Contact tracing app ready for Isle of Wight trial this week: Hancock. But is it ready for rollout? (updated)

May 5, 2020 | by

Announced today was what in normal times we’d call a beta test of the contact tracing app [TTA 25 April] developed by NHSX on the Isle of Wight. Transport Secretary Grant Shapps announced it Sunday to Sky News. BBC News detailed today that council and healthcare workers will be first to try the contact-tracing app starting Tuesday at 4pm, with the rest of the island able to download it starting Thursday. Gov.UK  The Isle of Wight has approximately 80,000 households.

Update: How the Isle of Wight residents reacted to the app. BBC News

How the app works: if someone reports COVID-19 symptoms through the app, that information goes to the NHS server and the server downloads that tracking information. The app then notifies the other app users that the person has been in contact with over the past few days, contact being defined as within 6 feet for 15 minutes. This can include someone a person has sat next to on public transport. The tracking in the app is via Bluetooth LE to other mobile phones. The app then alerts contacts with the app and gives advice, including how to get a test to confirm whether or not they do have COVID-19. Users will be able order tests through the app shortly.

Use of the app is voluntary and personal data is limited to postal code and what the user opts in to. So the intent of the app is to warn and test to reduce future outbreaks, as full lockdown is not and cannot be a permanent state. Mr. Shapps stated to Sky that the goal is 50 to 60 percent of the country using the app.

Unfortunately, many of the most vulnerable–older, sicker, and poorer adults–won’t have the smartphone, much less the app, and even with the smartphone, won’t be able to download the app or use it. It’s dependent on self-reporting, which may or may not be reliable. Phones can turn off Bluetooth LE. Another consideration, and one this Editor hopes has been tested, are extremes: extreme density in population and contact areas, and extreme distance, as in rural areas. Additional from BBC News, including a short Matt Hancock clip from the Monday briefing with an almost-touch of his nose or mouth right at the start (!)

The Guardian brings up privacy concerns as well as a Health Service Journal (HSJ) report that the app was ‘wobbly’ and had cybersecurity concerns which would exclude it from the NHS’ own app store. The HSJ story quoted their source stating that the government is “going about it in a kind of a hamfisted way. They haven’t got clear versions, so it’s been impossible to get fixed code base from them for NHS Digital to test. They keep changing it all over the place”.  The reporting data also will reside on NHS servers, not individual phones, but pushes out the alert from the server.

Worldometer gives the current UK statistic as total of 190,584 with 28,734 deaths. While case diagnosis continues to increase, fatalities have been steeply declining. There is concern that COVID is yet to spike in rural areas, as cases have concentrated in Greater London, the Midlands, and the North West. New York and New Jersey alone in the US have over 456,000 cases with just under 32,900 fatalities attributed to COVID-19, 3/4 of which have been in NY–almost as much as the entire UK. (However, the fatality statistic is widely questioned as not screened for contributing causes, since there are certain incentives for attribution.)

In other NHS news, NHS Digital, the information and tech side of NHS (not the innovation unit) has named a new deputy chief executive. Pete Rose will also take on the role of chief information security officer for the Health and Care System, including live services, cybersecurity, solutions assurance, infrastructure, and sustainability.

10 years in 2 months: prognosticating the longer-term effect of COVID-19 on telehealth, practices, and hospitals

May 2, 2020 | by

crystal-ballThis Editor recounted last night in the article below on The TeleDentists’ fresh agreements with Cigna and Anthem the observation of a former associate who has been in the thick of the remote patient monitoring wars for some years that telehealth/telemedicine has progressed 10 years in 2 months. Seema Verma, the head of the Centers for Medicare and Medicaid Services (CMS), stated to the Wall Street Journal (paywalled),  “I think the genie’s out of the bottle on this one. I think it’s fair to say that the advent of telehealth has been just completely accelerated, that it’s taken this crisis to push us to a new frontier, but there’s absolutely no going back.” Even in a short period of time, CMS-reported telehealth visits as of 28 March trebled from 100,000 to 300,000. When the April numbers are in, it would not be surprising to see it grow well into seven figures.

The genie may be out of the bottle, but what will the genie do? Genies are, after all, unpredictable, and fly around.  Out of the smoke, some educated guesses:

  • Insecure, non-HIPAA compliant audio/video platforms will be the first which should be struck from CMS approval. Zoom has become a hackfest, with all sorts of alerts from mobile providers like Verizon on how to secure your phone. (An organization of which this Editor is a member had a panel this week completely disrupted by a hacker in five minutes.) Skype’s problems are well known. The winners here will be telehealth platforms that integrate well with EHRs, population health platforms (or may be part of population health platforms), and have robust security.
  • Primary care practices and specialists, who’ve been surviving on non-F2F visits, will be adjusting their practices to patient demand, and integrating telehealth with physical visits in a way that their patients will prefer. This means a search for integration of EMRs/EHRs with secure platforms and reconfiguring areas such as care coordination. If planned correctly, this could create better management of patients with multiple chronic conditions.
  • Actual physical visits will rebound, creating financial pressure on Medicare, hospitals, and private payers. How many people’s health has declined in two-three months is key. Small practices, who may see this first, will see another level of pressure, because they will be held to their Medicare quality metrics in value-based models even if adjusted. Hospitals will also rebound–if they are able. The dark side: private payers may run the numbers and scale back on benefits for the 2021 year especially if COVID is projected to make a return.
  • Behavioral health may benefit, yet drive individual practices and a wave of retirements, or a consolidation into clinic or group settings. There’s a reason why Optum is buying out AbleTo; we may see a wave of competitor acquisitions in this area with the emphasis will be on cognitive health and short courses. Why retirements? Many psychiatric practices are still independent, concentrated geographically, and the average psychiatrist is over 50. Psychiatric EHRs are both costly and not particularly suited to practices. If faced with technological challenges, a lot of MDs and senior clinical psychologists may very well exit–threatening clinics which need MDs to legally operate.
  • Rural health’s failure accelerated. USA Today’s analysis pinpointed at least 100 rural hospitals to close within the year. They already operated on thin margins, but with COVID expenses for additional equipment, the closing down of more profitable elective procedures and dependence on Medicaid, the over 1,100 unprofitable hospitals, over half of which are the only hospital in their county, have received a body blow. HHS allocated $10 billion to rural hospitals and clinics of the $100 billion aid package, but it may be too little and too late. Becker’s Hospital Review continues to track the bankruptcies and closures. Here there are no easy solutions from the digital health area.
  • A culture of cleanliness should accelerate. If the genie pulls this out of the bottle, one major benefit will be that hospital-acquired infections will decline. Effective sanitization methods that reduce human application and scrubbing will be the ones to look at: disinfecting foggers and UV full room or area systems–or combinations of same. Cleanliness and lack of virii and bacteria may become a new metric. Look and bet on companies that can provide this, from rooms to computers/mobile tablets and phones.

Readers can help with these prognostications and especially how they will play out not only in the US, but also in the UK, Europe, and worldwide.

Anthem Blue Cross Blue Shield adds virtual dental care with The TeleDentists in 9 states

May 2, 2020 | by

Could it be that a certain sage from New Jersey is on the money in predicting to this Editor that telemedicine has advanced about 10 years in the past two months? Anthem Blue Cross and Blue Shield (BCBS) is adding the virtual dental care provided by The TeleDentists to its plans in nine states: Maine, New Hampshire, Connecticut, Ohio, Kentucky, Indiana, Wisconsin, Colorado, and California. Through 30 June, the plans will cover virtual exams at 100 percent with no deductibles, copays, paperwork or claims to file. The virtual visit dentistry service offered by The TeleDentists is designed for urgent situations and to avoid an initial visit to the ER which can be several hundred dollars.

A member will locate a remote dentist through Anthem’s provider finder, then link to The TeleDentists’ site where the member is screened for history. A connection to a dentist then takes place quickly, in as little as 10 minutes, 24/7/365. The format is a video consult plus chat (TeleDentists uses the HIPAA-compliant VSee platform) to evaluate the plan member, then to guide on next steps. If necessary, the dentist will prescribe medications, such as antibiotics and non-narcotic pain relievers.

In the US, Anthem is #3 after UnitedHealthCare and Kaiser. It is the largest for profit insurer in the Blue Cross Blue Shield Association. In California alone, it has 800,000 members.  This adds to The TeleDentists partnership with Cigna announced earlier this month [TTA 15 April]. Releases (9) on Business Wire. Hat tip to CEO Howard Reis.

AliveCor, OMRON announce cardiac monitoring strategic alliance, equity investment

April 30, 2020 | by

You know it’s a step towards a more normal state of affairs when this Editor can cheerfully announce something which has really nothing to do with a virus, pandemic, or something ending in 19, although there’s the expected COVID spin. Almost getting lost in All That was the announcement last week of a global strategic alliance between AliveCor, the developer of KardiaMobile, and OMRON Healthcare, the Kyoto-based cardiac health and wellness company. Cardiac monitoring was around well before this virus and with a focus on mobile monitoring, is a major up-vote for an innovative company like AliveCor.  What’s in the release is the announcement of a global alliance, technology integration, and at the very end of the release, closing of an undisclosed equity investment by OMRON Corporation (OMRON Healthcare’s parent). This is actually the second equity investment which OMRON has made in AliveCor, with the first being in March 2017 with the Mayo Clinic. Hat tip to co-founder and ever-dapper Dave Albert, MD via Twitter

The Future of Clinical Trials in the Post-Pandemic Era: HITLAB Seminar Series 6 May

April 30, 2020 | by

Wednesday 6 May, 11am to 12 noon Eastern Daylight Time

How can virtual trials improve patient enrollment, retention, and engagement in a clinical trial? How much of the future CRO model will be defined by digital solutions? These are two questions key for many digital health companies as they expand and/or pivot their business model. Answering these questions will be the task of the panel discussing “Clinical Trials in the Post-Pandemic Era”, a free virtual midday seminar hosted by HITLAB in New York.

Panelists are: Joris van Dam, Head of Digital Therapeutics at Novartis, Natalia Kotchie, Vice President R&DS Applied Data Science Center at IQVIA, Bill Taranto, President & General Partner at Merck Global Health Innovation Fund, and Jeff Ventimiglia, Senior Vice President, Medidata Solutions (sponsor). The panel will be moderated by Professor Stan Kachnowski, Director of the Digital Health Strategy program at Columbia Business School.

Seats are limited to 1,000. Registration is necessary through Eventbrite here. Registrants will receive a follow-on email with instructions on how to access the webinar.

Optum rumored on the digital health acquisition hunt again with AbleTo virtual behavioral health

April 29, 2020 | by

Optum, the part of UnitedHealthGroup that runs engagement, technology, and financial services for UHG, is in advanced negotiations to acquire AbleTo, a New York City-based behavioral health and virtual therapy provider, according to CNBC. Unusually, there is also a number attached: $470 million, about 10 times their forward revenue.

AbleTo is already well acquainted with Optum, as their Ventures arm provided financing in January 2019 in a corporate round. Over the past 12 years, the company has raised close to $47 million through a Series D. Interestingly, one of the early investors was Aetna, pre-CVS. Crunchbase

Optum of late has been on an acquisition tear, with first dialysis provider DaVita for $5 billion and then telehealth/remote patient monitoring company Vivify Health for an undisclosed but certainly far less amount. AbleTo is attractive not only in the context of telehealth (at last the belle of the ball!) but also for the underserved behavioral health market. Confirmation of its attractiveness? A fresh crop of competitors such as Quartet Health, Lyra, and ‘traditional’ telemedicine providers such as Doctor on Demand.

AbleTo was founded by Michael Laskoff, at one time quite the ‘face’ in the NYC digital health scene, who went on some years back to found another behavioral health company, Annum Health, focusing on alcohol addiction. AbleTo is one of the pioneers of virtual therapy, both telephonic and audio/video, using care teams of coaches and LCSWs to provide short-term cognitive therapy sessions. It is certainly an underserved market with over 50 percent of those researched citing cost and stigma to not obtain treatments, with about 2/3rds surprisingly under age 50, but not surprisingly about half with one or more chronic conditions. Most of its business is with payers and self-funded companies, although it still offers individual therapy plans.   Mobihealthnews

NHSX announces TechForce19 challenge awards (updated), COVID-19 contact tracing app in test for mid-May launch (UK)

April 25, 2020 | by

NHSX, the group within the NHS responsible for digital technology and data/data sharing, made two significant announcements yesterday.

TechForce19 Challenge Awarded

NHSX, with the Department of Health and Social Care (DHSC) and the Ministry for Housing Communities and Local Government (MHCLG), yesterday announced the 18 finalists in the TechForce19 challenge. This challenge was set up quickly to support the problem of vulnerable, elderly, and self-isolating people during this COVID-19 quarantine to reduce actual and feelings of loneliness and lack of safety.

Like most everything around coronavirus, this was fast tracked: the challenge announcement in late March, submissions closing on 1 April, and the selection announced on 24 April. Each finalist is being awarded up to £25,000 for further development of their technology systems.

The 18 finalists include a number of familiar names to our Readers (who also may be part of these organizations): Feebris, Neurolove, Peppy, Vinehealth, Beam, TeamKinetic, Alcuris MemoHub, Ampersand Health, Aparido, Birdie, Buddi Connect, Just Checking, Peopletoo/Novoville, RIX Research & Media (University of East London), SimplyDo, SureCert, VideoVisit, and Virti. Their systems include checking for the most vulnerable, volunteering apps, mental health support, remote monitoring, home care management, and in-home sensor-based behavioral tracking. Details on each are in the NHSX release on their website. NHSX partners with PUBLIC and the AHSN Network (15 academic health science networks). Hat tip to reader Adrian Scaife

Updated 29 April. Adrian was also kind enough to forward additional information to Readers on Alcuris MemoHub (left) as a finalist in the remote care category. Partners in the test are Clackmannanshire and Stirling Health and Social Care Partnership (HSCP), East Lothian HSCP, South Tyneside Council, and Stockton on Tees Borough Council and last for about two to three weeks. Release

COVID-19 contact tracing

NHSX announced the release, in coming weeks, of a contact tracing app to track your movements around people and if you become positive for coronavirus, “you can choose to allow the app to inform the NHS which, subject to sophisticated risk analysis, will trigger an anonymous alert to those other app users with whom you came into significant contact over the previous few days.” The app is being tested in ‘early alpha’ at RAF Leeming (Computer Weekly). The app will tell users that they are OK or if they need to self-isolate. Far more controversial, if one cares about privacy, despite all the caveats. Based on the articles, NHSX is targeting a release of the app by mid-May according to the BBC, which also broke the RAF test. It will presumably acquire a snappy name before then. ComputerWeekly 24 April (may require free business registration), Matt Hancock Commons statement 22 April

CEO to CEO: TSA’s Alyson Scurfield interview with Tunstall CEO Gordon Sutherland (updated)

April 25, 2020 | by | 1 Comment

If you are following the changes at Tunstall Healthcare, TSA’s Alyson Scurfield’s talk with Gordon Sutherland has some significant news. The investment from Barings, M&G, and the lender group has been confirmed as a change of ownership. It could be inferred from the release, but was not explicit.

From Mr. Sutherland: “The change in ownership deal is now subject to several legal steps including a European Commission review regarding Competition Law. We expect to be able to address any issues and the deal to be signed in late June/July.” Checking back on the Charterhouse website, Tunstall is still categorized as an unexited portfolio company (or ‘unrealised’ in a more delicate term).

Another reveal in this conversation is a strategic statement that segments care and presumably the company’s direction into four parts, somewhat like Roman Gaul (which was three or five, depending on the history you’re reading):

  1. Reactive care: for instance an alarm bell or PERS press
  2. Proactive care: reactive plus social care and well checks
  3. Predictive care: sensor-based tracking in the home. Presumably this would be rules-based (i.e. time) on ADLs.
  4. Tunstall has added to this Cognitive Care or “Intelli-Care” which would combine presumably #2 and #3 along with other healthcare data from the user which would be analyzed to deliver social or health ‘nudges’. While in its ‘infancy’ according to Mr. Sutherland, this type of system would also detect changes in vital signs which require intervention.

#3 and especially #4 referred to as in ‘infancy’ leave this Editor puzzled. Back in 2006-9, the QuietCare system (still sold by Care Innovations) had changes in ADLs based on a normative model baselined over two weeks pretty much nailed down. There are more advanced systems such as CarePredict that take that motion and movement and have put it on a wrist-based sensor system that is now sold for individuals at home as well as in group living–with fall prediction and a PERS for good measure. Vital signs monitoring can also be done with other personal devices, watches, and smartphone/tablet reporting, but medical grade monitoring is another step further with far more complex integration.

Part 2 of the conversation will discuss what are the anticipated changes to health and social care service sectors and the proposed strategic direction of TSA. Hat tip to one of our Readers

Updated 25 April: A further snippet on how the new investment will play out at Tunstall is found on healthcare business intel provider Laing Buisson’s Care Markets website. In their view, the Barings/M&G investment will be “supporting the restructure, which will see the business recapitalised and debt reduced to £180m….” The rest is unfortunately only available to Care Markets newsletter subscribers, of which we are not. Again, no mention of Charterhouse.

Medopad rebrands, pivots as Huma, acquires BioBeats and TLT, names Alan Milburn as chairman (UK)

April 17, 2020 | by

Medopad, a London-based software developer for healthcare specializing in digital biomarkers generated by wearables and apps, has rebranded as Huma and, with the brand splash, announced the acquisition of two companies:

  • BioBeats, a London-based mental health monitoring app and wearable combination that tracksheart rate, activity, sleep, mood, and cognitive function to create a wellbeing model.
  • Tarilian Laser Technologies (TLT), based in Welwyn Garden City, is a developer of continuous blood pressure and cardiovascular non-invasive measurement technologies. Their assets include patents, software, and hardware awaiting US FDA approval.

Purchase details were not disclosed, but TechCrunch’s sources indicate a $10 million deal for BioBeats.

Joining Huma is former UK Health Minister The Right Honourable Alan Milburn as chairman of its board of directors.

Medopad announced last November a Series B raise of $25 million led by Leaps by Bayer, Bayer AG’s venture capital arm which also participated in their earlier Series A (CityAM/Crunchbase). Medopad’s focus to date has been primarily with life sciences companies to predict disease risk, condition progression, and diagnosis for chronic diseases including Parkinson’s (based on monitoring finger movements, in partnership with China’s Tencent), Alzheimer’s and diabetes. Which does make the pivot surprising, given the financing origin.

The Huma rebranding is accompanied by the usual quotes from the founder/CEO to explain the pivot from disease states to the ‘wellbeing’ sphere and Huma being reflective of humanity (see the daVinci-esque logo). The release quotes are also in Mobihealthnews Europe/UK (along with an unexplained doubling of their Series B raise; their total funding is $50 million). The release also lists offices in New York at the Genome Center on lower 6th Avenue and Shanghai. Hat tip to reader Paul Costello

Beyond telehealth: sensor-based vital signs monitoring for early coronavirus symptoms being tested in Israel

April 17, 2020 | by

Now that the US, as well as other countries like Austria and Germany, are planning to emerge from full quarantine and lockdown (before we all go stir crazy and broke), can digital health move beyond telehealth consults to proactive detection of possible cases of coronavirus and other communicable diseases, which would be valuable in early-stage detection and mapping outbreaks?

The answer: possibly. An intriguing use of sensor-based diagnostic monitoring is being tested in Israel. A Tel Aviv-based company, Vayyar Imaging, is using its 4D radar imaging system to capture data without contact, such as pulse, heart rate variability, and respiratory rate. This extends the kind of contact testing with forehead thermometers which are often used in South Korea and Japan for airport arrival testing and, with other tests, during the Ebola event in the US.

The dedicated sensors can operate through walls and objects, are not line-of-sight, and are not influenced by lighting. They can map environments and track movements in real-time.

The tests are being run with MAFAT (Israel’s Defense Research & Development Directorate) and Israel’s Naval Medical Institute to run real-time monitoring with their personnel to detect early signs of the COVID-19 virus. The Israel National Emergency Team completed an earlier test in which two Vayyar sensor systems were adapted to remotely analyze patient data. Vayyar release.

Legrand launches care home support fund, adds to hospital staff and caregiver support initiatives

April 16, 2020 | by | 1 Comment

Most stories during the COVID-19 public health emergency (PHE) have been about infection counts, overstressed hospital ERs/EDs, numerators/denominators, drugs, vaccines, and when can we get back to normal–if we can get back to normal. Thus some different and good news is more than welcome.

Today it comes from Legrand. During the crisis, Legrand has already provided equipment and staff support in several countries for field hospitals, long-term care facilities, and caregivers. A sample:

  • In the UK, the Aid Call Touchsafe Pro emergency nurse call system was installed into several Nightingale field hospitals plus other hospitals where areas had been re-purposed for new wards. Tynetec Reach IP and Touch 2 pendants were deployed as a plug and play option to support hospital discharge.
  • In the US, Legrand helped New York State field hospitals with a cable management solution to supply power to 2,000 beds–completed in four days. In Indiana, a production line for display screens was converted to making cloth masks which are in short supply in hospitals and for civilians. 
  • In hard-hit Milan and Bergamo, Italy, temporary hospitals were furnished with emergency solutions (bedhead units, nurse call devices, and VDI cabling systems).
  • And in India, a university hospital in Kolkata was converted for treatment of coronavirus patients and equipped with the Group’s uninterruptible power supplies.

Legrand’s newest initiative, announced today, is the establishment of a ‘solidarity fund’ dedicated to care and nursing for the elderly. This fund will provide tangible support to staff who work in specialized facilities such as care and nursing homes. The fund will be administered through the Legrand Foundation, created in 2014 to combat “exclusion related to a loss of independence and electrical poverty, and promoting education and employment in the electrical sector.” An example of tangible support is to finance staff hotel accommodations near their work, to decrease stress, fatigue, and also protect their families. Legrand is also inviting contributions from both businesses and individuals wishing to join this solidarity initiative. TTA is pleased to feature these initiatives from Legrand/Tynetec, a long-time supporter. Release.

FCC opens application window for $200 million telehealth cost reimbursement program

April 15, 2020 | by

In more COVID related news, the Federal Communications Commission (FCC) will be administering the $200 million allocated by the CARES Act to fund telehealth related expenses for providers to furnish connected care for patients. The program will fully fund practices and health systems in telecommunications services, information services, and devices necessary to provide critical connected care services. Funding will continue through the national health emergency or until the program funds have been fully spent out.

The application period opened on Monday 13 April. Applicants can download a fillable PDF form linked to the FCC’s program web page, but before they do that, there’s several pre-requirements typical of any Federal program:

  • Obtain an FCC Registration Number (FRN) from the Commission Registration System (CORES), as well as a CORES username and password at that link. An FRN is a 10-digit number that is assigned to a business or individual registering with the FCC and is used to identify the registrant’s business dealings with the FCC.
  • Obtain an eligibility determination from the Universal Service Administrative Company (USAC) by filing FCC Form 460 through My Portal on USAC’s webpage. (Filers do not need to be rural health care providers in order to file Form 460 for this program.)
  • Register with the federal System for Award Management (SAM)

When approved, the program operates as a reimbursement program where approved providers will have to submit invoices and supporting documentation which are also subject to audit.

FAQs are linked here. Also HISTalk.

Cigna launches dental telehealth with Dental Virtual Care–including The TeleDentists

April 15, 2020 | by | 2 Comments

In the US, most insurance payers have been responding to the COVID-19 pandemic by waiving cost-sharing, such as deductibles and co-pays, for coronavirus treatment–and also waiving co-pays for medical telemedicine/telehealth visits for any reason. A medical area that hasn’t been considered previously, but is becoming more important as restrictions continue, is dental treatment. Nearly all dental practices have been shut or open for emergency treatment only since mid-March.

Cigna is possibly the first payer to innovate a Dental Virtual Care program for emergency care using its own dental network and that of The TeleDentists [TTA 19 June 19]–and at no cost through 31 May. (For instance, The TeleDentists’ average consult cost is $69.) Cigna’s 16 million members of their employer-sponsored insurance plans are eligible for the program. 

Teledentristry is designed for urgent situations, such as pain, infection, and swelling, and to avoid an initial visit to the ER. The visit is done through a video consult plus chat (TeleDentists uses the VSee platform) to evaluate the plan member, then to guide on next steps. If necessary, the dentist will prescribe medications, such as antibiotics and non-narcotic pain relievers.

The program will continue later than 31 May subject to state regulations and benefit plans as part of Cigna Dental Health Connect. Cigna release. Hat tip to CEO Howard Reis.

A ‘digital wall’ gives thanks and praise to UK healthcare workers (updated)

April 10, 2020 | by

In a deluge of press releases to TTA linking every app, service, virtual event, or device to the coronavirus, no matter the stretch, putting this Editor into ocular overload, a message from James McLoughlin at a small company based in Ascot called Thank And Praise Ltd. (TAP)  was a refreshing change. TAP’s social Healthcare “Thanking Wall’ lets individuals thank NHS workers–individuals, groups, or in general–for their work. TAP is primarily focused on both healthcare and education in the UK, including Northern Ireland. Their objective is to be ‘the global platform of thanks.’

I’ll let James, who is their commercial director, take it from here.

TAP (Thank And Praise), a unique social thanking platform, was created in January 2019 to enable the general public to show their appreciation for the unsung heroes in healthcare and education. In response to the COVID-19 crisis, TAP launched a free-to-use Digital Thanking Wall to enable members of the public to post messages of thanks to the courageous and selfless people working in healthcare/NHS and education at this time. Our campaign has resulted in 1000s of visitors to our website to read the hundreds of heart-felt messages, mainly for healthcare workers.

Readers, do drop in and leave a message on the Healthcare Thanking Wall and follow their LinkedIn page. At this Easter and Passover time, I cannot think of anything more appropriate. Hat tip to James McLaughlin. And thanks.

Release

After the COVID Deluge: a Topol-esque view of what (tele)medicine will look like

April 10, 2020 | by

A typically cheery view by Eric Topol, MD of what medical practice will look like after COVID is over. With the full court press to go remote in hospitals and practices worldwide, telehealth and telemedicine has gone fast forward in a matter of under two months. But what will it look like after it’s over? Most of what the good doctor is prognosticating will be familiar to our Readers who’ve followed him for years–certainly he was right on mobile health overall and especially AliveCor/Kardia Mobile— but not so on point with mobile body scanners (anyone remember VScan?)

When the high tide recedes, what will the beach look like?

  • “Telemedicine will play the role of the first consultation, akin to the house-call of yore.” (Terminology note–interesting that Dr. T still uses ‘telemedicine’ versus ‘telehealth’–Ed.)
  • Chatbots will serve as screeners–once they are proven to be effective (a ways to go here, as the Babylon debate rages on)
  • Smartphones will be the hub, connecting with all sorts of monitoring devices (the ‘connected health’ Tyto Care and Vivify Health model–which makes the Editor’s former company, the late Viterion Digital Health, even more of a pioneer that died crossing the Donner Pass of 2016)
  • Smartwatches are also part of this hub (this Editor remains a skeptic) 
  • Now is the time to harness technology by both health systems and individual practices, but multiple barriers remain. (This Editor can speak to the difficulties for both primary care and specialty practices in not only practice but also reimbursement–and acceptance by patients.) Device expense is also a problem for the non-affluent.

As to the rest, it is pretty much what we’ve heard from Dr. T before.  The Economist

Your Editor will add:

  • Easy to use, secure platforms that don’t put users through multiple security steps remain a concern for users. This Editor’s concern is that easy to use = insecure. Skype and Zoom are inherently insecure–Skype’s user unfriendliness and insecurity outside enterprise platforms and Zoom’s major security problems on its platform and user flaws are well-known (ZDNet).
  • Reimbursement, again! CMS has done a creditable job in broadening reimbursement for telehealth a/v and telephonic services, but coding remains a nightmare for practices struggling to remain open and with some lights on. After COVID, will CMS and HHS get religion, or put it right back in its rural bottle? Covered in the CARES Act passed at the close of March, $200 million sounds like a lot from the FCC to bankroll telecom equipment for providers, but these funds will go quickly. At least they are not delayed in endless rule making, as the Connected Care Pilot Program has been for two years. Mobihealthnews 

Tunstall Healthcare secures funding from Barings, M&G

April 10, 2020 | by

Tunstall Healthcare announced on Wednesday that they have secured additional funding from Barings, M&G, and an unnamed lender group for growth. The funding amount was not disclosed.

The release is unusually terse in that the funding round, while the lead, is only briefly mentioned in the actual release at the beginning and end. What the funding will support is generic, which is not atypical: “a significant commitment from Tunstall’s lenders and will provide the Company with flexibility and improve the overall financial strength of the business” and that the funding will go towards developing new systems.

There is also no pro forma quote from the CEO, Gordon Sutherland, and no mention of Charterhouse Capital Partners LLP. which has controlled Tunstall since Tunstall is still listed on their website as a unexited portfolio company.

Perhaps clues to their future, or past, are here. An anonymous source advised this Editor to take a closer look at a company called TGH Acquisitions Limited. Their report on Companies House indicates that indeed it is a financing arm of Tunstall Healthcare Group with its last report for the year ending 30 Sept 2018–and showing an after-tax profit of over £75 million. Unfortunately, the parent company Tunstall Healthcare Group in the same period showed a consolidated loss of over £284 million. The good news in that red ink is that the loss was reduced by over £100 million. The report to 30 Sept 2019, which should have come out in mid-February, is not on Companies House.

Tunstall Healthcare remains a major global company in the telecare and remote monitoring field, with operations in 17 countries. In January 2019, they sold their US operation to Connect America, exiting the hyper-competitive US market [TTA 29 Jan 19]. Recently, they entered the complex care management (CCM, often called chronic care management) and transitional care management (TCM) fields.

Given the global spotlight on telehealth during the COVID-19 pandemic, the funding may be just in time to ‘catch a wave’, as they say on the Jersey Shore.