Extending telecare services to 800,000 more people could save the UK £14.5bn: study

February 18, 2022 | by

An economic analysis by digital connectivity consultancy FarrPoint found that extending telecare and technology-enabled care services to more people aged 75+ could achieve benefits of  £14.5 billion over the next decade. By country, the savings are £12.3 billion in England, £1.1 billion in Scotland, £717 million in Wales, and £370 million in Northern Ireland.  The benefits are improving social inclusion, wellbeing and community resilience, alleviating bed blocking and hospital admissions which are highly quantifiable costs to the healthcare system.

Currently, 2 million people use telecare services in the UK. Based on current take-up rates of 1 in 5 (aged 75+), if this were 1 in 3, an additional 800,000 people could benefit from access to technology-enabled care across the country (eHealth Scot). Over the next decade, that group will likely grow to 1 million, totaling 3 million of the estimated 7.3 million aged 75+ in 2030 (Office of National Statistics estimate)

FarrPoint’s point of view is that the expansion of telehealth is necessary to alleviate the coming demographic crunch in the social care system to prevent a crisis. Their definition of telecare is a modest one: pendants connected to alarm centers and door, bed, and fall sensors.

Their findings are also linked with the first-ever telecare analysis across Wales for TEC Cymru, the program responsible for supporting the shift to technology-enabled care in Wales, where 67% of councils are moving from analog to digital technology for telecare services to their current 77,000 persons, mostly over 65. FarrPoint article

Caveat: we do hope they account for the downsides of VOIP and power outages cutting all telecom off to the vulnerable, all too common in the rural parts of the UK where they live [TTA 21 Dec 21].

Hat tip to Adrian Scaife, who has moved to the ‘Big T’ as Group Product Manager Housing at Tunstall Healthcare (in a smart move on their part!)

The ‘digital premium’ in the future of health, housing, and social care explored in new GGI paper

February 17, 2022 | by

A new paper by the Good Governance Institute (GGI), Resetting the digital premium, outlines the impact of embracing digital across public services. It is about what the ‘digital premium’ is, why it matters,  and how to move forward with digital technology in the health, housing, and social care areas. For boards in these areas, it provides practical advice and guidance on finding the best ways to provide comprehensive, high-quality digital services. Andrew Corbett-Nolan, CEO of GGI, added that “This paper comes at an incredibly important time, as boards have the opportunity to use digital products with a new approach to support the move forward from the ongoing Covid pandemic.”

Funded by a grant by Legrand Care, the report explores four themes at the heart of the digital premium: place, predictive technology and population health, security and wellbeing at home, and new digital standards. It is the second paper in the series, the first published in 2020 [TTA 26 Feb 2020].

The GGI created this report using multiple methods including desktop research, interviews, roundtables with NHS and other key public, third sector, and private organizations (in the UK and internationally), with an editorial board made up of senior health, housing, and social care leaders. 

Chris Dodd, CEO of Legrand Care, noted that “I welcome this latest whitepaper from the GGI and fully support the premise that connecting digital ‘thinking and doing’ with good governance enables proper stewardship of public assets and the public interest, but in doing so we must continue to tackle the digital divide and ensure we bring all on this transformational journey. This connection grounds strategic digital issues in real accountability, not just in organizations but in new networks, systems, and collaborations between organizations on which the future evolution of health, housing, and social care depends.”

The free five-part report is available for download on the Tynetec website. A tip of our cap to Kathryn Burton of Legrand Care for this news, and Legrand Care and Tynetec for their continued support of Telehealth & Telecare Aware. Their release is here.

DOJ to block UnitedHealth-Change Healthcare buy: report

February 17, 2022 | by

Change is controversial, at least for UnitedHealth. Healthcare Dive reported today that the Department of Justice (DOJ) is preparing a lawsuit to block UnitedHealth from purchasing Change Healthcare. Their source is a report published on a subscription financial website, Dealreporter, that their sources say that both companies will be meeting with the DOJ for what is charmingly called a ‘last rites’ meeting. Apparently, all the companies’ plans for divestitures [TTA 26 Jan] are not enough to satisfy DOJ on the antitrust issues raised not only by the DOJ, but also strongly by the American Hospital Association and the National Community Pharmacists Association.

Announced in January, the merger approval had been tabled in August and October/November, with the closing delayed accordingly, so the DOJ action resulting from their mandatory review under the Hart-Scott-Rodino Antitrust Act (HSR) was anticipated. Even in August, the delay did not bode well for this $8 billion in cash/$5 billion in debt deal.

What’s at issue here is the consolidation of data and businesses both UH and Change are in–health IT and revenue cycle management–and reduced competition that drives up costs for health systems and providers. As this Editor observed in March, OptumInsight, Optum’s data analytics unit, and Change provide a similar range of services in health IT and revenue cycle management (RCM). As one of the largest independents in these areas, Change contracted with providers and had access to the data of 1 out of 3 patients. Optum’s parent, UnitedHealthcare, is also the largest US payer. These were the factors that made those represented by the American Hospital Association (AHA) very nervous indeed [TTA 25 Mar] regarding pricing of these services–and they expressed their misgivings cogently in a seven-page letter (PDF link) to DOJ on 17 March. In their view, Change integrated into OptumInsight would reduce competition and increase pricing in RCM, claims clearinghouse and payment accuracy services, and clinical decision support services.

In DC, the view of what is anti-competitive is cyclical. The 2020 acquisition of WellCare by Centene was approved with nary a whinny. CVS-Aetna took forever because of a showboating judge, but was finally approved in 2019. Yet only two years before, the Aetna-Humana and Anthem-Cigna mergers were doomed to fail. In this administration, large mergers do not fare well; both Aon-Willis Towers Watson and Lockheed-Aerojet Rocketdyne were canceled.

Expect to hear more by end of month. 

Wednesday roundup: athenahealth acquisition closes, Tyto Care receives lung sound CE Mark, NHS’ elective care recovery plan for 6 million, NSW health secretary to Telstra Health

February 16, 2022 | by

Bain Capital and Hellman & Friedman completed their $17 billion acquisition of athenahealth on Tuesday. The purchase was from Veritas Capital and Evergreen Coast Capital, which remain minority shareholders along with an affiliate of GIC and a wholly-owned subsidiary of the Abu Dhabi Investment Authority. athenahealth claims over 140,000 ambulatory care providers in the US, which is not much growth considering they had 88,000 in 2017 and reportedly grew to 160,000. Release 

Telehealth diagnostic monitor Tyto Care received CE Mark approval for the Tyto Lung Sounds Analyzer. It is a standalone Software as a Medical Device (SaMD) that alerts to the potential presence of an abnormal breath sound in respiratory recordings that may be wheezing in adults and children. The analysis is based on their database of clinical exam recordings. Release

Whither the 6 million waiting? The NHS intends to reduce the backlog of elective care caused by the pandemic through the Delivery plan for tackling the COVID-19 backlog of elective care. Highlights are the rollout of a new online platform called My Planned Care, as well as plans for 100 community diagnostic centres, new surgical hubs, and increased capacity to offer tests, checks, and treatments–over three years. Healthcare IT News

And in Australia, the revolving door spins. Elizabeth Koff, secretary of NSW Health, will be moving to Telstra Health as managing director effective 1 July. She succeeds Mary Foley, who will continue to be a special adviser and a non-executive director of the board. Ms. Koff has spent three decades in the state health department which manages 228 hospitals and around 127,000 staff. New South Wales was subject to severe lockdowns in 2020 and 2021, which continue to a lesser degree.  Healthcare IT News ANZ

Owlet gets back into the baby zzzzz’s market with Dream Sock and Dream Duo–but now not medical devices!

February 16, 2022 | by

Without a splash or fuss, Owlet reintroduced its baby monitoring sock as the Dream Sock last month. Formerly known as the Smart Sock, Owlet got into FDA Hot Water in October [TTA 4 Dec 21] with their marketing the Smart Sock, which monitored sleep patterns, blood oxygen saturation, and pulse rate, as a medical device that would fall under 510(k) marketing clearance requirements, including premarket approval (PMA). The Smart Sock and Smart Duo were pulled from market on 22 November.

The Dream Sock, according to Owlet’s product page, is all about baby sleep, measuring sleep quality indicators, including wakings, heart rate, and movement. It provides a sleep quality score via a sleep coaching app. The difference between the old sock and app is that the blood oxygen saturation (SpO2) measuring capability is deleted. The SpO2 monitoring and the claims they were making were likely causes of the FDA’s warning.

The web store listing is for $299 for a Dream Sock fitting up to 18 months, with the Dream Sock Plus, which fits 0-5 years, at $359. The Dream Duo adds the Cam video baby monitor to the system for babies up to 18 months for $399. Sales are restricted to the US at this time. The products can also be found on the usual web stores.

On both the home page and on the product pages, the disclaimer statement is loud and clear:

WARNING: Owlet products are not medical devices. They are not intended for use as medical devices or to replace medical devices. They do not and are not intended to diagnose, cure, treat, mitigate, alleviate or prevent any disease or health condition, or investigate, replace or modify anatomy or any physiological process. [snip]

Digging into the website, Owlet states that they are “actively pursuing submitting a medical device application to the FDA to bring the Smart Sock technology to medical and consumer markets in the future.”

Owlet shares (OWLT:NYSE) have taken a massive value drop since it completed its SPAC with Sandbridge Acquisition Corporation and parked in the Unicorn Lot last July. It opened at $8, crested to over $10 in mid-August, then started to drop precipitously before Labor Day. It closed on Tuesday at $1.83. If only for the Cute Factor, one wishes them luck.

Friday’s really quick takes: Oracle-Cerner starts Federal reviews, Curve Health, Signify buys Caravan, and a gaggle of single name companies!

February 11, 2022 | by

The long and winding road of Federal scrutiny–and other legal actions–begin for Oracle and Cerner. To be expected, the first hurdle is a review under the Hart-Scott-Rodino Act, by the Federal Trade Commission (FTC) and the US Department of Justice (DOJ). This should conclude by 22 February. The Securities and Exchange Commission (SEC) is also reviewing. As is routine in takeovers of public companies, there are seven civil filings by ‘supposed’ Cerner stockholders in either the District Court for the Southern or Eastern District of New York, their favorite venue, all claiming lack of information. Expect more. Kansas City Business Journal (which may be paywalled), Becker’s Health IT

New York-based newcomer Curve Health scored a $12 million Series A from Morningside Ventures with participation from Alumni Ventures and Recover-Care Healthcare, as well as returning investors Lightspeed Venture Partners, IDEO, Inflect Health, and others. Total funding is now $18 million (Crunchbase). Curve Health specializes in ‘virtual hospital’ telemedicine for skilled nursing facilities (SNFs) and community paramedicine, along with billing and health information exchange. Last July, they partnered with CareConnectMD, a California-based provider group that delivers value-based care for people living in nursing homes via its High Needs Direct Contracting Entity (DCE). Curve’s founder, Tim Peck MD, previously founded Call 9, a telemedicine/onsite service for nursing homes, which closed in July 2019 [TTA 15 May 2020] Release

Signify Health, a senior home care and value-based care provider, is acquiring ACO organizer and management services provider Caravan Health in a $250 million cash/stock deal with contingent additional payments of up to $50 million based on performance. Caravan’s founder and the current CEO will be joining Signify. It’s a move that may bolster Signify, which has had a few valuation challenges, because it expands Signify’s provider base and expands its current narrow episodes of care area (the former Remedy) into additional advanced payment models. Release, Mobihealthnews

Short short takes on single-word company news….

Expressable’s remote speech teletherapy platform closed a $15 million Series A funded by F-Prime Capital and including existing investors Lerer Hippeau, NextView Ventures, and Amplifyher Ventures. The new funding will go towards national expansion. FierceHealthcare  Hat tip to this Editor’s former colleague Amy VanStee, who recently joined them.

Balanced is a new digital platform for exercise coaching targeted to older adults. Users can modify based on assessed fitness level, input injuries, health conditions, and fitness goals. They added to an early seed round to total $6.5 million in seed funding, led by Founders Fund and Primary Venture Partners, with participation from Lux Capital and Stellation Capital. Cost for unlimited use is a gentle $20 per month. Given yesterday’s near-implosion of that expensive must-have of the aggressively fit and heavily dripping, Peloton, is fitness getting real?  Mobihealthnews

AndHealth, founded by the CEO plus veterans from CoverMyMeds, now has $57 million from Francisco Partners, with participation from the American Medical Association’s venture capital arm Health 2047, Kirkland & Ellis and Twofold Ventures. AndHealth specializes in Virtual Centers of Excellence (VCOE) programs for migraine and autoimmune disease reversal programs as an employer-sponsored benefit. Release

Berlin-based Ada extended its Series B by $30 million for a total of $120 million. Ada partners with major pharma for its AI-assisted symptom assessment app. TechEU

Nurx is merging into Thirty Madison. Nurx is primarily a provider of birth control, women’s and sexual health meds via telemedicine, while Thirty Madison specializes in telemedicine for chronic conditions. Thirty Madison was valued at over $1 billion after its Series C round in June. Nurx’s lines will be added to Thirty Madison’s menu which includes Keeps (hair loss) and Evens (GI issues). FierceHealthcare

Wednesday roundup: Amazon Care now (actually) nationwide, Australia’s Eucalyptus telehealth’s A$60M, Withings 2 buys, Glooko buys xbird, HoloLens for nurse-GP comms in Cumbria

February 9, 2022 | by

Amazon Care, which has compiled a history of playing their news quite close to the vest, coyly dropped another hankie on their website today with a blog post that confirmed that their virtual care platform is now available nationwide. In 2022 they will be adding in-person services to 20 more cities, including San Francisco, Miami, Chicago, and New York City. Companies offering Amazon Care as an employee benefit include Silicon Labs, TrueBlue, and Whole Foods Market (an Amazon company). Back in October, TTA outlined our thoughts on Amazon Care’s structure, offerings, cheap pricing, and our opinion that Amazon’s real aim is to accumulate and own national healthcare data on the service’s users. Then they will monetize it by selling it to pharmaceutical companies, payers, developers, and other commercial third parties in and ex-US. Patients may want to think twice.

On a lighter note, Australia’s Eucalyptus telehealth scored a tidy Series C of A$60 million ($42 million), led by Airbnb and Canva’s early investor, BOND, plus previous investors. Eucalyptus’ telehealth platform markets five services: men’s health-focused Pilot, women’s fertility brand Kin, skincare site Software, sexual health business Normal, and menopause service Juniper. The fresh funds will go towards software development and expanding into the UK. Mobihealthnews

Withings is also on a bit of an acquisition tear, buying Berlin-based nutrition app 8fit on top of last month’s Impeto Medical, which developed a tool for monitoring peripheral neuropathies. 8fit offers efficient workouts, customized meal plans, and self-care
guidance in six languages. While the acquisition cost was not disclosed in the release, Withings plans to invest $30 million to integrate 8fit features into their products. Impeto, a R&D company, developed an FDA cleared technology that measures the ability of sweat glands to release chloride ions in response to electrical stimulus. For those with neuropathy, that sweat gland innervation is reduced and sudomotor function is impaired. Impeto’s tool has already been integrated into Withings’ smart scale, the Body Scan, to be released in the second half of 2022 after FDA clearance. Release, Mobihealthnews

Another Berlin-based company in AI that’s been acquired is xbird. The buyer is Glooko, a diabetes and chronic condition monitoring platform. xbird captures data generated by devices and processes it through algorithms and machine learning models, and will expand expands Glooko’s advanced analytics capabilities and tools. The management and staff will join Glooko GmbH. Glooko release

Closing our update is a Cumbria catchup. Nurses at Kendal Care Home are wearing Microsoft’s mixed-reality HoloLens 2 headset to call GPs through Microsoft Teams. Using the HoloLens, doctors can talk to both the nurses and patients. Kendal Care Home has been working with local GPs, Kendal Integrated Care Community, and University Hospitals of Morecambe Bay NHS Foundation Trust to train staff in the use of the headset, which started use at Kendal in October 2020 and has largely replaced their tablets and smartphones for telehealth consults. In addition to Kendal, the Heart Centre at Alder Hey and Imperial College Healthcare NHS Trust used HoloLens 2 during the pandemic. DigitalHealth.net

The devil is in the (migrated) data: GAO watchdog barks at the VA’s transition from VistA to Cerner

February 9, 2022 | by

The US Government Accountability Office (GAO) released their “watchdog” report on the Department of Veterans Affairs’ first, failed implementation at Spokane’s Mann-Grandstaff VA Medical Center in October 2020. Their 52-page whopper of a report came to a simple conclusion: the VA didn’t ensure the quality of the data migrating from the EHR warhorse VistA and their Corporate Data Warehouse to Cerner Millenium. Thus clinicians couldn’t use Cerner two ways–one was training in how to use it (as noted in VA’s own analysis) so they could not find the patient information they needed–and the fact that even if they knew how to use it, the data migration apparently was incomplete. The GAO found that the VA did not establish performance measures and goals for migrated data quality based on Federal guidance. The result was inevitable. According to the report, “clinicians experienced challenges with the quality of migrated data, including their accessibility, accuracy, and appropriateness.” 

There is also a method called a stakeholder register which helps to identify and engage all key stakeholders. VA did not use this, so some areas were overlooked in the continuity of reporting and preservation of records. This affects not only patient records, but also scheduling.

The main takeaway is that GAO recommends to VA that they establish performance measures and goals that ensure the quality of migrated data and use a stakeholder register managed by the VA’s deputy secretary to engage all the relevant stakeholders in the migration in reporting needs. VA published its own analysis of its implementation and rollout failures in December. Healthcare IT News

The end of the bubble? SOC Telemed, SPAC’d at $10 per share, acquired for $3 and $300M by Patient Square Capital

February 8, 2022 | by

SOC Telemed (NASDAQ: TLMD), one of the earliest health tech SPACs [TTA 4 Aug 2020], is going private in a deal with the Sand Hill Road healthcare investment firm Patient Square Capital. Patient Square is paying $3 per share in cash.

Based on the 100,840,000 shares outstanding (MarketWatch), this Editor’s best estimate of the transaction is about $303 million. Holders of 39% of the outstanding shares have already voted in favor of the transaction. The deal includes a 30-day “go shop” period in which SOC Telemed’s board of directors can solicit additional bids. Unless there is a superior bid, the deal with Patient Square is expected to close in the second quarter of 2022. 

According to the release, Dr. Chris Gallagher, CEO since September of 2021 will remain. He was previously co-founder/CEO of Access Physicians, a multi-specialty acute care telemedicine business acquired by SOC Telemed in March of 2021. SOC Telemed claims to be the largest telemedicine provider in the US acute care market, supplying virtual consults in specialty areas such as neurology, psychiatry, and ICU. 

Here is where it gets interesting–and worrisome for telehealth. SOC Telemed’s SPAC in August 2020 started at $10.00 per share and a valuation of $720 million. On 2 February, two days before the announcement, SOC Telemed was trading at $0.64 per share. That is a plunge of 94% from the SPAC, with a 72.6% drop in the prior three months that was only arrested by the buyout. The reality is that the Patient Square offer represents a 368% premium over SOC Telemed’s closing share price on 2 February. It is currently trading in about the $2.75 range. 

The worrisome trend is that since August, the publicly traded and established industry giants, Teladoc and Amwell, have also taken it in the shins on their share prices. Teladoc has tumbled by half and Amwell (American Well) by 60%. Even the private companies like MDLive and Included Health (Grand Rounds + Doctor on Demand) must take note that telehealth consults have plunged to about 4% of claims. SPACs, which had opened up an alternate, less complicated channel of public financing for health tech and had its own role in inflating company valuations, have faded due to a combination of circumstances. Will more cautious investments and fewer IPOs be the trend in telehealth for 2022?

Predictions, predictions for telehealth, digital health, and all those cybersecurity risks

February 3, 2022 | by

crystal-ballJanuary is the month for predicting what’s ahead, and while this Editor has no pretensions to be Sibyl the Soothsayer despite the picture, let’s look at what others see in their cloudy crystal balls.

Frank McGillin, CEO of The Clinic by Cleveland Clinic, works intensively with telehealth in this joint venture between Cleveland Clinic and Amwell. His prediction: telehealth will evolve towards concierge care, as providers reduce “platform sprawl”, coordinate the virtual care experience, and provide multidisciplinary virtual care.

  • Telehealth is now “a permanent mode of access”, though the pandemic created “platform sprawl” as providers reached for any and all modes and providers which could be implemented quickly
  • Healthcare providers and plans now have to scale back and reconcile all this to “design a digital trajectory with intention”
  • This means developing a personalized approach to telehealth delivery and to provide a seamless, highly coordinated care experience
  • Their approach is to focus on multidisciplinary virtual visits and case analysis for patients with complex conditions, such as their Virtual Second Opinions program for conditions such as brain tumors and prostate cancer.
  • Virtual multidisciplinary support reduces the risk of suboptimal treatment plans and can eliminate long travel times and exposure to COVID-19 for vulnerable patients. For payers and employers, this can add up to better outcomes and reduced cost of care.
  • “Intelligent” remote monitoring also removes another layer of risk in providing the right care at the right time
  • Continuation of relaxed interstate licensure requirements are needed to provide fast access to medical experts, particularly for primary care providers.

Interview with Healthcare IT News 

Healthcare Dive has been running a series on industry trends, and this installment focuses on digital health.

  • Healthcare will become more predictive and proactive, with insights fed by connected devices and analytics (commonly lumped under AI) that enable organizations to collect, analyze, and act on massive amounts of data.
  • But algorithms don’t have judgment and data can have bias, leading to poor decisions, such as the distribution of vaccines. Expect more oversight from the Federal level down on AI research and policymaking, 
  • Virtual care will continue to grow in virtual diagnostics, patient-reported outcomes applications, and digital homecare platforms
  • Telehealth and digital health is integrating into the traditional delivery and payment model–partnerships with health systems, payers, and employers.
  • Virtual care access is booming in niche areas such as women’s health, hospital at home, and mental health, with investment dollars flowing in. Telemental health is moving into consolidation.
  • Cybersecurity will become more of a focal point for healthcare companies in 2021, with hackers finding their way into all these contact tracing apps designed in a hurry, plus digital health systems, many of which are poorly protected. Targeted attacks have skyrocketed.

And speaking of cybersecurity, over at HealthITSecurity, they rounded up the experts to opine on All Those Security Risks that fast implementation of telehealth and moving devices out of the hospital walled garden have created. Remote patient management is now an asset, no longer a ‘nice to have’, for providers, setting up a situation where patients are increasingly both the beneficiaries of more convenient health delivery and victims of security breaches and ransomware.

  • ‘Out of hospital’ care means that data is being transmitted between multiple points. Network security isn’t guaranteed. So attacks can originate at the weak points–either the home or hospital environment.
  • The fast implementation of telehealth during the pandemic meant not only did systems not work together well, it also meant multiple points of vulnerability
  • Over 80% of surveyed healthcare providers globally harbor concerns about data security and privacy (Kaspersky/Arlington Research). And a shocking 70% admitted that their practice used outdated legacy operating systems, exposing them to security vulnerabilities.
  • “A culture of security” means maintaining endpoint security and BYOD policies across the organization’s network, identity management and zero trust tactics, and yes, security consciousness on patients’ parts.
  • Patients should not be responsible for security, providers partly, which leaves the responsibility with the vendor. But healthcare organizations are responsible for evaluating their vendors, and how they are interacting with and storing their data.  

Congress calls to extend PHE telehealth flexibilities; FCC’s $48M telehealth funding boost, telehealth’s shortcomings in pediatric asthma treatment

February 2, 2022 | by

Permanent telehealth flexibility and expanded use still being debated, and still stuck in Congress. The expansion of telehealth that came with the US public health emergency (PHE) isn’t permanent, despite some expansion plugged into the Medicare Physician Fee Schedule. That can only come with legislation passed by Congress and signed into law–and it is still being debated. A fresh group of 45 Congresscritters (this Editor can’t restrain a certain sarcasm) is now plumping for a more permanent extension for a set–but undefined– time, as part of February funding legislation. This effort is being led in the Senate by Brian Schatz, D-Hawaii, and Roger Wicker, R-Mississippi. Oh yes, the power of a letter to the House and Senate majority and minority leaders (sigh!) Meanwhile, the CONNECT for Health Act and the Telehealth Modernization Act have languished for months in the Senate Finance committee and in House Ways and Means. Healthcare IT News

Over at the Federal Communications Commission (FCC), they’re doling out the sixth and final tranche of $47.89 million to 100 provider and community health organizations that applied to the COVID-19 Telehealth Program. The total FCC funding in this round 2 was $249.95 million that built on funding that was part of the CARES Act. The full list is in the FCC release (PDF). MHealthIntelligence

A combination of in-person care with telehealth as an adjunct may be the best protocol for treating pediatric asthma, a UC Davis Health study found. The first part of the study analyzed EHR records for asthma patients aged 2-24 treated at UC Davis Health in 2020. Of 502 patients, telemedicine usage was significantly lower among:

  • Patients with a primary language other than English (OR = 0.12, 95% CI: 0.025–0.54, p = 0.006)
  • School-aged children (OR = 0.43, 95% CI: 0.24–0.77, p = 0.005),
  • Those who received asthma care from a primary care provider instead of a specialist (OR = 0.55, 95% CI: 0.34–0.91, p = 0.020).

Focus groups are qualitative and should be used for direction and to surface issues, and they did with telehealth. The 12 parents and five young adult patients who were randomly selected and participated stated that:

  • The parents felt that in-person care built better rapport, was more effective in counseling the child and young adult patients on their medication and condition, and more actively engaged their children
  • Parents did not feel confident in correctly using diagnostic tools like peak flow meters and home spirometers on a telehealth visit
  • Scheduling follow-up telehealth appointments was more difficult than in-person 
  • Where telehealth stepped up was convenience–to see their specialist without travel time. The visit also ‘cut to the chase’ by seeing one physician only, not an entire care team. And it was protective of their children during the pandemic. 

Most of the focus group participants agreed that a combination of telemedicine and in-person visits would be preferred when asthma is well-controlled. Published in the Journal of Asthma. Also MHealthIntelligence, which read the study conclusions a bit different than this Editor.

AliveCor releases KardiaMobile ECG in the convenient credit card size

February 2, 2022 | by

AliveCor, the parent company of KardiaMobile mobile ECG devices, is releasing for sale the KardiaMobile Card, a credit card-sized single-lead ECG. It was FDA cleared in November. It’s mighty for its size, detecting six of the most common arrhythmias: atrial fibrillation, bradycardia, tachycardia, PVCs, sinus rhythm with SVE, and sinus rhythm with wide QRS. The pricing is $149 and includes the $99 annual KardiaCare subscription, which renews after the first year. 

In a price and product comparison, the standard KardiaMobile single lead, which is a strip with two press sensors, remains on sale for $169 and the 6L, which has a slightly bulkier sensor but is clinically equivalent to a six-lead ECG, is $239. KardiaCare includes advanced determinations, cardiologist reviews, heart health reports, and more. Owners of older smartphones should review compatibility before buying, however. Release, Mobihealthnews

As of 1 February, there is no update on AliveCor’s legal actions against Apple on patent infringement in the Apple Watch: April’s patent infringement complaint filed with the US International Trade Commission (ITC) [TTA 29 Apr 21] and their late May Federal antitrust suit in the Northern District of California [TTA 9 July 21].

Friday short takes: Uber Health taps geriatrician CMO (updated), Sensyne Health completes £11M financing as part of formal sale, ATA + ECHAlliance ally, add GHCP Summit, Reimagine Care home-centered cancer care lands $25M

January 29, 2022 | by

Uber Health’s first-ever chief medical officer is an unusual choice–a geriatrician. Michael Cantor, MD, JD is a board-certified geriatrician. According to his LinkedIn profile, he had previously been a CMO at insurtech Bright Health and CareCentrix. From the release, his expertise is in designing clinical programs for older adults and vulnerable populations for the most pressing gaps in care–and how technology can address them. Uber’s focus is in mobility–patient transportation and deliveries as part of social determinants of health (SDOH). They report 71% gross bookings growth for the business unit from Q4 2020 to Q4 2021. Release, Healthcare Dive

An update on Dr. Cantor: his CMO position at Uber Health is part-time, according to his LinkedIn profile. He will be continuing at Intuition Robotics as their CMO, having started with them in May 2021 (release). Intuition developed the ElliQ robot companion and is extending it to healthcare for older adults. Hat tip to Laurie Orlov for the info.

Some dismaying news from Oxford is that Sensyne Health, a clinical AI company for life sciences companies that analyzes data from US and UK health system EHRs, is having financial difficulties that have caused them to enter a Formal Sale Process (FSP). The £11.35 million will keep them solvent and not force a stop to their trading on the London Stock Exchange, and the FSP process will organize their outstanding debt until a purchaser can be found. Sensyne was founded by former UK science minister Lord Paul Drayson, and only last May inked two deals with the Colorado Center for Personalized Medicine (CCPM) and St. Luke’s University Health Network (PA/NJ) to expand its dataset. Sensyne release, Healthcare IT News

The American Telemedicine Association (ATA) announced that they will collaborate with Belfast-based ECHAlliance (European Connected Health Alliance) in the Global Health Connector Partnership (GHCP). The GHCP includes HLTH, The Digital Health Society, Health Parliament, the Commonwealth Centre for Digital Health, and Africa Health Business. The Global Health Connector Partnership Summit will convene at ATA2022, 1-3 May, in Boston. Release

Nashville-based Reimagine Care completed a $25 million capital raise led by Santé Ventures, Martin Ventures, and LRVHealth. Reimagine is a provider of home-centered cancer care for oncology practices and providers. The funding will be leveraged to further develop and commercialize the company’s first-of-its kind technology-enabled services in the Access Care Platform, launch their virtual care center, and expand the patient care team. Home-centered treatment reduces costs and increases patient convenience.  Release

Will ’22 digital health investment be historic? Or a question mark? The jury is out.

January 29, 2022 | by

Some say historic, or will it be a historic question mark? It’s only January…Earlier this month, a Silicon Valley healthcare VC funding analysis [TTA 14 Jan] looked at 2021 funding — up over 150%–that was skewed to biopharma and health tech. It noted the SPAC slowdown, anemic post-IPO performance, and a decline in M&A value, while consolidation and buying for expansion will be the trend.

Healthcare Dive spoke to some industry mavens, and came up with a split picture. Some see turbulence ahead due to rising interest rates, a fluctuating market, and political instability leading to tighter purse strings, others see blue skies and lots of money flooding in from new investors in love with health, following the Amazons and Microsofts, fearing that they’ll miss out. Certainly, 2021 was more than warm. Both Silicon Valley Bank in the previous analysis and Rock Health came up with just under $30 billion in 2021 investment.

The feather in the wind: Rock Health’s numbers indicated skyrocketing exits–with SPACs nearly double that of IPOs. Funding hit record mega rounds of $100 million+ that spread to early rounds–10 Series B and one Series A. Mega money means mega pressure to perform in young companies. The SPAC highway increasingly narrowed to a two-lane road by end of year based on regulatory scrutiny and even some timing out (SPACs have to consummate a deal in two years). Exits for investors are to take back money or write off losses, if they get shaky about a company or category, even if they find a more attractive squirrel. Yet the fact is that $13 billion raised by VCs this month has to go somewhere–but will it be in health tech? Time will reveal all.  Also Healthcare Dive on the Rock Health year-end report.

News, deals, rumors roundup: Cerner’s DOD and VA go-lives, Akili’s ADHD therapy SPACs, Talkiatry’s $37M raise, Alto sings a $200M supper–and the Cigna-Centene rumors don’t stop

January 28, 2022 | by

While Cerner’s acquisition by Oracle is winding its way through regulatory approvals, their EHR implementations are moving forward through both the Military Health System (Department of Defense) and the Department of Veterans Affairs (VA).

  • Within the MHS, Brooke Army Medical Center and Wilford Hall Ambulatory Surgical Center, both in the San Antonio (Texas) Market, went live with MHS GENESIS on 22 January. The change most visible to patients is the transition from TRICARE Online to the MHS GENESIS Patient Portal which enables 24/7 access for visit notes, secure messaging, test results, appointment scheduling, and online prescription renewal. MHS covers military retirees, active military, and family beneficiaries. According to the MHS’s website, the goal this year is to get to halfway–to implement MHS GENESIS in more than half of all military hospitals and clinics. It’s been taking place since 2017 and, in true military fashion, it’s planned in waves. Coming up are Naval Medical Center Camp Lejeune in South Carolina on 19 March and William Beaumont Army Medical Center in El Paso in summer.
  • VA is moving far more slowly, just getting to its second hospital. The Columbus VA go-live has been pushed back from 5 March to 30 April, citing training slowdowns due to a spike in staff COVID cases. Walla Walla, Washington is set for after Columbus, but the date is to be confirmed. The first, failed implementation at Spokane’s Mann-Grandstaff VA Medical Center in late 2020 was the subject of Federal hearings and a complete redo in VA’s plans and procedures in cutting over from VistA to Cerner Millenium. TTA 28 July and previous. Federal News Network

Akili Interactive, which has developed tech-driven, game-based cognitive therapies for ADHD and other psychiatric and neurological conditions, has gone public through a SPAC via a merger with Social Capital Suvretta Holdings Corp. I, The transaction is expected to close in mid-2022. Akili will be listed on the Nasdaq stock market under the new ticker symbol AKLI.

The SPAC is expected to provide up to $412 million in gross cash proceeds and value the company at over $1 billion. Investors in the $162 million PIPE are Suvretta Capital Management’s Averill strategy, Apeiron Investment Group, Temasek, co-founder PureTech Health, Polaris Partners, Evidity Health Capital, JAZZ Venture Partners, and Omidyar Technology Ventures. The funds raised will support the commercial debut of EndeavorRx, a FDA-cleared and CE-marked prescription digital therapeutic for pediatric ADHD. The technology is termed the Selective Stimulus Management Engine (SSME) and will be rolled out for ADHD, ASD, MS, and MDD treatment.

TTA noted Akili last year in a trial of AKL-T01 at several hospitals for treatment of long-COVID-related cognition problems. Unfortunately, the writing in their SPAC release made this Editor feel like she needed a few treatments.

Mentalhealthtech (psychtech?) continues to attract funding. Psychiatric care startup Talkiatry topped off its July $20 million raise with an additional $17 million from Left Lane Capital for a $37 million Series A financing round. CityMD founder Dr. Richard Park, Sikwoo Capital Partners, and Relevance Ventures also participated. Talkiatry uses an online assessment for a preliminary diagnosis and then matches you with a participating psychiatrist.  It is in-network with payers such as Cigna, Aetna, UnitedHealthcare (Oxford Health Plan), Oscar, and Humana. Funding will be used to expand beyond NYC. Mobihealthnews

Digital pharmacy is also hot. Alto, which promises same-day filling and courier delivery, raised a $200 million Series E led by Softbank Vision Fund. Their total to date is over $550 million. Alto serves selected areas mainly in California, Nevada, Texas, and NYC (Manhattan, Queens, Brooklyn). Competitors Capsule had another raise of $300 million in April for a total of $570 million and Medly raised a $100 million Series B in 2020. Mobihealthnews

In the wake turbulence of Centene’s dramatic management shakeup last month [TTA 18 Dec], rumors continue to surface that insurer Cigna is interested in acquiring all, or possibly part, of Centene. Bloomberg News in publishing its article earlier this week cited ‘people familiar with the matter’ said that talks took place last year, but that they are not ongoing. Seeking Alpha picked this up, adding market activity boosting Centene. Perhaps the disclosure and the ‘denials’ align with what this Editor has heard–that it’s very much ongoing but under wraps.

A Centene buy makes sense, but only with Cigna. While Cigna is almost double the market value of Centene, it does not have the sprawling business model the latter has, nor do their businesses overlap much. However, some divestiture would be needed to do a deal, given the constrained regulatory environment in the US on the Federal and state levels. Any insurer merger is seen as anti-competitive, unless it is an acquisition of a smaller, struggling plan. 

It certainly would vault Cigna into the top rank of insurers with non-Centene branded exchange, Medicare Advantage and Medicaid plans, a provider network, an established MSO, and other lines of business including Magellan behavioral health management. Cigna might also value Centene’s international holdings, such as private hospitals Circle Health in the UK and Ribera in Spain. A sale would also create a quick and profitable ROI for Politan Capital Management, the activist investor company that initiated the retirement of 25 year CEO Michael Neidorff last month, rather than managing and reorganizing the sprawl of Centene’s businesses to make it more profitable.

Telehealth saves $100+ per visit or lab tests, reduces unnecessary ER/ED + urgent care visits 19%: Cigna/MDLIVE study (updated for RPM offering))

January 27, 2022 | by

Studies which quantify telehealth cost savings and visit reduction are always welcome. Cigna, through its telehealth company MDLIVE (purchased in April 2021), crunched the numbers and found some quantifiable savings and positive results:

  • Depending on whether the visit is for non-urgent primary care, visiting a specialist, or urgent care, telehealth savings are in the $100 range per visit: $93, $120, and $141 respectively. 
  • For urgent care, reducing unnecessary visits to both urgent care clinics and ER/ED settings is a major cost savings and a key measure of health plan performance. Virtual visits were found to reduce unnecessary emergency room or urgent care visits by 19%.
  • Lab visits were also reduced in cost. Patients who saw MDLIVE providers during urgent care visits were able to avoid unnecessary tests, saving an average of $118 for each episode of care.

Unfortunately, some of the results offered up by Cigna are countered by other sources–and surprisingly they didn’t cross-check:

  • Evernorth, their health services business, estimates that telehealth visits are currently 25% of all visits. That is far above the claims information that FAIR Health tracks, where telehealth is below 4%. Back in April 2020, it was 13%. Even Epic’s tracking indicated that the peak of 69% of visits in April 2020 tailed off one month later to 21% [TTA 8 Jan].
  • Citing 2020 only data around virtual wellness screenings and health conditions as a new normal is problematic. Cigna claims that more than 75% of Cigna customers who had an MDLIVE virtual wellness screening in 2020 not only lacked a primary care physician but also that two-thirds of these PCP-less patients learned they had a health condition via the virtual screening. Practices and people were locked down for most of 2020 and these numbers are likely skewed. 

But as quantifiable directional findings, the top three are welcome news. Cigna/MDLIVE release, Becker’s Payer Issues

Updated  MDLIVE announced today a remote patient monitoring program for members with chronic conditions Members can upload monitoring information such as blood glucose or blood pressure to their patient portal so that their MDLIVE doctor can review during the next telehealth visit. This feature will be available to health plans that utilize MDLIVE primary care services. Later this year, they will offer a device interface to the patient portal so that no manual entry will be needed. Mobihealthnews