment *after* release is unfair

June 13, 2023 | by

Is this thinking ahead or a high-priced legal exercise in futility? The US District Court decisions by Judge Edward Davila pertaining to restitution were clear: $452 million is owed jointly by Elizabeth Holmes and Sunny Balwani to 14 victims, including Safeway and Walgreens [TTA 31 May]. The question is how it will be repaid. The original order by the District Court for Holmes stated only a $25 per month payment while she is at the Bryan FPC. The Justice Department has now requested that the error be amended to now stipulate a $250 per month payment, or at least 10% of her income, after completion of sentence. Holmes’ legal counsel has now filed papers objecting to this assessment, which will take place at least nine years in the future. They cite her “limited financial resources”.

It seems that Holmes will have more trouble paying the $25/month from Bryan, as her financial resources will be even more limited. By some estimations, $25 per quarter is the average earning from prison work. What’s also apparent: her legal counsel is costing her much more than that just for the filing.

Balwani, on the other hand, has been ordered to pay $1,000 per month after his release. The District Court also fined him $25,000 for reasons not disclosed in news sources. Holmes has not been fined. 

One wonders how the lenders will be repaid–proportional checks for pennies? Monthly or quarterly? This Editor is sure that the Murdoch family interests will be waiting eagerly for the payment, while the investments for Murdoch and most others were written off years ago. The small investors whose investment advisors bought shares on the secondary (resale) market get not even that penny.

Much has been made of her net worth circa 2015 when her Theranos stock was valued on the bubble at $4.5 billion, but that was then and this is now. The Feds continue to search for hidden assets held by both Holmes and Balwani. CBSNews, NY Post

VA awards four remote patient monitoring companies to share in $1B Home Telehealth contract (updated)

June 9, 2023 | by

The Department of Veterans Affairs awarded on 1 May the latest contract for veteran Home Telehealth (HT) remote patient monitoring systems to four companies. They are perennial and incumbent vendor Medtronic Care Management Services, with HT newcomers Cognosante, Valor Healthcare, and DrKumo.

The duration of the Remote Patient Monitoring-HT contract is for a base period of two years and six (6) option periods. Each vendor can receive a minimum of $100,000 and maximum of $250,000,000 for a total value of all vendors in the contract of $1.032 billion, which is about the same as the previous award setup. It covers 72,000 patients with chronic care, acute care, health promotion/disease prevention, and non-institutional care (NIC) needs, and was awarded through the Office of Connected Care. This contract provisions for systems and hardware/software tools for the connected care of veterans at home. The solicitation originally came out in September 2021 and the award for multiple reasons was delayed for nearly two years.

Cognosante is perhaps the most interesting one here as an IT services company that offers telehealth and RPM as part of a main suite of diversified business process outsourcing. It already does business with the VA and the government, most recently with the VA in 2022 for support of a system used to manage referral and authorization processes for community care services (GovConWire). Former Senator Thomas Daschle is on their board of directors.

Valor Healthcare also is a current VA provider in operating more than 50 community-based outpatient clinics (CBOCs). Valor as prime contractor partnered with GlobalMed on the contract, with GlobalMed as the technology provider for software integration and security services. GlobalMed already provides telemedicine carts to the VA and is a contractor for virtual health services for the Defense Health Agency’s (DHA) Medical Community of Interest network.

DrKumo is the upstart, founded in 2021 by CEO Kelly Nguyen, Pharm.D and CTO Duc Pham. Their main feature is RPM for disease and chronic care management. 

All four companies prominently feature their connections with the VA and veterans, featuring the latter prominently in their management. Medtronic is the long-time (since the ’00s) incumbent and a leading vendor to the VA and the MHS in multiple areas.

The VA is a tough client, which other companies with HT contracts (and the personal experience of this Editor while marketing director of Viterion two contracts ago) can testify to. While VA may award contracts with four companies, many things can happen in the execution, such as failure to satisfy government US-origin requirements on the hardware origins, as specified in the Trade Agreements Act (TAA). Your hardware will need to be “substantially transformed” in the US or in a signatory country designated by the TAA. More than one vendor has effectively lost their contract over this; it happened to Vivify Health (now part of Optum) in 2018 and they with Iron Bow walked away [TTA 16 Jan 2018]. Another major hurdle is acceptance by VA care teams, and here all three companies are up against incumbent Medtronic.

Update 1 Nov: Another incumbent, AMC Health, which in 2022 partnered with GE HealthCare on post-hospital monitoring, switched partnerships and moved to partner with Cognosante. Partnerships are near-impossible to discern from the award notices. This is per their chief operating officer, James Considine, to the Editor. 

Becker’s, GovConWire, Valor release, GlobalMed release, SAM.gov award notice-Medtronic, SAM.gov award notice-Valor, SAM.gov award notice-DrKumo, SAM.gov award notice-Cognosante

Friday roundup: VA Spokane quashes staff cuts; EHR market share ex-US; Epic’s proposed UK HQ expansion; Apple watchOS 10 adds health features; Nox Health on Pear buy; GP2U Telehealth sold

June 9, 2023 | by

VA assures Mann-Grandstaff VA Medical Center staff that they won’t face cuts due to their budget deficit of about $35 million. The Northwest regional network director Teresa Boyd said to staff in a 1 June message that  the hospital had “not been asked to cut current staff or reduce services to Veterans to mitigate any effects of the deficit.” Mann-Grandstaff was The Last Straw for the Oracle Cerner implementation, and problems with the EHR and the loss of productivity (estimated at 18%) contributed significantly to the ongoing deficit. This follows on the earlier center director’s statement that Mann-Grandstaff would face at least a 15% cut to make up the shortfall [TTA 31 May]. The Spokesman-Review story goes on to recap the mound of miseries around the Oracle Cerner rollout as well as the local angle with Senator Patty Murray and Representative Cathy McMorris Rodgers, a Spokane Republican who has called for the VA to scrap the Cerner system, but who also called on VA Secretary Denis McDonough to pledge to use money Congress had already appropriated to prevent cuts to staff or services in Spokane.

Speaking of Oracle Cerner, KLAS’ 8 June report on EHR hospital market share outside of the US has Softway Medical by far the leader. Oracle Cerner has the #3 ranking while Epic, tops in the US, is #10. The top 13 are (by 2022 number of hospital beds):

1. Softway Medical: 17,805
2. Dedalus: 9,436
3. Oracle Cerner: 7,564
4. CompuGroup Medical: 6,039
5. IQVIA: 5,803
6. MV: 4,309
7. Philips: 3,486		8. InterSystems: 2,876
9. System C: 2,706
10. Epic: 2,564
11. ezCaretech: 2,376
12. Maincare Solutions: 2,222
13. Meditech: 2,027

Leading in Europe are Softway Medical, Dedalus, System C, and CGM (not on list), while in Asia/Oceania IQVIA, InterSystems, ezCaretech lead. In Latin America, MV and Philips in Brazil with NTT DATA (not on list) in Argentina. Becker’s

But Epic has plans to expand. One sign: plans to move their UK headquarters staff currently located in several buildings in Bristol to a much larger campus on the outskirts of town in nearby Long Ashton. The campus site is currently pasture fields and the village cricket club. This coincides with plans to develop a ‘garden village’ with 2,500 homes to the south that may include a rail station. The public hearing is 12 June in Long Ashton. Bristol Post

Apple debuted its latest iteration of its Watch, OS10, on Monday at its annual Worldwide Developers Conference, with new mental health, vision health, fitness, and medication tools.

  • Mental health: Mindfulness app logs emotions and daily moods, with a Digital Crown that turns to choose a shape to represent their feelings. The Health app adds depression and anxiety assessments which can be turned into a PDF that can be shared with appropriate health resources. 
  • Vision health: this allows users to track time spent outdoors, which can be good for mental and physical health, but supposedly can create nearsightedness through sun exposure (!). This Editor finds this most curious as most of us myopics were ‘that way’ by age 5 or earlier.
  • Fitness tools: a boon for cyclists with workout reminders, fall detection (unless it’s obvious), and an automatic connection to the person’s iPhone to display heart rate, elevation, race route, custom workouts, and cycling speeds. 
  • Medication: follow-up reminders to log medication sent 30 minutes after the scheduled time

Mobihealthnews, CNET video

Nox Health, which bought $3.9 million of Pear Therapeutics assets [TTA 24 May] spilled a bit to Mobihealthnews on their plans for Somryst, the Pear FDA-cleared insomnia treatment. Nox is already in the sleep health business and has several lines of business around benefits for self-insured employers and payers, plus sleep diagnostics and related technologies targeted to hospitals and health systems including the VA. Nox’s origins are in Iceland and while developing sleep diagnostics from hospital to home got to know Pear while they were developing Somryst. Their CEO also has some thoughts on why Pear got sliced up.

Down Under, GP2U Telehealth is being sold, the second change of ownership in just over two years. The seller is UK-based Doctor Care Anywhere (DCA) Group. Australia’s Connected Medical Solutions, operating as My Emergency Doctor (MED), agreed to buy GP2U for A$3 million (US $2 million): A$500,000 in cash and A$2.5 million in Connected Medical Solutions shares. DCA bought it in September 2021 for A$11 million (US$7.4 million), which is quite a haircut in any currency, but announced that the sale is to reinforce its focus on its core UK market. MED partners for telehealth services with over 40 healthcare services, including ambulances, primary health networks, residential aged care facilities, hospitals, urgent care centers, and multi-purpose centers. DCA’s current UK consults in April/May totaled 121,200, up 30%. Mobihealthnews, MarketWatch

Watch your cash burn! Now 31 months average for startups between Series A and B. Now what do you do?

June 8, 2023 | by

Yes, it’s an even longer way from Series A to B. Add some rockslides to that picture (left) and that’s what the road looks like. A thoughtful article in Crunchbase illustrates the changes over the past dozen years. We are certainly not in the palmy throw-money-at-great-ideas-devil-take-the-hindmost days of 2020-21. Their chart has both median and average time from Series A to B and both are at an all-time high: 31 months on average and 26 months for the median, sharply up from 2022’s 26 and 22 months respectively. The lowest quartile of startups took a stunning 38 months median to get to a Series B–that is over three years.

The question for most startups is how long they can hold out till the next successful fundraising. The pattern has been that once the Series A is completed, the founders put most of their time and energy into raising the next round. What they should be doing, according to the article, is cutting costs and extending runways till the time that things improve among funders. Startups should also keep in mind that investors now prefer lower-risk, slower growth, lower ongoing loss startups to the high flying (in 2020-21). high-cash burn/high-growth startups. 

There are exceptions of course in hot sectors, notably AI and generative AI, but formerly scorching mental health has distinctly frosted over. And if your startup is already profitable, that also attracts funding if the sector is appealing.

The CB conclusion is cautionary and to the point: 

Sooner or later, however, Series A companies will have to do one of five things: Get acquired, go public, become self-sustaining, raise more financing, or shutter. If enough years pass with none of the first four options happening, it becomes increasingly likely the startup will not make it.

This Editor will add that the latest shutterings have been in women’s health which never has received a lot of investment (5% according to Rock Health) and to funders is too niche: NYC-based Bunnii (fertility planning) and SimpleHealth (birth control), which sold its assets to Twentyeight Health. Both got trapped in the funding trough between promises and actual funding. Axios

What’s the way forward from the tough picture above? Well, digital therapeutics probably should be avoided as their track record from Happtique’s vetted app prescribing (failed by 2014) to Pear Therapeutics (failed 2023) has been a losing one. This Editor saved a January MedCityNews article to see if their thumbs up-and-down projections on startups raising capital held up six months later. 

  • Thumbs up: companies that serve multiple stakeholders by creating value for providers, pharma, payers, employers, and consumers; those that not only save clients money but also make them money after one year (!); labor/staff-saving systems; anything with clear ROI; concretely addressing issues with affordability, accessibility, and accuracy. 
  • Thumbs down: niche players that serve highly targeted markets; care navigation (and other-Ed.) services where ROI is hard to track; too crowded sectors like patient engagement and clinical documentation unless they can provably be the lowest cost, most efficient provider versus competition

This Editor would add as ‘thumbs up’ technologies that facilitate simple and less expensive deployments that address extreme pain points around Federal/state compliance and legal/safety cost issues such as staff safety, drug diversion, and patient/resident elopement. 

FTA: Companies are advised to diversify their funding as well: reduce dependence on private capital by looking for investments from alternative sources like the government for non-dilutive funding.

What’s your thoughts and experience?

AI news: GE HealthCare’s 510(k) for Precision DL (+ GE stake sale), Samsung adopts care.ai for in-facility patient monitoring, Mayo Clinic-Google Cloud generative AI, Wolters Kluwer buys Invistics for drug diversion detection

June 8, 2023 | by

GEHC receives FDA clearance for Precision DL (deep learning) image processing software. It improves image quality on GEHC’s PET/CT, Omni Legend, which enables faster scanning time and improved small lesion detection. Deep learning as part of AI is a subset of machine learning (ML), which uses a neural network with three or more layers that simulates the human brain in processing and ‘learning’ from large amounts of data and drawing judgments from it. (See our recent Perspectives for a more nuanced explanation.)  According to GEHC’s presentation brochure on Precision DL, it is trained with thousands of PET images made using multiple reconstruction methods. Mobihealthnews

GEHC was spun off from parent General Electric (GE) in January. GE retained about 19% of its stock at the time with the remaining being distributed to GE shareholders, but on Monday announced that it would sell 25 million shares, or about $2 billion in value, in a debt-for-equity exchange. The debt is held by affiliates of Morgan Stanley which would then receive the stock, which has done well. This would reduce GE’s stake in the spinoff considerably.  Reuters, Yahoo Finance

Samsung partnering with care.ai for facility ‘smart care’. Orlando-based care.ai’s Smart Care Facility Platform monitors for conditions and learns from patient behaviors. It can be used for infection prevention and control, patient and protocol monitoring, workforce optimization, and virtual care. The AI-powered platform will be integrated into Samsung displays for clinician use, including virtual care. The system will be utilized in hospitals, nursing homes, and care facilities. care.ai release, 

Mayo Clinic is also jumping on the AI bandwagon with Google Cloud. Google Cloud’s Enterprise Search in Generative AI App Builder (Gen App Builder) will be used to make it easier for clinicians and researchers to find the information they need and improve the efficiency of clinical workflows to ultimately improve patient outcomes. According to the release, Enterprise Search in Gen App Builder unifies data across dispersed documents, databases, and intranets, making it easier to search, analyze, and identify the most relevant results. Mayo is an early adopter of the system. Google Cloud release  

Wolters Kluwer Health has acquired Atlanta-based Invistics. Invistics’ Flowlytics tracks medication in hospitals and other patient care settings through ML-based systems. The most critical ‘hot button’ use is for detecting drug diversion, which is when a healthcare worker illegally obtains or uses prescription drugs intended for a patient. This is done by reconciling drug transactions from purchase to patient, with their system being used to rapidly and accurately identify patterns of behavior consistent with drug diversion. More routine usage is for automating controlled substance compliance. This will fit in with Wolter Kluwer’s existing products Simplifi+ and Sentri7 in their Clinical Surveillance, Compliance & Data Solutions unit. Information on transaction cost and management transitions were not disclosed. Release

Hat tip to HIStalk’s new AI News feature 7 June for both Mayo-Google Cloud and WK-Invistics.

ISfTeH Student Contest and Award 2023, Friday 16 June

June 8, 2023 | by

The International Society for Telemedicine and eHealth (ISfTeH) will be presenting the second session of this annual contest. Four students in this cohort will be presenting their work in the field of telemedicine and digital health via Zoom on Friday, 16 June, 2:00pm CEST (UTC+2, US Eastern Daylight Time 8:00am, BST 1:00pm).

The use of 3D technology in Medical Education: an experience report
Iasmin Lourenço Ribeiro, Rio de Janeiro State University, Brazil
 
Integration Between Medical Graduation and Professional Master’s Degree in Telemedicine and Telehealth at a Brazilian Public University
Juliana Magalhães Aguiar Cardoso, Rio de Janeiro State University, Brazil
 
Captar-Libras: Video Communication System for the deaf applied to pre-medical care
Lucca Fagundes Ramos de Oliveira, Universidade Federal de Ouro Preto, Brazil
 
Social Media as a Tool to Enhance Training and Patient Recruitment in a Large Trial With Patients With Hypertension and Diabetes in Minas Gerais – Brazil
Taiza dos Santos Azevedo, Universidade Federal dos Vales do Jequitinhonha e Mucuri, Brazil

The first session was in April. From the earlier presentations and these, a jury will assess and score the presentations. Gold, silver, and bronze medals (with a cash prize) will be awarded to the three best presentations.

The ISfTeH Student Contest and Award and the prize for the winners are supported by ISfTeH member Medgate.

If you are working at a school or university and would like your students to be involved in future editions of the contest, or if you want your students to become members of the ISfTeH, contact our ISfTeH Student Membership coordinator, Dr. Simone Farah.

Perspectives: How AI and ML can accelerate the growth of telemedicine across the globe

May 31, 2023 | by

TTA has an open invitation to industry leaders to contribute to our Perspectives non-promotional opinion area. Today’s Perspectives is from Deepak Singh, a thought leader in AI and telehealth. In his work, he builds AI-powered healthtech and telehealth solutions that can reach from big cities to remote areas of the world. With double master’s degrees in business and information systems, he has 10 years of experience in product development, management, and design ranging from telecom to multimedia and from IT solutions to enterprise healthcare platforms. This article discusses how artificial intelligence (AI) and machine learning (ML) can accelerate the global growth of telemedicine, including a consideration of risks and possible solutions.

Introduction

The ongoing technological advancements have led the way towards greater opportunities for the growth of the global health business, particularly telemedicine through increased connections via the internet, robotics, data analytics, and cloud technology that will further drive innovation over the next ten years. It is obvious that artificial intelligence (AI) usage plays a noteworthy part in the maneuvering and execution of medical technologies when considering the bulky amount of data handling needed by healthcare, the requirement for consistent accuracy in complex procedures, and the rising demand for healthcare services.

Telemedicine is the practice of performing consultations, medical tests and procedures, and remote medical professional collaborations through interactive digital communication. Telemedicine is an open science that is constantly growing as it embraces new technological developments and reacts to and adapts to the shifting social circumstances and health demands. The primary goals of telemedicine are to close the accessibility and communication gaps in four fields: teleconsultation, which is having all kinds of physical and mental health consultations without an in-person visit to a medical facility; teleradiology, which uses information and communication technologies (ICT) to transmit digital radiological images (such as X-ray images) from one place to another; telepathology, which uses ICT to transmit digitized pathological results; and teledermatology, which uses ICT to transmit medical information about skin conditions.

AI has been progressively implied in the field of telemedicine. AI deals with machine learning (ML) that discloses complex connections that are hard to figure out in an equation. In a way that is similar to the human brain and neural networks that encrypt data using an enormous number of interconnected neurons, ML systems can approach difficult problem-solving in the same way that a doctor might do by carefully analyzing the available data and drawing valid judgments.

A growing understanding of artificial intelligence and data analytics can help to broaden its reach and capabilities. Telemedicine’s goal is to boost productivity and organize experience, information, and manpower based on need and urgency and it can be augmented by the use of AI and ML.

Evolving application of AI and ML in Telemedicine

In order to enable clinicians to make more data-driven, immediate decisions that could enhance the patient experience and health outcomes, AI is being employed in telemedicine more and more. The use of AI in healthcare is a potential approach for telemedicine applications in the future.

Al and ML were able to bring about the necessary revolution in so many sectors due to their competence, increased productivity, and flawless execution of tasks. AI is now surpassing the boundaries of being a mere theory and stepping into a practical domain where the need for human supervision for the execution of jobs by machines will be minimized all due to the presence of enormous datasets along with an increment in the processing power of that data. A computer-based algorithm that uses AI has the ability to analyze any form of input data such as ‘training sets’ using pattern recognition which eventually predicts as well as categorize the output, all of that is beyond the scope of human processing or analytical powers that uses traditional statistical approaches. In the field of telemedicine, the adoption of AI and ML still has to go a long way till its vital concepts are understood and applied likewise, nevertheless, the current scenario gives a promising picture where many research projects have applied AI to predict the risk of future disease incidence, decrypting cutting-edge imaging, evaluating patient-reported results, recording value-based metrics, and improving telehealth. The perspective to mechanize tasks and improve data-driven discernments may be comprehended by profoundly improving patient care with obligation, attentiveness, and proficiency in prompting AI.

Drawbacks of artificial intelligence in telemedicine (more…)

Mid-week roundup: Holmes turns herself in, ChatGPT as good ER explainer, VA Spokane to cut staff to pay for Oracle Cerner EHR problems?, former Cerner campus conversion

May 31, 2023 | by

Holmes’ time at Bryan begins. Today (30 May) in a Texas morning, Elizabeth Holmes self-surrendered to the Federal Prison Camp (FPC) at Bryan to begin her 135-month sentence (11 years+). With good behavior and enrollment in certain programs, she may serve about 85% or about 9.5 years as No. 24965-111. The ‘shakycam’ video link here from Sky News (scroll to 3:18) initially from across the street then at the fence shows her delivery in a NY state-plated Ford Expedition to the facility parking lot. Her parents give her paperwork to the officers, then she with the officers walk into the camp facility, with a goodbye wave by partner Billy Evans (ballcap by the car). After all the drama, the denouement is bog-standard save for the paparazzi. She is wearing glasses, a tan sweater and blue jeans, the latter two which will be exchanged for a uniform. Many might be surprised that the prison camp has green grass lawns and trees, without towers or impenetrable fences. This is a low security facility for 650 women on 37 acres, but it remains a prison with all the schedules and restrictions that entails.

Her appeals to the Ninth Circuit Court on her conviction and sentencing, with now the restitution, continue as does the puzzle of how to compensate the victims identified by the US District Court as being owed $452 million payable jointly by her and Sunny Balwani. The order of restitution is here (PDF) There are a dozen identified financial victims from the relatively small (the Eisenmans’ $150,000) to the $125 million of Keith Rupert Murdoch. Both Safeway ($14.5 million) and Walgreens ($40 million) are identified separately. At this point at Bryan, she will be earning between $0.12 and $1.15, earning perhaps $25 every four months based on older data. According to the BBC article today, half of that will go to her victims, said Randy Zelin, a professor at Cornell Law School. The Feds will continue to scrutinize for hidden assets. Mercury News

Our Theranos Saga that started in October 2015 now endeth here, except for news on appeals or changes in circumstances.

On a somewhat lighter note, this non-paywalled Insider article charts the up and downsides of using ChatGPT as an explainer to patients in the ER/ED.  Joshua Tamayo-Sarver, MD, has been an ER doctor for almost 14 years as well as a VP of innovation for two healthcare tech companies, Vituity and Inflect Health. He recently started using ChatGPT4 as an adjunct to treatment, to explain difficult emergency situations to patients and family in simple non-medical language. Dr. Tamayo-Sarver’s article in Fast Company provides a solid narrative of how the simplicity and empathy of ChatGPT’s explaining treatment (in this case of a 96 year old woman with lung edema and dementia) works and helps the staff de-escalate the situation developing with her children and give them a chance to start her correct treatment determined by the doctor, not ChatGPT. (What was her outcome?) As the doctor explains, working with ChatGPT is inadequate for diagnostics, but adequate for ‘hungover intern’ level actions: taking patient history, creating long-form communication for patients and staff, and explaining highly technical information with empathy and compassion.

Will the Spokane VA location which proved to be The Last Straw for the VA with Oracle Cerner from October 2022 pay for it with cuts in staff? This year, Mann-Grandstaff VA Medical Center is projected to run a budget deficit of about $35 million. In a March email, the Mann-Grandstaff director Robert Fischer stated that the Northwest VA VISN (regional) director said this will require Mann-Grandstaff to cut about 15% of staff. Yet the VA chief of VA health care, Shereef Elnahal, has denied this. The controversy around this has prompted VA’s secretary, Denis McDonough, to issue a statement that he will look into these reports but stopped short of confirming that no staff would be cut. Spokesman-Review (Spokane)  Hat tip to HISTalk 31 May

Cerner’s Continuous Campus in Kansas City, Kansas, apparently will be redeveloped. Two local developers are in contract with Oracle to buy the empty 63.5 acre property with twin nine-story office towers. Last week, local authorities approved rezoning with an amended master plan. Developer plans are to convert the north tower to 224 to 232 market-rate apartments above ground-floor commercial space. While the plan for the south tower is to stay as 660,000 square feet of office space plus parking, no interest has come from lessees. According to reports, Oracle’s purchase of Cerner and shutdown of many operations in the area dumped 4.1 million square feet of real estate in the area.  Fox4KC

Flat is Good: CB Insights’ Q1 global digital funding, deal numbers finally steady

May 25, 2023 | by

CB Insights’ quarterly global digital funding roundup had some good news for a change–the bleeding may be stopping, despite the failures of funding havens Silicon Valley Bank, Signature Bank, and First Republic Bank.

  • Funding was flat in Q1 2023 from Q4 2022 at $3.4B. Flat was positive, as every quarter in 2022 fell between 25%-35% versus the previous quarter.
  • Yet this was contrary to the decline seen in the total venture capital area, where funding fell 13% from Q4 2022 to Q1 2023
  • Deal numbers went up by 1% from Q4 2022’s 383 to 387–essentially flat, while venture deals fell again for four quarters
  • Leading in deals and funding was care delivery and navigation tech–44% of total funding and 37% of deals. It also had the largest deal size–$12.6 million–and five of the top 10 deals. Trailing a distant second was monitoring, imaging, and diagnostic tech, with 20% of total funding and 23% of deals.
  • In the back of the pack, early-stage companies made up a minimum of three-fourths of their deals: drug R&D tech (75% early-stage deal share), digital therapeutics & wellness tech (76%), and health insurance & RCM tech (81%)
  • In Q1, Europe’s digital health funding at 18% of total was $612 million. EU deals are picking up and are now at a record-high deal share (26%) in Q1 2023. US funding continued to lead, with $2.3 billion in digital health funding, equivalent to 68% of the global total. 
  • Mega-rounds remain anemic: 17% of digital health funding which is the lowest since Q2 2019. They were three: kidney care company Monogram Health’s $375 million raise, primary care provider Carbon Health’s $100 million, and fertility startup Kindbody’s $100 million. Comparing year prior for Q1, mega-rounds declined 85% between 2023 and 2022.
  • M&A exits finally increased in Q1–to 39 from 15 in Q4 2022

CB Insights summary points. The full report is available to their customers. Also Healthcare Dive.

Another Bright Health selloff: Zipnosis sold to Florence Labs

May 24, 2023 | by

Bright’s money-raising continues. Bright Health’s Zipnosis was sold to Florence Labs for an undisclosed amount. Zipnosis, acquired stealthily by their Minneapolis neighbor Bright in the latter’s Happy Time of April 2021, is a telemedicine/telehealth company that provides white-labeled ‘digital front door’ asynchronous telehealth and diagnosis triage for large health systems fully integrated into hospital EHRs. Today’s release does not mention acquisition cost or management/employee transitioning, though Zipnosis is confirmed in their boilerplate to have about 60 employees. One suspects the sale amount was not large.

Notably, the Zipnosis website has been cleansed of any Bright Health identification or releases. A quick look at Zipnosis staff on LinkedIn indicates the cutover (and presumably the sale) took place in March but for various reasons such as financial closings was not announced until today.

Zipnosis is one of telehealth’s Ur-companies, founded in 2009 and gaining 50-60 health systems before their sale. Zipnosis was a good buy, lightly funded, and with a unique technology that fit well and conveniently into EHRs. It was a smart addition for Bright’s practices under NeueHealth along with entree to health systems. Their later and larger competition at least in synchronous telehealth for health systems was Bluestream Health, bought last month by eVisit as more evidence of healthcare consolidation. 

Florence Labs is a just-out-of-stealth startup based in NYC that automates clinical workflows and patient-facing access to address the problem of acute care clinical capacity. It was founded in 2021 by Aniq Rahman (president of Moat, acquired by Oracle in 2017 for $850 million). It was recently and modestly funded (March release) with $20 million in seed capital from Thrive Capital, GV (Google Ventures), and Salesforce Ventures with participation from Vast Ventures, BoxGroup, and Atento Capital. It’s currently working with about 40 healthcare systems, the most recently announced Luminis Health in Maryland.  It’s not to be confused with the significantly larger Florence Healthcare (clinical trial site enablement).  FierceHealthcare

Mid-week roundup: Pear assets fetch paltry $6M *updated*, Bright Health’s reverse stock split, Oracle Cerner loses hospital EHR share, Lifeforce health optimization scores $12M Series A

May 24, 2023 | by

From a $1.6 billion valuation to $6 million in a bankruptcy court is sad. Pear Therapeutics‘ assets were sold at a bankruptcy court auction for $6 million. Even that took four bidders slicing themselves individual pieces.

  1. Nox Health Group of Atlanta ponied up the major bid of $3.9 million for Pear’s Somryst, their FDA-cleared insomnia treatment. Nox Health offers sleep-related treatments to employers and payers.
  2. Harvest Bio anted up $2.03 million for the ISF licenses and patents, plus Pear assets related to schizophrenia, multiple sclerosis, depression, and the remaining pipeline projects. They also bought the corporate trademarks, the PearConnect commercial platform, and the rights to the FDA-cleared reSET and opioid-specific reSET-O programs. Editor’s view: with no discernable website or Crunchbase listing, Harvest’s purpose could be to buy themselves the core of a business. (See below for more)
  3. Click Therapeutics paid $70,000 for the patents that powered Pear’s platform, except Invention Science Fund (ISF) licenses and patents. Click is an NYC-based developer of digital therapeutics to treat migraine, smoking cessation, schizophrenia, depression, and more.
  4. WELT Corp. of Seoul, South Korea, put down $50,000 for Pear’s migraine-focused program. Samsung-backed WELT develops digital biomarkers tracked by smartphones and sensors to track, monitor, and predict health outcomes.

The court filing (PDF) is here. The hearing to finalize the approved bids took place yesterday (22 May) in the United States Bankruptcy Court for the District of Delaware. The $6 million is nowhere near the $32 million in debt that Pear had on the books at the time of their Chapter 11 filing [TTA 13 Apr]. The $1.6 billion was the valuation of Pear at the time of its SPAC in December 2021 and Pear had raised over $400 million previously. Mobihealthnews, STAT

Update 30 May: The mysterious Harvest Bio LLC is now a little less mysterious with the tracking down by STATNews‘ Mario Aguilar that the signatory for the purchase of over $2 million in assets from Pear is none other than Pear’s former CEO, Corey McCann. @mariojoze. Brian Dolan on LinkedIn adds the tracks of a molto stealthy Boston-based funder, T.Rx, which is using a recently set up fund (1/23) to back up McCann’s bid. Former Pear exec (head of search, evaluations, and in-licensing), independent investor, and Zus Health investor Michael Langer appears to be a co-founder and managing director of T.Rx, according to Mr. Dolan. Zus Health raised $40 million back in March and is headed by former athenahealth head Jonathan Bush.

In other implosion news, Bright Health on Monday executed its reverse stock split buying itself time on the NYSE from delisting. The board and shareholders approved a 1:80 split. It is now trading as BHG1 and closed today (Tuesday 23 May) at $14.38. Bright is in real extremis–selling its California health plans, either fined or under investigation in four states, in a lawsuit over unpaid claims with SSM Health, and needing a quick $500 million to pay off their outstanding JP Morgan credit facility. Ouch.  [TTA 7 Apr, 20 Apr, 4 May, 5 May  Mobihealthnews, Becker’s Payer Issues, Seeking Alpha    See 24 May update on their sale of Zipnosis

Oracle needs to execute a turnaround at Cerner. Stat. And it’s not just at the VA. KLAS Research in a report published today calculated EHR hospital market share by both location and hospital beds. Epic is running away with the core hospital market with a 39.5% market share while Oracle Cerner has 24.9%. The KLAS findings are access-restricted, but the publicly available toplines are that Epic is the only vendor with positive net change in hospital market share and beds, while Oracle Cerner has lost beds and gained share in small hospitals, losing large ones. Third ranked is Meditech with a 16.3% share. It’s not unthinkable to shrink out of this business. Once upon a time, GE Healthcare was a major player in this sector with Centricity–and exited back in 2015, retreating to specialty physician practices. Becker’s

In contrast, if it has some celebrity shine, money gets raised. Lifeforce closed a Series A round at what is now a strong amount–$12 million. It promises a clinically integrated approach to health optimization for longevity based on physical and psychological biomarker data, clinical expertise from doctors and health coaches, and validated interventions on a telehealth-based platform. Blood draws every three months are done by registered phlebotomists. It also markets nutriceuticals, peptides, and hormones as part of treatments to members. Co-founded by Dugal Bain-Kim, Peter Diamandis, and Tony Robbins, Lifeforce is endorsed by Serena Williams. The $12 million raise was co-led by M13 and Peterson Ventures with participation by Ridgeline Ventures, Rosecliff Ventures, and Seaside Ventures. The maintenance program starts at $349 for an initial baseline assessment and $129 per month for membership thereafter. However, when this Editor as a marketer sees claims in the release headline such as “World’s Most Effective Health Optimization Platform”, yellow flags start flying. Mobihealthnews, Lifeforce release

Thursday roundup: Kaiser-Geisinger won’t close till ’24, Validic buys Trapollo, Veradigm’s ’22 financials delayed again, ORA telehealth’s $10M Series A, ATA adds 3 to board

May 18, 2023 | by

Some more reveals on the Kaiser Permanente/Risant Health/Geisinger Health deal. Perhaps the most significant one in Kaiser’s quarterly financial statements was that the closing with Geisinger is projected to be sometime in 2024, subject to the usual regulatory approvals. As announced in April, Geisinger will be the founding system of a new non-profit group, Risant Health, that will bring together a targeted five to six non-profit community health systems. Financial disclosures were also made that were centered on the timing of substantial investments and commitments:

  • Kaiser’s financial commitments to Risant will be made in the five years following closing. The $5 billion previously announced is the upper end of the support. Confusingly, Kaiser is also committing to a minimum investment of $400 million over five years inclusive of funds generated by Risant Health. 
  • Risant’s support and investment into Geisinger will end earlier, in 2028, but in that time will make an investment of a minimum of $2 billion to support Geisinger’s hospital, technology, and strategic development. It will be inclusive of funds generated by both Risant and Geisinger.
  • Risant will also make available to Geisinger no less than $100 million” through 2028 to support expansions of Geisinger’s health plan and care delivery services into bordering Pennsylvania communities.
  • Risant will also make available to Geisinger funds for research and education for 10 years after the 2024 closing

Kaiser’s Q1 was far better than its money-losing ($4.5 billion) 2022, with $1.2 billion in net income. Geisinger has not yet reported Q1, but it had a $842 million net loss in 2022.  FierceHealthcare

Digital health/personalized care company Validic is buying Trapollo, a similar connected care company. Both have platforms facilitating chronic care patient management via remote care and EHR integration. The acquisition price and workforce transitions were not disclosed. Trapollo’s former owner, Cox Communications, will become a shareholder in Validic. Trapollo senior VP/general manager Steve Nester will have the same title at Validic. It will remain at the Validic HQ in Durham, NC, with Trapollo’s former distribution center remaining in Sterling, VA. This continues the trend of consolidation of businesses in similar or complementary services. Release

Veradigm, the former Allscripts, 2022 financials continue to be in a tangle. As previously reported [TTA 3 Mar], Veradigm delayed its Q4 and FY 2022 reporting due to a software flaw that affected its revenue reporting going back to 2021. On 22 March, this expanded to their extending their year-end audit and 10-K filing because of “internal control deficiencies related to revenue recognition.” In a recent SEC filing, they stated that they may be able to file their 10-K by 14 June, but cannot guarantee it. The revenue impact may be as high as $40 million and affect their 2021 closing. HIStalk 5/17/23

Singapore’s ORA Telehealth just scored the region’s largest Series A raise–US$10 million. It was co-led by TNB Aura and Antler with participation from Gobi Partners, Kairous Capital, and GMA Ventures for a total funding to date above US$17 million. ORA is unique in that it’s a vertically integrated platform that markets to a young customer base (average age: 38) on three platforms: Modules (676 different formulations of prescription skincare), OVA (women’s health), and andSons (men’s health).

The American Telemedicine Association (ATA) welcomed three additions to its board this week:

  • Marc Adelson, JD, Teladoc Health’s deputy chief legal and global chief compliance officer. Prior to joining Teladoc in 2011, he was  co-founder and executive legal director of the Institute for Patient Safety & Quality in Virtual Care, the first federally qualified patient safety organization (PSO) focused on virtual care.
  • Kavita Patel, MD, MS, a practicing primary care physician at Mary’s Center, a Federally Qualified Health Center in Washington DC and Maryland. She is also a venture partner at New Enterprise Associates, an NBC/CNBC/MSNBC contributor, and was formerly director of policy for the Office of Intergovernmental Affairs and Public Engagement in the Obama administration
  • Sarah Pletcher, MD, MHCDS, system vice president and executive medical director for strategic innovation at Houston Methodist, and responsible for advancing a wide range of virtual and other innovative care models and solutions.