Samsung stretches into electronic skin sensors with OLED display for heart rate

Stretchable skin sensors were the rage a few years ago, yet disappeared off the radar well before the pandemic. A good part of it was that the sensor tech was confined to university labs and small companies attempting to commercialize it into ‘smart clothing’ paired with a smartphone, a form factor that never found a market. Since those early days, what has entered the mainstream are sensors/smartphone combinations for blood glucose reporting. So it’s positive that Samsung, expert at commercialization and the technology around displays, has set its R&D unit, the Samsung Advanced Institute of Technology (SAIT), to developing a prototype stretchy skin patch for vital signs monitoring that combines both a sensor and display.

SAIT developed a sensor (left) that combined a stretchable LED (OLED) display and a photoplethysmography (PPG) sensor. The tests applied it to the inner wrist near the radial artery to measure and display heart rate in real time.

The device uses a combination of elastomer, a polymer compound with excellent elasticity and resilience, with existing semiconductor manufacturing processes to apply it to the substrates of stretchable OLED displays and optical blood flow sensors.

The study found that the sensor achieved:

  • Stable performance in a stretchable device with high elongation. The display can be stretched up to 30 percent.
  • The movement of the arm did not affect the OLED display 
  • The adhesion and location of the display and sensor made, in their findings, continuous heartbeat measurements possible with a high degree of sensitivity compared to existing fixed wearable sensors

The researchers claim this is for the first time in the industry and proves the commercialization potential of stretchable sensors. While the OLED display leaves a lot to be desired in readability and it seems chunky, it’s another step in creating more easily worn ‘all in one’ monitoring devices that stretch to fit, don’t require a wristband, or constant checking on one’s phone. The SAIT research was just published in Science Advances, 4 JuneSamsung release, The Verge, Mobihealthnews

NHS Digital GPDPR medical database data extraction start postponed from 1 July to 1 September

Facing a GP revolt and legal action, NHS Digital has postponed the extraction of patient data records from surgeries until 1 September for the General Practice Data for Planning and Research (GPDPR). Before the House of Commons on 8 June, health minister Jo Churchill announced the extension. “We will use this time to talk to patients, doctors, health charities and others to strengthen the plan, build a trusted research environment and ensure data is accessed securely.” Health secretary Matt Hancock also announced that the patient opt-out deadline, originally 23 June, will be extended (date TBD). Pulse (may require registration), NHS revised release

On 4 June, before the extension announcement, the Doctors Association UK (DAUK), the Citizens, openDemocracy, the National Pensioners Convention, and Conservative MP David Davis were among the signatories to a legal letter sent to the Department of Health and Social Care (DHSC) threatening action to halt the data collection from GPs. Pulse (may require registration)   

While Ms. Churchill, Mr. Hancock, and Simon Bolton collectively insist that the additional time will be used for consultations with patients, doctors, health charities, and others, the proof will be in both the data collection and how informed patients will be of their options. Both the opt-out date and September, given the summer holidays, aren’t much time. In this Editor’s estimation, for a major effort, the end of this year would be far better. Perhaps we should send them this poster? Additional TTA coverage 2 June.

News and deal roundup: OneMedical’s $2.1 bn for Iora, CareDx buys Transplant Hero, Mount Sinai’s Elementa Labs; UK news–NHSX/Babylon, Doro-Everon, Tunstall

West Coast-based concierge medical provider One Medical goes ‘mass’ with Iora. One Medical, best known for serving the affluent well through a membership fee, direct pay, commercial insurance, and sponsored contracts with large employers like Google for primary care, announced plans to acquire Boston-based Iora Health. Iora’s primary care providers serve a different market, with primarily Medicare patients moved into full-risk value-based models such as Medicare Advantage plans and practices in shared savings arrangements such as Direct Contracting. The investor presentation here discloses the all-stock purchase with 26 percent of ownership going to current Iora shareholders. Iora for now will be run separately, which makes sense given the disparity in patient base. The major element in common? Primary care practices and ‘white-glove’ services. Healthcare Dive, FierceHealthcare

Consolidation in digital transplant care assistance. CareDx, which provides a wide variety of management services for organ transplant providers and recipients, is acquiring New York-based Transplant Hero. Transplant Hero is an app that reminds recipients to take their vital medications, and was founded by a transplant physician. Financial terms and integration going forward were not disclosed. Release, Mobihealthnews.

Mount Sinai Innovation Partners (MSIP) creates a new health tech incubator. Elementa Labs launched this week, specifically seeking pre-seed or seed-stage healthcare and biotech startups. Companies must also have a clear objective for working with Mount Sinai to develop a comprehensive development plan.The first startup on board is avoMD, a mobile-friendly point of care clinical decision support platform. Applications for the 12-week program close 30 September. FierceHealthcare

UK activity heats up with the late spring…

NHSX and NHS England are assessing Babylon Health’s triage app. According to an exclusive in Pulse (may require registration), a senior delegation from both visited University Hospitals Birmingham NHS Foundation Trust (UHB) last month to look at its use of the Babylon technology. However, NHSX has disclaimed any work towards a national program with Babylon as practices reopen throughout the UK.

DoroCare UK and Everon announced a partnership on products and services for social care, such as Everon’s Lyra, a cloud-based emergency call system, and Doro’s Eliza, a smartcare hub. Release

Tunstall announced the release of the Tunstall Service Platform (TSP) in the UK. It’s described as a connected care software platform supporting the Tunstall Alarm Receiving Centres coordinated by local authorities and social housing providers. It has four unique functions: PNC (call handling), service manager, fieldforce manager, and proactive services. It also will transition these systems from analogue to digital and will be operable in both. Release

The Theranos Story, ch. 73: the defense tries to stack the jury deck in Holmes’ favor, prosecutors say. And Theranos swag and memes are hot!

Law and Order Proceeds. For those of us who follow US trials, or have served on a local or county jury, smart attorneys do a fair amount of ruling jurors in–and out. The voir dire process in high-profile trials is critical. Jury consultants make comfortable livings creating profiles of their ‘ideal juror’.

Thus it should not be a surprise that Elizabeth Holmes’ spare-no-expense-or-strategem defense would file in May with the court an over-the-top 41-page, 112 question jury document. Their rationale is to screen jurors for issues related to the extensive news coverage around la scandale Theranos, Holmes herself, and even the pandemic (!).

In the prosecution’s view, questions such as “Do you have investments?”, “Do you have health insurance?”, and inquiries about social media use, were “untethered” from pretrial publicity and the coronavirus pandemic.

By comparison, the prosecution presented to Judge Edward Davila a modestly sized nine-page questionnaire with a scant 51 questions. Typically, many of these questions are routine, such as reading about the case and if they had any pre-existing opinions which would prevent that person from a fair judgment of the facts presented in the case. On pandemic issues, the prosecution drew from previously used questionnaires that addressed them, though this Editor cannot see how the pandemic is pertinent to this case.

Holmes is facing 12 felony fraud charges. The trial will start 31 August and will be held on Tuesdays, Thursdays, and Fridays through 17 December, according to a filing last week by Holmes’ legal team. She faces maximum penalties of 20 years in prison and a $2.75 million fine, plus possible restitution. East Bay Times

Attention eBay Shoppers!  According to CNBC, original Theranos-labeled items are fetching real coin on auction sites like eBay and Poshmark. An original Theranos lab coat is supposedly listed for $17,000. Over at Etsy and Redbubble, which sell artist-created items, logo-printed t-shirts and masks, including those with Holmes’ face and the Silicon Valley meme, ‘Fake It Till You Make It’, “Girl Boss” signs, throws, posters (left), and greeting cards. (Good things? Yeesh!) are all over. The funniest is a sweatshirt with ‘Theranos Testing–A Guaranteed Result’. Over on Etsy, a merchant’s most popular Theranos item is a mug emblazoned ‘Theranos Early Investor’. (Is it cracked?) Perhaps Holmes could put her Theranos trinkets and trash online to defray a few costs. Or copyright her image like Bogart?

OnePerspective: How the shift from analogue to digital telephone services affects telecare provisioning

TTA has an open invitation to industry leaders to provide a personal perspective on issues of importance to readers. This week, Charlotte Rathbone, Product Account Manager for CareUnity Digital, Chubb, examines the ongoing transformation of the UK telecommunications industry and how the shift to digital technology will affect telecare provision.

Interested contributors should contact Editor Donna. (Pictures and graphs/infographics are welcome)

According to the Technology Services Association (TSA), the representative body for technology-enabled care, more than 1.8 million vulnerable people* rely on telecare in the UK. In most cases, telecare consists of a care alarm in a person’s home, which when triggered by pressing a button or an automated sensor, sends data via the Public Switched Telephone Network (PSTN) to a monitoring centre, where an operator will give advice or seek help.

The UK telecommunications industry however is undergoing rapid change. By 2025* all analogue telephone services across the UK will be switched off as infrastructure is upgraded to digital connectivity. This approaching switch highlights the need for dedicated digital telecare solutions. 

So how will this affect telecare services in the UK?
As early as 2023*, British Telecom (BT) customers may not be able to buy an analogue phone line. Instead, BT will move its customers to a digital Internet Protocol network in readiness for the shutdown of traditional telephone lines in 2025. It’s then that we’ll see the PSTN and all Integrated Services Digital Network lines switched off. These lines are currently used by many telecare services to feed alarm data into their monitoring centres.

While the digital migration is underway, analogue telecare alarm services are reporting a rise in the number of failed alarm call attempts – with one service provider reporting a failure rate of 11.5% for the first alarm attempt*. This is concerning.

Another concern is failed care alarms through loss of power. When analogue alarms run on a digital network, they require a router to be plugged in at home. In the event of a power failure, this router will stop working, so if a vulnerable person triggered their alarm, it would duly fail.

It’s little surprise that telecommunication providers and Ofcom are all recommending a shift away from traditional analogue devices to digital devices to ensure consistency of access to care*. Some countries including Sweden are ahead of the curve when it comes to switching to digital. More than 95% of Swedish digital alarm installations now use mobile network connections*. There is some way to go in the UK.

Currently, there are approximately 1.6 million analogue telecare devices** across the UK that need to be changed to digital-dispersed alarm units so it’s going to be a gradual process. There are, however, benefits for telecare service providers that make the change sooner rather than later. 

Why switch now?
As we approach the switchover date, the time to replace analogue units in the field reduces. This will likely result in significant resource pressures for customers to complete the transition; by switching early, this can be completely avoided.

References
*TSA, 10 Facts about Analogue to Digital: How it will affect telecare.   ** TSA survey of service provider members, May 2021.

Hat tip to Kathryn Ranger of PRG Marketing Communications

Tunstall Group acquires Secuvita (NL)

Breaking news. Tunstall Healthcare announced today (2 June) the acquisition of Dutch alarm/home automation company Secuvita, Financial terms, integration, timing, and management going forward were not disclosed. In the announcement, Tunstall Group CEO Gordon Sutherland referred to Secuvita’s technology  integration with Tunstall Cognitive Care’s proactive care model. Benelux is one of Tunstall’s six key regions. The acquisition adds to Tunstall’s customer base 70,000 Secuvita users.

Secuvita’s director and owner is Patrick Gaasbeek. It was founded in 2006 as a brand independent service provider for social alarm systems. Today, their significant sectors are care alarms (standard and mobile), healthcare home automation (smart home), and remote care for home care, housing, and emergency centers. Featured clients on their website are Florence, Aafie, and Vérian. The company is based in Apeldoorn, Netherlands. 

NHS Digital GPDPR medical database plans criticized by Royal College of GPs, privacy advocates (updated 8 June)

What our UK Readers may have missed on the long bank holiday weekend. And why this matters outside the UK.  NHS Digital is being roundly criticized by privacy advocates, the Royal College of GPs (RCGP), the Doctors’ Association UK (DAUK), and individual GP surgeries on plans for creation of the General Practice Data for Planning and Research (GPDPR).

The GPDPR will compile information on 55 million patients–every patient in England registered with a GP surgery–into a database available to academic and commercial third parties for research and planning purposes. NHS has been collecting patient data on patients in a database, the General Practice Extraction Service (GPES), for the past decade. The GPDPR will replace it. Data collection on patients in England starts 1 July. What will be collected is at the end of this article as background.

The objections center on the sensitivity of the data, the short window of notification to patients, the lack of a clearly notified opt-out with sufficient time, and how it will be used.

  • The data apparently can include mental and sexual health data, criminal records (!), and other sensitive information. 
  • The short time–six weeks–between the announcement in late April (a low key affair with Matt Hancock-signed blog posts on the NHS Digital website, YouTube videos, and flyers at GP surgeries), and the start of data collection from the surgeries
  • How many patients are actually aware that this is happening and of their options is debatable. (See next two bullets)
    • If a patient didn’t pick up on it in the six-week window ending on 23 June (and go to the page with the Type 1 Opt-Out), a patient can opt out for data going forward, but cannot withdraw any data collected into the database prior to that date.
    • If a patient is in the National Data Opt-out program, their medical data will be collected anyway, since it applies to only identifiable and confidential patient information.
  • Many GPs are concerned about further erosion of the physician-patient relationship and the lack of communication to patients on how the data will be used, the ethical questions around the organizations to which it will be sold, and how patient privacy will be preserved.

The blackest mark here on NHS Digital is that the groups ostensibly involved in the development of the database–the RCGP and the British Medical Association (BMA)–are the ones sounding the alarm, along with the aforementioned DAUK and privacy groups such as MedConfidential and Foxglove. There is also a rebellion starting among London GPs. Reportedly, 36 doctors’ surgeries in Tower Hamlets, east London, will withhold data. An email is circulating to about 100 surgeries in north London questioning the legitimacy of the NHS data collection. This is despite penalties if they don’t submit.

Why does this matter if you’re not in England? Medical data–collecting, manipulating it, connecting it, finding insights, and selling it–is the Gold Rush of the 2020s. Pharma and payers as markets are just the start. Nearly every Roundup or deal this Editor covers has companies with a chunk of this gold rush. Why are telehealth companies worth their IPO/SPAC/funding prices? Why is McKesson ‘big banging’ four separate businesses into one division? Why do we follow ‘data warehouses’ like Sensyne [TTA 26 May],  Mayo Clinic’s big bet on a multi-line Remote Diagnostics and Management Platform [TTA 23 Apr], and virtual pharmacies like Capsule?  Why are insurtechs like Oscar and Bright Health hot? Why is it the #1 target of hackers?

It’s not altruistic. Services can be duplicated. Companies can be a hair away from failure. But ah, their data…the data has huge market value, even if its potential is not fully understood yet. Ask any data analytics person. Ask China, probably the most aggressive nation in collecting the health and personal data of its citizens, with Chinese capital for years now leading investment in global health tech companies.

In an article back in October 2015, this Editor described the many ways that deidentified patient data, in this case genomic data, can be identified by researchers through cross-checking via research database “beacons”, a network of servers. Referring to the 23andme and Ancestry.com collection of innocently given genomic data from consumers, this Editor proposed a Genomic Bill of Rights in 2018 and again in 2020. If this Editor, no data geek, can deduce it (hat tip to Toni Bunting back in 2015), this information has to be well known to researchers and to privacy advocates.

The controversy is just starting to ramp up. And it should. It’s about time there was a reckoning. The Guardian 30 May, 1 June

More background. According to the NHS Digital page on the GPDPR, patients will be anonymized by a process where de-identification software will replace their NHS Number, date of birth, and full postcode with unique codes produced by de-identification software. The data collected from GPs in England starting 1 July will be on: (more…)

Babylon Health going the SPAC route with Alkuri Global for $4.2 billion value (updated for 3 June announcement)

Another big SPAC on the boards. Telemedicine/symptom checking app Babylon Health has closed a deal to go public via a SPAC (special purpose acquisition company) via Nashville-based Alkuri Global Acquisition Corp.  The deal with Alkuri, run by two former Groupon Inc. execs, was reported of 28 May and was imminent, according to the usual “people familiar with the matter” speaking with Bloomberg News (may be paywalled). 

If the Babylon-Alkuri SPAC comes to pass (it did–see below), the company valuation was reported to top $3.5 billion. Alkuri also is lining up investors for $270 million of private investment in public equity (PIPE) funding, the sources said. Alkuri is led by Groupon’s ex-CEO Rich Williams and former COO Steve Krenzer, The money connection is likely Sultan Almaadeed, a former executive at the Qatar Investment Authority, who is Alkuri’s chairman.

This isn’t the first time Babylon has talked SPAC. Back in April, Babylon almost went into a SPAC backed by financier Alec Gore. Other SPACs in prior talks with Babylon were Freedom Acquisition I Corp., backed by former Credit Suisse Group AG CEO Tidjane Thiam, as well as a vehicle from Klaus Kleinfeld, the former head of Arconic. Yahoo!Finance

Babylon’s last big raise was a $550 million Series C in 2019, led by Saudi Arabia’s Public Investment Fund with prior investors Kinnevik AB and Munich Re AB. Their total funding since 2015 is $631.1 million. Crunchbase.

Updated. And so it came to pass that on Thursday 3 June, two days after our article published (and while this Editor was on assignment), it was formally announced. Reuters reported that Babylon’s pro-forma equity valuation is up to $4.2 billion. Babylon will enjoy $575 million in gross proceeds. This includes a PIPE of $230 million, a little lower than earlier reports, from investors such as AMF Pensionsförsäkring and Palantir Technologies Inc. Existing Babylon shareholders will roll 100% of their equity into the combined company and will own approximately 84% of the pro forma company at closing sometime in the second half of the year. It will trade on NASDAQ under BBLN. Ali Parsa, Babylon’s founder, CEO, and face of the business, will remain chairman and CEO. Babylon’s release has the financial details, including the investor presentation. FierceHealthcare 

ATA2021 coming up (virtually) starting 1 June through 29 June

The American Telemedicine Association (ATA) kicks off the virtual version of its annual meeting, ATA2021, starting next Tuesday, 1 June. Sessions are distributed every Tuesday and Thursday in June through the 29th. This year’s theme is Telehealth: Enabling Flexible, Inclusive and Contemporary Care Delivery

A sample of the format is below for Week 1: 

Opening Keynote:  Lessons Learned from 2020 Provide a Springboard for Increased Telehealth Adoption (June 1, 11:10-11:30am EST)

    • Joe Kvedar, MD, ATA Chair of the Board; Mass General Brigham

Afternoon Keynote: The Future of Helping Underserved Resources and Reflections on Work in Africa (June 1, 1:40 PM – 2:00 PM EST)

    • Ali Parsa – Babylon
    • Lois Quam – Pathfinder International

Did We Cover Better Aligning Virtual Care with Employers and Consumers (June 3, 1:40-2:00pm EST)

    • Glen Tullman, Transcarent
    • Bertha Coombs, CNBC

Release (PDF)–and see these links for the program overview, agenda, and pricing/registration. Registration includes programming, workshops, recordings, and sponsor networking. Hat tip to Gina Cella of Cella Communications

News and deals roundup: CoverMyMeds ‘big bang’, Noom’s $540M Series F, insurtech Bright Health’s IPO, Grand Rounds-Included Health, GoodRx, Cedar-OODA, Huma, Bluestream Health’s outreach

McKesson shmushes four units into CoverMyMeds. McKesson’s Big Bang combines four McKesson business units–RelayHealth (pharmacy networking), McKesson Prescription Automation (software), CoverMyMeds (medication access for patients), and RxCrossroads by McKesson (therapeutic and drug commercialization). They are being reassembled into one massive unit under the CoverMyMeds name. The unit will have about 5,000 people and will be headed by Nathan Mott. More here in a blog post/announcement posting that’s short on information and long on cheerleading.

And the funding rounds keep marching down the alphabet. Noom, the weight loss app, gained a generous Series F of $540 million led by Silver Lake with participation from Oak HC/FT, Temasek (Singapore), Novo Holdings, Sequoia Capital, RRE and Samsung Ventures. Valuation is now at $4 billion. Adam Karol, a managing director at Silver Lake, and former TaskRabbit chief executive Stacy Brown-Philpot will join Noom’s board. The fresh funding will be used to expand into areas such as stress and anxiety, diabetes, hypertension, and sleep.

Noom had a banner year in 2020, with $400 million in revenues as people tried to shed Pandemic Pounds (aided by a near-ubiquitous ad push). The app has had 45 million downloads to date in 100 countries, largely in the US, UK, Canada, Australia, Ireland, and New Zealand. According to a (paywalled) Bloomberg News report, feelers are out for an IPO which may be valued at $10 billion. TechCrunch, Reuters, FierceHealthcare

Bright Health Group filed its S-1 registration statement with the Securities and Exchange Commission (SEC). Their rumored $1 billion IPO will be on the NYSE and trade under the symbol BHG. Timing, share value, and number of shares are to be determined. It’s speculated that the valuation at that point is expected to be between $10 and $20 billion. Bright Health is an insurtech operating exchange and Medicare Advantage (MA) health plans under Bright HealthCare  in 14 states and 50 markets, covering over 620,000 lives. They also have a separate care delivery channel called NeueHealth, 61 advanced risk-bearing primary care clinics delivering in-person and virtual care to 75,000 unique patients. Last month, they purchased Zipnosis, adding their white-labeled telemedicine for large health systems business. Bright Health Group release, Mobihealthnews

Short takes:

Doctor on Demand and Grand Rounds, which finalized their merger earlier this month, have agreed to acquire Included Health. Terms and timing were not disclosed. Included Health specializes in care concierge and healthcare navigation services for the LGBTQ+ community. FierceHealthcare, Release

GoodRx acquired rival RxSaver for $50 million in cash in late April to bulk up against Amazon. FierceHealthcare

Medical billing and pre-visit tech company Cedar is acquiring payer workflow tech company OODA Health for $425 million deal in a mix of cash and equity. It’s expected to close at end of May. OODA’s co-founder, chairman, and co-CEO is Giovanni Colella, MD, also co-founded Castlight Health and founded RelayHealth (see above), so another successful exit for him. FierceHealthcare, HISTalk

London-based Huma, raised $130 million in a Series C. Leaps by Bayer and Hitachi Ventures led the round. The former, mysterious Medopad now seems to have settled on a platform that supports ‘hospital at home’ plus pharma and research companies in large, decentralized clinical trials. There’s an add-on of $70 million to the Series C that can be exercised at a later date. Release, HISTalk

White-label telehealth provider Bluestream Health is partnering with The Azadi Project to provide virtual care services to refugee women and girls fleeing from countries like AfghanistanIranIraq, and Syria for safety in Greece. “Bluestream Health has teamed with The Azadi Project to provide a virtual care platform that stretches around the world. The women fleeing war-torn and conflict-affected countries have suffered unspeakable abuse, and while seeking safety in Greece, they are further exposed to terrible living conditions and hostility.”  said Matthew Davidge, co-founder and CEO of Bluestream Health.  Release

UK news roundup: West Wales’ CONNECT project, WelcoMe app for disabled access, X-on Surgery Connect expands, Arc Health in 46 care homes, Alcove’s £75M contract with Suffolk County Council

The CONNECT project, which launched in West Wales at the very beginning of the pandemic last March, is a community support project using both technology enabled care (TEC) and human support. Covering individuals who are older, need home care support, and live at home, it is run by Carmarthenshire County Council’s (CCC) Delta Wellbeing team and covers Carmarthenshire, Ceredigion and Pembrokeshire. To date, they have assessed 1,800 people, supported 8,500 individuals isolated during lockdown with necessities like food, made 18,500 proactive wellbeing calls in the first three months, responded to 1,646 call outs with fewer than 100 requiring emergency services, and responded to over 500 falls with 97 percent within 60 minutes. The CCC is using Tunstall kit for alarms, fall detection, GPS tracking, and 24/7 community response service. Delta Wellbeing is a Local Authority Trading Company, completely owned by CCC, and is the largest digital monitoring platform in Wales. Wales Herald

WelcoMe is an free app that enables businesses to better support the needs of their disabled customers or patients. It’s designed for use on mobile or desktop so that a person can create a simple profile that outlines personal key requirements and information about what support they need during their visit. Those requirements are communicated to the business or practice staff so that they can be ready on arrival. It makes for an easier visit all around and eliminates surprises. This Editor discovered WelcoMe through an announcement by the The London Centre for Cosmetic Dentistry, the first UK dental practice to adopt the app for their practice. There is a small fee for businesses–£30/mo plus a £49 onboarding fee. The app was developed by Neatebox Limited. Release (PDF). Hat tip to Suzy Ellis of Ellis & Boyd PR

X-on Surgery Connect, a provider of cloud telephony for primary care surgeries, has added another 116 practices in Greater Manchester (Stockport’s 36 practices) and London (80 practices within North Central London Clinical Commissioning Group). The Surgery Connect system provides telephone triaging, call center support, remote working support, telehealth remote consultation and video support. The deployment covers approximately one million patients, out of a total of 8.5 million patients in 835 practices in England and Wales. Unfortunately the release was supplied only via email and not online/PDF.  

Arc Health remote diagnostic platform has been installed  in 46 care homes in South East London. Arc’s video clinical exam and diagnostic technology connects the care homes to primary care surgeries via guided or patient self-use of Arc’s exam tools. The Arc kit used in the care home includes a stethoscope, blood pressure, pulse, and a camera wand to perform ear and throat exams and connects to a video platform that captures the information. Arc Health is part of the National Innovation Collaborative funded by NHSX. The care homes are part of South East London CCG, and the Lambeth Together and One Bromley borough health and care partnerships. Release on HealthTechDigital.

Alcove has inked a contract with Suffolk County Council (SCC) valued at £75 million over three years. Renewal is possible for another four years on an annual basis. According to UK Authority, Alcove will be developing a “new operating model for leveraging care technologies and data in the adult social care sector, with the potential to take this into wider health and care.” The procurement contract will be available for other authorities, fire and rescue, ambulance, probation, and community services in the east of England. SCC has been using Alcove technologies, including their Carephone service, to keep isolated older people connected with services during the pandemic. 

An unappreciated long term pandemic health effect? Increased frailty among older adults.

Some of the universal effects of the COVID-19 pandemic and the prolonged lockdown, lifting in practically all of the US and starting to lift in the UK, is weight gain (‘pandemic pounds’), a changed perception of ‘maintenance’, and in some, a certain reluctance to get back to what was normal life. We are reading that younger workers are reluctant to leave 100 percent remote work and go back to offices at all. Even older workers want to limit in-office time to once or twice a week, having lived free of brutal commutes. Anti-social has become fashionable, based on a simple search of t-shirts for sale (!).

But for the older adult battling to keep engaged and mobile, the toll of prolonged ‘sheltering in place’ has been far greater and less reversible, if at all. A thought piece in Kaiser Health News found that “Large numbers of older adults have become physically and cognitively debilitated and less able to care for themselves during 15 months of sheltering in place.” This includes older adults who did–and did not–have COVID-19.

Doctors are seeing combinations of:

  •  Weight gain–and weight loss due to lack of interest in eating, not eating or hydrating well
  • Depression from lack of contact with family and the outside world
  • Cognitive difficulties
  • Physical deconditioning, leading to severe lack of mobility and falls. Lack of activity leads to muscle mass loss of up to 20 percent in as little as five days.
  • Exacerbation of chronic illnesses such as diabetes, congestive heart failure and chronic obstructive pulmonary disease (COPD)

For those in assisted living, a comeback is made even more difficult with restrictions still in place. Many have deteriorated so much that rehabilitative therapies do little good. The rest of the article describes rehabilitative outreach to those living at home, ranging from in-home physical therapy, to combinations of phone/video/in-home outreach, peer advocates, and encouraging older adults to go see their doctors in person. A follow-up article gives tips for older adults to reemerge in the post-pandemic world, with an emphasis on slowly increasing physical activity, reestablishing routines and social contacts, plus minding one’s diet.

The Theranos Story, ch. 72: a little lifestyle and celebrity is admissible at trial–but not too much. And no profanity, please!

The long-awaited update from the US District Court in San Jose. Judge Edward Davila ruled last Friday limiting the specifics on Elizabeth Holmes’ lifestyle that the prosecution wanted to present as evidence. Only general evidence of Elizabeth Holmes’ Silicon Valley CEO lifestyle would be admissible. The prosecution, in his words, “Each time Holmes made an extravagant purchase, it is reasonable to infer that she knew her fraudulent activity allowed her to pay for those items,” but that “Evidence of Holmes’s wealth can be construed as ‘appeals to class prejudice’ which are considered ‘highly improper’ because they ‘may so poison the minds of jurors even in a strong case that an accused may be deprived of a fair trial.” To the judge, evidence of Holmes’ wealth and fame are not even moderately related to the intent to defraud, the last of which is the heart of the charges.

The prosecution therefore has to walk a very fine line. It’s apparently fine to say that Holmes enjoyed a luxurious lifestyle equivalent to her Silicon Valley peers, with the usual perks. But details on brands of clothing, hotels, and other specifics “outside the general nature of her position as Theranos CEO,” is beyond the scope of the trial.

Judge Davila may be doing the prosecution a large favor by limiting this evidence. Too much reliance on lifestyle as the main motive to defraud is a crutch that could backfire with the jury, especially when they see in August a modestly dressed new mother Holmes. It could also open up an appeal on the basis of prejudicing the jury. To this Editor, there is abundant direct evidence of fraud of patients and investors in a technology that didn’t work, never could work, and the coverup. No need to overegg the pudding. Mercury News

And no profanity in the court! The jury will be spared the infamous employee meeting chants telling a rival testing company (Sonora Quest) and John Carreyrou of the Wall Street Journal to do something unprintable in a business article with themselves. The defense won the argument that these chants were the Silicon Valley Norm to motivate employees. Even the prosecution admitted that these might be “somewhat inflammatory”. Colorful, but inadmissible.  Mercury News

And lest we forget. Holmes is facing maximum penalties of 20 years in prison and a $2.75 million fine, plus possible restitution. The trial starts 31 August. Earlier chapters of this saga are here.

News and deals roundup: SCP Health-SOC Telemed, Epion Health-MSU, Sensyne Health’s new data agreements, Geisinger’s RPM app

SCP adds more SOC. SCP Health, a clinical management company that provides both staff and services to hospitals, and SOC Telemed, an acute, post-acute, and specialty care telemedicine provider, are increasing their engagement. SCP presently provides specialty care staff for SOC’s Telemed IQ platform for acute care. SCP will be increasing engagement with the platform to expand into a hybrid clinical approach between onsite and virtual care for hospital medicine, emergency medicine, and critical care programs. SOC Telemed was an early SPAC less than a year ago in August 2020 and last month shelled out $196 million for competitor Access Physicians. SOC release

NJ-based Epion Health, which has a digital check in and patient messaging platform that includes telehealth, announced an agreement with MSU Health Care, the academic health center of Michigan State University. MSUHC’s 600 providers will use Epion’s platform for provider search, patient registration, check-in, patient education, and payment for services. Epion’s client base is primarily regional provider groups. Epion release.

Sensyne Health of Oxford inked two deals in the past week for expanding its already extensive medical dataset of anonymized and de-identified patient data, adding patient data from the Colorado Center for Personalized Medicine (CCPM) and St. Luke’s University Health Network (Pennsylvania and New Jersey). The strategic research agreements add their data records to Sensyne’s dataset, now at 18.2 million records. Sensyne mines the data primarily for use by life science clients. When Sensyne commercializes these discoveries, they will share proceeds with CCPM and St. Luke’s respectively. Sensyne releases for CCPM and St. Luke’s.

Geisinger Health launches ConnectedCare365 app + RPM for chronic condition patient management.  The app, developed by Noteworth, monitors and analyzes multiple vital signs provided by patients directly or through devices, combining them with information from Geisinger’s EHR to send information and notifications directly to the care team. The app also connects families and caregivers with the care team via messaging. Noteworth release.

Survey: 80% of Americans believe telehealth can provide quality medical care–up 23 points from 2020

Directional data that confirms the acceptance of telehealth gained five years of progress in one–and that could justify continued massive investment in telehealth. One year after COVID-19 introduced Americans to telehealth as the sole alternative to the in-person medical visit, perceptions have changed positively among users and non-users. Customer engagement/business process services company Sykes Enterprises surveyed 2,000 US adults (18+) in March and found the majority of their respondents not only now believed that they could receive quality care via telehealth, but also that it provided needed care and is preferred for parts of their annual exam, in addition to other specific acceptance points.

Highlights of the survey: (more…)

Tunstall excluded from Sweden’s framework agreements for municipal alarm and technology procurement

Health tech in the Nordics rarely makes the news, except for Kry and Nokia. Tunstall has made news, but of the troublesome sort. Adda Inköpscentral, the strategic supply consultant which manages the Swedish framework agreement for procurement of telehealth alarms, is excluding Tunstall as a supplier in two ongoing procurements for security alarms and security-creating technology. The framework agreements are Security Alarms and Alarm Reception 2019 and a corresponding agreement, Security-creating Technology 2018. Adda has reached out to competitive companies for future contracts under these two agreements, which are winding up.

Worse, Adda is excluding Tunstall as a supplier for the new security alarms four-year framework agreement. The decisions are based on their investigation, concluding that Tunstall “violated the previous framework agreement in several respects”. “Our decision to exclude Tunstall from future framework agreements is based on our assessment that the company cannot live up to our high demands as a framework agreement supplier.” (Google translation)  Adda’s notice on Tunstall exclusion

The reasons why date back to October and multiple incidents in alarm responses. Adda’s investigation, which wrapped in late April, cited failures such as long response times in alarm response. SVT Nyheter used more dramatic language. “Thousands of old and sick were affected when the alarms stopped working in over a hundred municipalities. In Luleå, a woman who sounded the alarm died in vain (sic) several times.” Apparently, a software update went bad, disabling the alarms, but SVT‘s reporting has covered other incidents.

According to SVT, Adda currently manages procurement agreements for 200 municipalities. In Sweden, municipalities are free to negotiate their own contracts. If they choose to work under the framework, the municipalities create their own detailed contracts using the framework as a basis. Contracts signed under the old agreement remain in effect. 

Tunstall has commented that “they are disappointed with the message, do not agree with the criticism and are now analyzing the decision to decide whether to appeal it.” Additionally, they commented to SVT that “they had handed over an action plan and hoped to be able to sign the agreement in the near future.” Tunstall’s Swedish HQ is in Malmö and their security center in Örebro. Hat tip to an anonymous Reader 

Editor’s note: Editor Donna invites Tunstall to reach out to me for comments or updates.