AdhereTech’s smart pill bottle gets a new retro design

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/07/AdhereTech-pill-bottle-e1436497826583.jpg” thumb_width=”120″ /] My visit to CEWEEK in NY at the end of June was, in contrast to the 2014 edition, light on compelling health tech. One that stood out, for all the modesty of their display, was NYC-based AdhereTech. It’s a med reminder system pushed to the max: a pill bottle that dispenses normally, but collects and sends adherence data in real-time, with a system that analyzes and records the data. If a dose is missed, they send out customizable alerts and interventions to patients, using automated phone calls, text messages and other reminders. It also uniquely measures the level in the bottleso it can automatically notify the patient, provider and pharmacy about a refill.

When last we saw them, they had just won a spot in the inaugural (2013) Pilot Health Tech NYC program. They have redesigned the bottle to have a more compact, retro med bottle-like shape along with a brighter light and chime. (more…)

Payer reimbursement for telehealth, telemedicine gains in Delaware, Connecticut (US)

Two states–Connecticut and Delaware–are now requiring private commercial insurers to cover telemedicine and telehealth services at parity with in-person visits. Connecticut was first, signed into law on 22 June but not starting till 1 January 2016. It covers not only video consults but distance care delivered both synchronously and asynchronously, such as store and forward transfers, and covers remote patient monitoring. It specifically omits audio-only consults, email, texting and fax (!). The Connecticut law also requires parity of payment with in-person visits to prevent lower reimbursements. Delaware’s law was signed 7 July to take effect immediately, and based on the summary is similar in breadth to Connecticut’s. Delaware is now the 29th state to enact telehealth/telemedicine reimbursement legislation. Articles written by members of the Foley & Lardner law firm. JD Supra, Lexology

On the Federal front, Representative Mike Thompson (D-CA) and three other members of the House of Representatives introduced H.R. 2948, the Medicare Telehealth Parity Act of 2015. It would remove the current geographic restrictions for telehealth (in the Federal definition including telemedicine), expand services, expand telehealth/RPM for additional chronic conditions and expand home care service into hospice and dialysis. It is a rework of last session’s H.R. 5380 and is at very early days having gone to a Congressional committee. Unfortunately its passage has a snowball-in-July chance with Govtrack.us giving it zero chance of enactment. Rep. Thompson’s website, FierceHealthIT, ATA-Jonathan Linkous support statement.

Previously in TTA: Telehealth reimbursement makes legislative progress in Texas, US House

Rock Health’s mid-year report: 2015 investment leveling off

Rock Health‘s 2015 report is revealing in one aspect–that the authors try to put a game face on what is a flat situation in digital health investment for first half. Not even the most optimistic of the digerati expected a lift of 16 percent as we saw in 2014 versus 2013 [TTA 2 July 14], but the 8.7 percent fall off from 2014’s blistering $2.3 billion to $2.1 billion in 2015 year-to-date was unexpected. StartUp Health’s report indicated a slower start to 2015, though slightly less, so the reports correspond. Digital health still is growing faster than software, biotech and medical device.

Other highlights:

* The top six categories accounted for 50 percent of investment funding: wearables, analytics, consumer engagement, telemedicine, enterprise wellness, EHR/clinical workflow

*  In M&A action, this year’s first half has almost matched 2014’s full year total, but with only 13 percent of the investment. Most are digital health companies acquiring others for small amounts. (more…)

Novartis extends ViaOpta app for visually impaired to smartwatches

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/07/ViaOpta-Nav-Apple-Watch.jpg” thumb_width=”200″ /]New to this Editor (and I suspect our Readers) in assistive technologies for wearables are Novartis’ ViaOpta apps to aid the visually impaired and facilitate their independence as well as safety. Now available for smartwatches as well as smartphones, its features are primarily centered on assisting with navigation, including (new) points of interest and worldwide maps. Another new feature, recognizing and ‘reading’ both scenes and objects, is for smartphone only because it is dependent on the phone’s camera. Cues are both audio, vibration and visual (see left). Novartis claims this is the first wearable app designed specifically for the visually impaired and blind, now estimated at 285 million worldwide. It’s available in 11 languages and best of all, it’s a free download. Smartwatch demo is on YouTube. Novartis release. Mobihealthnews.

Breaking (holiday weekend) news: Aetna does the ‘deal deal’ with Humana

Crap Game (Don Rickles): Ya make a DEAL!
Big Joe (Telly Savalas): What kind of a deal?
Crap Game: A DEAL DEAL.

Kelly’s Heroes (1970), on getting the German Tiger tank and commander to help them in their bank heist

A $37 bn deal, that is. Announced on the Friday before the US Independence Day holiday (a day which may define media ‘black hole’), Aetna and Humana announced either their merger or the acquisition by the former of the latter, depending on what account you read. If approved by the Feds, the combination of #3 and #4 insurers (by revenue) respectively will exceed 33 million insured, making the combined entity #3 in insured individuals (after UHG and Anthem) and #2 in revenue. The announcement also stated that Louisville, Kentucky, Humana’s current headquarters, will continue to manage the Medicare, Medicaid and military Tricare businesses. Both are in Medicare Advantage, which is problematic due to market share and anti-trust considerations in at least four states, according to Reuters. (Humana has about 20 percent of national Medicare Advantage private policies.) We’ve previously noted the unfavorable comparison to the end stages of airline deregulation–consolidation reducing competition and consumer-favorable pricing. No word on the future of the Humana brand and marketing, which has always been executed well.

As to the outlook for digital health support–the prognosis by this Editor of this combination is, in the Magic 8 Ball’s answer, ‘reply hazy, ask later’.

  • Humana was known in the industry for being fairly open to opportunities and backed them with funding (Healthsense, Vitality, what remained of Healthrageous) under business such as Humana Cares. Humana at Home also owns a home care management company, SeniorBridge. Will this be of interest to Aetna in population health management, or an early ‘For Sale’?
  • Aetna, by contrast, has pivoted several times. CarePass consumer apps was a patient engagement experiment that proved the point that policyholders don’t want apps from insurers. Healthagen (an acquisition) was first positioned as an ’emerging businesses’ skunkworks of sorts umbrella-ing over iTriage (now integrated into the parent), ActiveHealth, Medicity and other digital health/analytics related businesses, then scaled back in early 2014 [TTA 28 Feb 14]. Repositioned as ‘population health management, the ACO business dominates.

Various reports: Daily Mail, Forbes (which likes it not at all and sees none of the touted ‘economies of scale’) and the WSJ.

Onward the 76 Hundred! Healthcare M&A, funding jam the news

Healthcare mergers, acquistions, investments and joint ventures are doing their own Charge of the Light Brigade as we cross the mid-year bar.

* Onward the 76 Hundred! 7,600 startups around the world are developing solutions in digital health, according to accelerator/investor StartUp Health’s 2015 mid-year report. It also notes that ‘personalized solutions’ are the It Girl of digital health, and that data analytics/big data has fallen to third in investor interest after wellness/benefits (largely skewed by Zenefits) and patient/consumer 
experience received large funding rounds. Cheering news is that StartUp Health notes that investment in 50+ health companies is remaining steady. But the rest might be a bit frothy. The Gimlet Eye’s tut-tut: “whatever Zenefits is, it can’t produce enough Employee Wellness and manage enough HR to be worth an investment of $500 million”. For our Readers, we give you a direct link to their 2015 Midyear Funding Insights Report. (We await RockHealth’s take on the the Year to Date.)

* Onward with an IPO! Telemedicine darling Teladoc (TDOC, NYSE) is even more so with a smashing initial public offering, targeted to open at $19 which closed on Wednesday at $28 and today (Thursday) at same. Rosy forecasts abound despite those annoying losses ($12.7 million in 1st quarter ’14) and court action (Dallas News, TTA 9 June) . We at TTA are sticklers on terminology; still, we were happily surprised to see USA Today in our corner chiding Mr Gorevic on his misapplication of telehealth for telemedicine.

* Onward to Invest in Each Other! The new Allscripts-NantHealth deal gives new meaning to swap. EHR Allscripts bought a $200m, 10 percent equity stake in NantHealth, the health informatics chunk of Dr. Patrick Soon-Shiong’s NantWorks mini-conglomerate. Meanwhile another Soon-Shiong company bought stock valued at $100m in Allscripts. Neil Versel in MedCity News

* Onward from Amsterdam to Tel Aviv! MedCity News and Reuters also report that Teva Pharmaceuticals and Philips Healthcare have inked a joint investment (more…)

Nortek Security acquires Numera (Updated)

Updated. Numera, which those of us with long memories remember as iMetrikus (before 2011, and also a Grizzled Telehealth Pioneer), announced late on Tuesday that it has been acquired by Carlsbad, California-based Nortek Security & Control. Nortek is known for security and home controls/automation (2GIG), with a significant holding in generally white-labeled traditional PERS units mostly under the Linear brand. Numera’s Libris and Libris+ PERS with telehealth connectivity will be sold under the Numera brand and be fitted into Nortek’s existing health-related business and home controls, according to the press release. The EverThere telehealth/activity/location reporting platform, according to Nortek’s FAQs, is especially important as this cloud-based health and wellness software platform can integrate into their home controls area. The transaction, according to Nortek, is valued at $12 million and they disclosed that the acquired businesses recorded unaudited net sales of approximately $5 million in 2014. It does not include the Numera Social behavior change/social engagement business which will be “rebranded”.

Upcoming international telehealth events

In summer, the mind does turn to attending conferences in more interesting places. Here are three of interest:

27-29 July: 2nd International Conference on Health Informatics and Technology, Valencia, Spain at the Melia Valencia Palacio De Congresos. Information and registration

Their sister conference is the Global Conference on Telemedicine and eHealth at the Crowne Plaza Houston River Oaks. As it’s 17-19 August, in Houston, pack a personal air conditioner and dehumidifier. Otherwise, it’s a nice city with much to recommend it. Information. Both are organized by the OMICS Group.

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/07/guanoLogo.jpg” thumb_width=”125″ /]Finally, if you are looking for a startup boot camp and something truly different, here’s one with real ambiance. At M.E.S.H.–Medical Entrepreneur Startup Hospital–you’ll be camping in tents and sleeping in cots in a forest just outside of Berlin, Germany. 9-10 September. They invite investors as well–no information on if they get better tents. The objective? The fusion of humans and technology, including what gets under your skin.  Organizer is the interestingly named (and logoed) DocCheck Guano AG (above) along with KPMG and Grants4Apps.

Worcestershire County Council seeking vendors for ‘Future Lives: New Technology’ (UK)

Susanne Woodman of the WCC was kind enough to inform this Editor that they are seeking up to five businesses to create a technology-based social care solution. They are inviting interested companies to meet with them for a presentation and informal discussions on Wednesday 22nd July 2015 at 10.30am County Hall, Spetchley Road, Worcester WR5 2NP. More tender details and how to apply for Future Lives is here.

Billy & Lisa Graham, killed in Tunisia last Friday

So often when you read of dreadful things happening, it is easy to make light because there is no personal connection.

It is therefore with particular sadness that we have to report the untimely deaths of both Billy Graham and his wife Lisa in the shooting in Tunisia last Friday.

Billy was well loved and respected in the industry, working in Scotland as Business Development Manager for Tynetec, and previously with Chubb. As such, even if readers did not know him personally, there is a high probability that they will have attended many conferences and exhibitions where he was also present.

Telehealth & Telecare Aware sends our deepest condolences to the Graham family and friends.

“The data security fault, dear Brutus, is not China, but in the company org chart”

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/06/Org-chart1.jpg” thumb_width=”150″ /]Mansur Habib, PhD and cybersecurity strategist, formerly CIO for the Baltimore City Health Department, proposes that any data breach analysis should start first with a hard look at the organizational chart. If the CIO or the chief information security officer (CISO) doesn’t report directly to the CEO, the executive clearly does not place priority on IT and data security, treating it as a cost center to be restricted; in his words, they do not ’embrace cybersecurity risk as business risk’. In his 2013 doctoral research in 2013 and subsequently, Dr Habib observed that about half of US HIT and cybersecurity heads report to the chief financial officer (CFO) or some other executive like a CAO (administrative). His withering take on most CEOs are that they are more concerned with stock price (more…)

Seven safeguards for your mHealth app

With cyberattacks from all sources on the rise, and mHealth apps being used by providers in care coordination, telehealth, patient engagement and PHRs, Practice Unite, which has some experience in this area through designing customized app platforms for healthcare organizations’ patient and clinician communications, in its blog notes seven points for developers to keep in mind:

1. Access control– unique IDs assigned to each user, remote wiping of the mHealth app from any user’s device.
2. Audit controls
3. Authentication
4. Integrity controls, such as compartmentalization, to ensure that electronically transmitted PHI is not prematurely altered or corrupted
5. Transmission security: data encryption at rest, in transit, and on independently secured servers protects PHI at each stage of transmission
6. Third party app integration–must fully comply with HIPAA safeguards
7. Proprietary data encryption

But all seven points need backing from the top on down in a healthcare organization. (More in the article above)

Digital agenda items: past and future

There’s much to learn about future digital trends from an analysis of what’s happening in South Korea. For this, the Korea Communications Report provides fascinating reading. For example, the bar charts on page 56 (yes it is worth scrolling that far) demonstrate the huge surge in video usage towards hte end of last year as 4G became established. As Prof Mike Short (for whom I am grateful for this and other pointers in this post) commented “It may prompt some ideas about Broadband and higher speed Mobile could help in Healthcare – eg the Dr will see you now”.

Another really interesting resource is the EU’s Digital Agenda Scoreboard 2015: Strengthening the European Digital Economy and Society which enables you to explore all sorts of statistics about European life, and then visualise it in a variety of different ways. It will be a real help for those ‘scene setter’ slides at the start of a presentation. Highly recommended.

Another interesting pointer was the FT which had a major supplement on digital health (more…)

Apps, apps, apps – health, care, wellbeing: must-reads for developers

Last week we covered two calls for health & care app developers: the ADASS apps event, which is looking for apps presenters, and PatientView which is looking for developers’ feedback on what they need when developing health & wellbeing apps; today we focus on medical app news.

PatientView has just released the results of their previous survey entitled “What do patients and carers need in health apps – but are not getting?” This analyses the views of 1,130 patient and carer groups worldwide. The needs and challenges raised were then discussed in a multi-stakeholder meeting held to help define concepts for new apps that address patient and carer unmet real needs. An essential read for health & care apps developers.

Staying just a little longer on statistics, the CTIA resource library has some interesting primarily US-oriented items including a recent item entitled “One in Five US Consumers Use Mobile Apps for Exercise Tracking”.

As many will be aware, this editor has argued for 18 months now in these columns (& elsewhere) for an official approval process for medical apps that includes a measure of efficacy, so they can be compared, where appropriate, with other forms of intervention such as drugs (in the case of treatment for depression, anxiety and pain relief). Workstream 1.2 of the National Information Board has now published their roadmap (disclosure: this editor is on the Advisory Board of 1.2 and two others) which describes how they plan to tackle this topic.

At the same time MIT has now announced the establishment of the Hacking Medicine Institute. This will assess whether digital health products and services really work and, if they do, help them to prove their efficacy to consumers, doctors, and insurers, possibly introducing a little competition which should speed things up nicely. (For a more detailed review of the workstreams including DHACA’s involvement, go to the DHACA website blog – you will need to become a member if you aren’t already, however it’s free).

The Australians have also just produced the MARS (Mobile App Rating Scale) for ranking medical apps. They conclude that: (more…)

Two-thirds of US insured not interested in payer health apps: survey

A survey of over 1,200 insured (individual and employer plans) sponsored by research firm HealthMine and conducted by Survey Sampling International shows that only 30 percent of this group would participate in a payer-provided mobile app, despite 89 percent using a smartphone and/or tablet. Even worse, only 18 percent liked to learn health, wellness, and lifestyle information from a mobile app. It demonstrates that current apps are not compelling or engaging–and the huge paradox of payers make them less, not more, attractive. Perhaps this Editor goes out on a limb, but US insurers have a trust problem on multiple levels (as claim deniers, as impossible to deal with); apps they provide are perceived as capturing information an individual doesn’t really want them to see. Overall, users are not using their smartphones for health reference at all–well below 20 percent. The leading use is for tracking fitness (21 percent) and calorie counting (16 percent). Is it that real research on health is the province of the desktop PC, where it’s easier to find and read? They also aren’t using mobile to find their doctors, despite all the hype from ZocDoc and Vitals: 8 percent had used a doctor finder app in the past six months. Mobihealthnews, HealthITOutcomes

Google X develops health tracker–for research and clinical trials only

And it’s not for sale. The life sciences group within Google X is testing on small groups a wrist-worn device which can sense with high accuracy pulse, heart rhythm, skin temperature and environmental information like light exposure and noise levels. Bloomberg News, which appears to have broken the story, quotes Andy Conrad, head of the life sciences team at Google: “Our intended use is for this to become a medical device that’s prescribed to patients or used for clinical trials.” Obviously it will be more accurate both in hardware and in back end algorithms than what’s currently marketed via Android Wear for smartwatches. Perhaps this is meant for the ‘superusers’ of healthcare services at the top 5 percent using 50 percent of spend, the new ‘It Girls’ of healthcare, TTA 28 May)? However, he’s also projecting out 20-30 years, so health systems and researchers, do not hold your breath waiting for this to become reality. (This is also a counter to Apple’s ResearchKit.) Also Yahoo Finance and The Verge, which has a gigantic photo of a smartwatch but no caption attribution. The Verge also mentions their research in MS. Gizmodo also adds that Mr Conrad is directing the Google X Baseline project, which is doing human testing and crunching data to develop a baseline of normal human health.

More about Google X in this video interview on Tested with Astro Teller (for real), ‘captain of moonshots’ for the company, on ‘thinking big and failing quickly’. (24 minutes)