Theranos, The Trial of Elizabeth Holmes closes, ch. 14: was it fraud over business failure–or building a company, not a criminal enterprise?

The flat spin starts as the trial winds up. On Thursday, the prosecution presented its closing argument to the jury, and the defense began its summary which will finish on Friday.

The key prosecution points made by Assistant US Attorney Jeffrey Schenk were:

  • Elizabeth Holmes’ decisions were all hers. She first defrauded investors, then deceived patients.
  • “She chose fraud over business failure. She chose to be dishonest with investors and with patients.”
  • Elizabeth Holmes was not a young, naive CEO. She had headed Theranos for nearly a decade. But it was ‘a house of cards.’
  • A decision about Sunny Balwani’s abuse is not pertinent to the case and does not have to be made to reach a verdict. 
  • That has to be made on whether this was deliberate investor and patient fraud.“Ms. Holmes knew these honest statements would not have led to any revenue,” Schenk said. “She chose a different path.”

Mr. Schenk reviewed the testimony of all 29 witnesses and statements made by Holmes herself, with the specific aim of refuting every defense point made about her not being aware that the technology didn’t work, or that she was not in charge of the marketing, advertising, business development, partnerships, and finances. He put a very fine and obvious point on it with a chart for the jury entitled “Knowledge of falsity,” which listed her false statements alongside exhibits.

Enter the defense, represented by Kevin Downey. He started by telling the jurors that they had a high burden of proof in finding Holmes guilty “beyond a reasonable doubt”and that crucial information was left out of the government’s case. It was ‘incomplete’ and that their opinion would change with his review of the evidence. Holmes acted ‘in good faith’. In that review, Downey provided illustrations of 11 successful partnerships Theranos had with drug companies. As to the board, he pointed out that they were not cronies who one would expect in a fraudulent enterprise; “She appointed these people, an incredibly illustrious group of people.”

The defense continues on Friday. The jury will be given instructions after the defense concludes, and it’s expected they will have over the holidays to deliberate. MercuryNews (paywalled but refresh repeatedly to view), CNBC, The Guardian

To be continued….

TTA’s earlier coverage: Chapter 13, Chapter 12Chapter 11Chapter 10, (10-13 recap the Holmes testimony); Chapter 9Chapter 8Chapter 7Chapter 6Chapter 5Chapter 4 (w/comment from Malcolm Fisk)Chapter 3Chapter 2Chapter 1

Short takes: £150 million for UK social care tech out of £1 billion, bias by design in medical device use investigated, Netsmart buys Remarkable Health, Vinehealth seed rounds £4.1 million

The Department of Health and Social Care (DHSC) has presented to Parliament a £1 billion, three-year healthcare system reform plan. The white paper, People at the Heart of Care, highlights the following as part of a larger 10 year program:

  • £300 million in housing investment for supported housing
  • new technology and digitization backed by at least £150 million to improve care quality and safety, support independent living and allow staff to provide focused care where it is needed 
  • £500 million for 1.5 million adult social care workforce career training and qualifications 
  • £70 million to assist local authorities and improve the delivery and standard of care
  • up to £25 million to support unpaid carers

Part of the tech upgrading includes 80% of social carers having digitized care records that connect to a shared care record by March 2024. The improvements will be funded through the 1.25% Health and Social Care levy. Gov.uk, HealthcareITNews

The UK DHSC is investigating whether the design and use of medical devices such as pulse oximeters could be potentially biased by race. This stems from the disproportionate death rate during COVID-19 of blacks, Asians, and other minorities. The review announced will look at whether AI tools can be biased in their algorithms and whether pulse oximeters may be inaccurate due to darker skin color. HealthcareITNews

Behavioral health continues its hot streak, with specialty EHR provider Netsmart acquiring Remarkable Health, a practice management software developer for behavioral health. Their CT|One electronic health record (EHR) and Bells, the first virtual clinical documentation solution created for behavioral health and human services organizations, will be integrated into Netsmart’s EHRs. Acquisition cost and management transitions were not disclosed. Release

UK-based Vinehealth, an oncology support app that also gathers patient-reported outcome (PRO) data for drug development and clinical trials, closed a seed round of $5.5 million (£4.1 million). Expansion plans include an introduction in the US. Funders were led by Talis Capital with participation from previous investors Playfair Capital and Ascension, plus an extensive list of angel investors including KHP MedTech Innovations, a collaboration between King’s College London, King’s College Hospital NHS Foundation Trust, and Guy’s and St Thomas’ NHS Trust. The Vinehealth app has had 15,000 downloads since January 2020. TechCrunch

Theranos, The Trial of Elizabeth Holmes, ch. 13: a crescendo of ‘I don’t knows’ and ‘I don’t remembers’…and the defense rests! (updated)

Elizabeth Holmes returned to the stand in her own defense today, continuing with cross-examination by the prosecution’s Robert Leach. From the coverage published so far of six hours of questioning, Holmes has done everything to deny key statements she made multiple times to writers and investors, just short of ‘taking the Fifth’ (Amendment, which is a Constitutional guard against self-incrimination). 

Starting with the now-infamous 2014 Fortune cover story authored by Roger Parloff, Holmes admitted to Leach that the claim of 200 tests using the equally infamous nanotainers was incorrect, but used what marketers call ‘weasel words’: “I believe that now.” Did she not believe that then? She then proceeded not to remember that she forwarded the article via email to investors on 12 June 2014. “I think I could have handled those communications differently.” 

More not knowing or remembering. Were Theranos labs being used on military medevacs, as witnesses from Walgreens and Safeway, among others, have testified? Was Walgreens told of difficulties with the Theranos labs? Did or didn’t she dismiss concerns raised by Erika Cheung and Tyler Shultz to John Carreyrou of the WSJ as coming from disgruntled employees? Did she present a 2015 revenue projection of nearly $1 billion to investors, especially as the internal estimate was much lower and there were no contracts with pharma companies? Did she listen to her lab directors about problems with the tests?

But regrets, she had a few. The WSJ investigation, for instance. And slapping pharma company logos on Theranos reports.

It all comes down to who the jury believes. The prosecution either will close today or tomorrow (Wednesday). The defense will return to wrap up, either with Holmes or with expert witnesses such as Mindy Mechanic and, possibly, others. The defense will return to the 3 Ds–diffusion, deflection, and diminished capacity. The luridly resonant theme of Sunny Balwani as an abusive Svengali, which led her to be not in control of herself even after he departed, will be the coda. The Guardian, CNBC

Wednesday Update. Boy, was your Editor wrong. The defense rested today (Wednesday).

  • Dr. Mindy Mechanic, the defense’ expert on relationship violence, will not be testifying about the nature of the Balwani-Holmes relationship. By not calling Dr. Mechanic, the prosecution cannot call their psychiatrists who also spoke with the defendants. For his part, Balwani has consistently defended himself from these charges of relationship abuse. The prosecution is also seeking to strike Holmes’ testimony of being sexually assaulted while a freshman at Stanford as now being irrelevant to the case, but it is hard for a jury to unhear it.
  • Holmes was, of course, the star witness in her own defense, joined in minor roles by paralegal Trent Middleton from Williams & Connolly, Holmes’ law firm, who summarized evidence in the case, then former Theranos board member Fabrizio Bonanni, who testified that Holmes attempted to remedy Theranos’ problems–but only after it came under regulatory scrutiny, which was late in the game. He had been offered the COO position but declined as ‘too old for that’.
  • Holmes returned in her final testimony to Balwani. Sunny, she said, was her most important advisor though she was, admittedly, the decision-maker. He was volatile. She “tried not to ignite” Balwani in emails and frequent texts. “Sunny would often blow off steam or vent through text,” Holmes said. “I was trying to be supportive.”
  • Returning to tugging on the heartstrings of the four women on the jury, she stated that breaking up with him was a ‘process’. He’d just show up at places she would go, like church and The Dish near Stanford. 
  • Holmes explicitly denied ever trying to mislead investors, Her own summary was restating her original ‘healthcare vision’ and the impact the company would make on healthcare.

Summaries by the prosecution and defense will be next up. Mercury News (partial paywall), CNBC

To be continued…

TTA’s earlier coverage: Chapter 12, Chapter 11Chapter 10Chapter 9Chapter 8Chapter 7Chapter 6Chapter 5Chapter 4 (w/comment from Malcolm Fisk)Chapter 3Chapter 2Chapter 1

Owlet sock pulled from US distribution after FDA warning letter

Awwww turning to Owwwww! High-flying Owlet has lost some altitude due to the consequences of a 5 October FDA warning letter. The outcome, at least for now, is that Owlet cannot sell its Smart Sock in the US. The Smart Sock measures sleep patterns, blood oxygen saturation, and pulse rate through pulse oximetry. FDA is now considering it a medical device that falls under 510(k) marketing clearance requirements, including premarket approval (PMA). Effective 22 November, the Owlet app will no longer be downloadable, although current owners who have downloaded the app for the Smart Sock and the Cam will not be affected. There are Owlets in the reseller pipeline, such as Amazon, which have now been rendered non-working. The Owlet Smart Sock can be sold outside the US, but not from the website.

What is surprising from the FDA letter is that they have had this issue with Owlet for five years. From the letter: “Since 2016, the FDA has corresponded with Owlet that the Owlet Smart Sock meets the definition of a device under the FD&C Act and does not fall under the compliance policy for low-risk products that promote a healthy lifestyle (General Wellness guidance).” The latter is a catch-all that has enabled various tech products to go to market with statements such as “not intended to diagnose, cure, treat, alleviate or prevent any disease or health condition”. It may have been either an escalation of monitoring capabilities, of marketing, or of the FDA deciding after the SPAC that Owlet needed to be treated differently. Owlet came to market in 2013.

Owlet’s letter to customers alludes to the FDA warning letter and that no safety issues were raised. They promise here and on the website that they will “transition to a new app and consumer wellness product that addresses FDA’s concerns”. The website continues to sell the Owlet Cam and Dream Lab, with ‘Coming Soon’ in January for the new Dream Sock and Dream Duo, but with no details. What’s not known are any details on their capabilities, whether they will fall under ‘general wellness’, and whether Owlet has begun the laborious and long process of filing as (likely) a Class II device.

Owlet enjoyed a SPAC during the summer [TTA 23 July] that nabbed it $135 million and a valuation of over $1 billion. It traded then at $8. Today’s close was $3.95. Its market cap is now less than half. It’s disappointing to this Editor that Owlet didn’t file with FDA well before the SPAC. They now have the opportunity to get FDA clearance, but the more likely outcome is that, at least for now, they will market a less capable device that falls under ‘general wellness’. Deseret News, FierceBiotech, CNET, The Verge

News and deal roundup: Best Buy’s $400M for Current, VA’s Cerner restart 2022, CVS-Microsoft product deal, and Athenahealth (finally) sold for $17B

Whew! Best Buy revealed on its quarterly earnings call that they paid $400 million for Edinburgh/Boston-based RPM developer Current Health [TTA 13 Oct]. It’s near the end of the call transcript published on the Motley Fool. There will be no impact on their financial performance this year and will have a slightly negative impact on the Q4 non-GAAP operating income. Hat tip to HISTalk

Also today in HISTalk is a nifty summary of the Department of Veterans Affairs (VA) Cerner implementation timing and restaffing. There’s a graphic on the 2022-23 (FY 2022-24) rollout plus the new organization. VA has appointed a new Program Executive Director, Terry Adirim, MD, MPH, MBA, moving from Acting Assistant Secretary of Defense for Health Affairs, and established a new EHR Integration Council. VA release. VA also published a 10 page analysis on what went wrong with the initial tests and lessons learned, such as creating an EHR ‘sandbox’ for clinician training.

CVS Health and Microsoft continue with a new partnership, this time for digital health products. The five-year deal will include development in two areas: personalizing health recommendations that direct consumers to when and where they need a CVS, and operationally to leverage technology and machine learning for automation to reduce waste. Microsoft release, Healthcare Dive, HealthcareFinanceNews

And in the biggest non-surprise of the past few days, Athenahealth’s (or as they prefer, athenahealth) sale closed before the end of the year in a deal valued at $17 billion. The buyers were, as expected [TTA 19 Nov], Bain Capital and Hellman & Friedman, along with Singapore’s sovereign wealth fund GIC and a wholly-owned subsidiary of the Abu Dhabi Investment Authority. The 24 year-old Athenahealth, one of the EHR pioneers, was acquired by Elliot Investment Management’s PE arm Veritas and Evergreen Coast Capital in 2019 for about $5.7 billion. Its base is down to about 140,000 ambulatory care providers, having exited the small hospital market some time back. In the EHR market dominated by Epic and Cerner, surely Veritas and Evergreen are relieved to be at least getting some cash back. But there’s Misery Sharing, as they are both retaining a minority investment. (A small hint from a marketer–never lower-case the first letter in any part of your name. You make yourself unimportant and it hasn’t been ‘modern’ for a loooong time. It wasn’t lucky for British Airways, either. Perhaps the new majority owners will get this.)  Healthcare Dive, Business Wire

Theranos, The Trial of Elizabeth Holmes, ch. 12: all bucks stop with the CEO (updated)

Tuesday was the last day this week of Elizabeth Holmes’ cross-examination by Federal prosecutors. Despite Monday’s excursion by the defense into how emotional and physical abuse by her live-in partner and corporate president could have warped her business judgment (a ‘me-too’ variation on the infamous Twinkie Defense relating to diminished capacity), and perhaps concealed from her the depth of Theranos’ problems, the cross-examination returned to the essentials. Who was the boss? Assistant US Attorney Robert Leach drew from her this: “Ultimately all roads led to the CEO?” “Yes,” she replied. “The buck stops with you.“ “I felt that.” 

The prosecution was highly effective in drawing out of her how Holmes controlled the company, and despite her claims of not knowing its finances, she knew what to say to round up funding. This countered the emotional drama of the prior day around ‘Svengali’ Balwani’s abuse and controlling actions. Holmes confirmed that she was the New Elizabeth in her hands-on role in altering pharma company reports, marketing materials, investor presentations, knowing their financials–and trying to kill unfavorable stories:

  • She added logos to Theranos’ pharma reports about partnerships with Pfizer and Schering-Plough to make it appear that the documents came from them. Add to these an altered analysis that came from GlaxoSmithKline (GSK), where Holmes admitted adding a logo but couldn’t recall deleting the conclusion “finger prick/blood draw procedure was difficult (needed larger lancet and better syringe system).”
  • She hired lawyers to review the Theranos website for claims at the time of the Walgreens launch in 2013. The language drew quite the critical eye for its language in their report to her. Our Readers will recognize these walk-backs on superiority claims: replacing “highest quality” with “high quality,” “highest levels of accuracy” with “high levels of accuracy,” and “more precise” to “precise.” Claims made needed to be substantiated. It’s not clear from the articles whether these were made.
  • Where walk-backs on these claims were most certainly not made were the investor presentations, including not disclosing that most testing was done on third-party machines, leaving the impression that Theranos labs were capable of running 1,000 tests.
  • Texts between Balwani and Holmes confirmed she knew that Theranos was in critical financial shape throughout 2013, burning through funding like tinder. 2014 was ‘fake till you make it’ time with sunny (sic) revenue projections–convincing to PFM Management and the DeVos family office, kicking in funds totaling close to $200 million, and then a cascade of funds following them. All of whom should have known better, admittedly.

In 2015, Holmes went directly to one of her investors, Rupert Murdoch, CEO of News Corporation and owner of the Wall Street Journal, to have John Carreyrou’s investigative reports killed. To Murdoch’s great credit, not only did the stories run, but also Carreyrou was legally defended against the mad-dog attorneys of Boies Schiller snapping at his heels. Boies Schiller also harassed and tracked former employees-turned-whistleblowers Erika Cheung and Tyler Shultz. Holmes also approved hiring the killer ‘oppo’ research of Fusion GPS. The latter became infamous a year later in sourcing and promoting now-debunked ‘evidence’ of Russian ties to then-candidate Donald Trump.

To counter the rising tide of negative news, Holmes went on CNBC’s ‘Mad Money’, hosted by, in this Editor’s opinion, the ever-credulous, often unhinged, and in recent years de trop Jim Cramer, and bald-face lied that “Every test we run on our laboratory can run on our proprietary devices.”–when only 12 did, not even the 15 Carreyrou documented.

It isn’t known yet whether Holmes will return to the stand next week for more cross-examination or a rebuttal by the defense. What is most likely is that the defense will continue with the themes of diffusion and deflection, creating cognitive dissonance in the jurors’ minds that while Holmes acted in control and committed fraudulent acts, Balwani had so thoroughly emotionally abused her that she was not in control of herself even after he departed. Look for expert testimony from Mindy Mechanic, an expert on intimate partner violence and abuse, to show that words of ‘love’ in 500-odd texts isn’t love at all. (Cue ‘What’s Love Got To Do With It’)

The Verge, CNBC, Yahoo Finance, Ars Technica

Updated: Theranos junkies (Judge Davila’s pronunciation of which is the subject of an entire Mercury News article) may want to follow John Carreyrou’s podcast, epically titled Bad Blood: The Final Chapter. He’s up to 11 episodes and close to 11 hours, so if you think your Editor is focused on this…it’s a deep dive indeed from the reporter who found that Theranos should have been spelled with an F for Fake. The link here is to the ThreeUncannyFour player, but Sony Media has made it available on other podcast platforms such as Spotify.

To be continued…

TTA’s earlier coverage: Chapter 11, Chapter 10Chapter 9Chapter 8Chapter 7Chapter 6Chapter 5Chapter 4 (w/comment from Malcolm Fisk)Chapter 3Chapter 2Chapter 1

 

Perspectives: How enhanced digital communications can improve patient engagement

TTA has an open invitation to industry leaders to contribute to our Perspectives non-promotional opinion area. Today, we have a contribution from Dave O’Shaughnessy, Avaya’s Healthcare Practice Leader for EMEA and APAC. The subject is the hot button of patient engagement–how telehealth and virtual care systems can be used to connect patients to providers, improve patient understanding, and increase both patient and provider satisfaction.

Interested contributors should contact Editor Donna. (We like pictures and graphs too)

For most of us, the term “patient engagement” seems straightforward. Patients who come in for their annual exams or patients with a chronic disease who regularly take their prescribed medications are considered engaged patients. But what about the rest of us who feel reluctant to contact our GP when we have health concerns or don’t take our prescribed medicine when we should. If these people were better engaged, their patient experience and outcomes would be improved.

Communications technology that was once considered cutting-edge is now holding healthcare back and one of the most significant obstacles to building an engaged patient experience is the traditional calling-centric communication model. Today, implementation of virtual care systems (telehealth), especially via cloud-based software-as-a-service (SaaS) applications that can be accessed from smartphones or tablets, improves patient engagement levels, and directly contributes to their overall health and outcomes.

So, what should a healthcare provider look for in a modern cloud communication and customer engagement solution? Here are four vital components for starters:

A unified communications platform

A unified communications and patient engagement platform in the cloud provides seamless connections across modes of communication (voice, messaging, chatbots, online meetings, and video), as well as devices (desktop, mobile, and tablet devices). Because it’s all integrated, patients get to use their communication channel of choice over their device of choice, and providers get the features they need to ensure that patients can engage a suitable person when they get in touch. In addition, self-service capabilities such as automated messages for appointment reminders and confirmations help to dramatically reduce time-wasting no-shows for healthcare organisations.

Real-time communications and collaboration

Provision of care requires constant and intuitive access to clinical information and the ability to effectively and efficiently communicate across dispersed teams to exchange critical information throughout care-coordination workflows. Effective and secure real-time collaboration across all communications channels helps staff reach the right people across the organisation at the right time using the most appropriate mode of communication. Most critically of all, these communication services for clinical staff must be easy-to-use, leveraging features like Single Sign-on authentication across multiple apps on a mobile device and offering intuitive click-to-call or team-calling abilities helping teams collaborate easily and rapidly.

Follow-up Patient Engagement

When patients aren’t engaged, they are less likely to follow instructions, resulting in more frequent readmissions. Cloud-based communications solutions with features such as click-to-chat and click-to-video allow patients to keep informed of what, and when, they need to take action for positive health outcomes. Providers can also add automated outbound patient notifications using SMS or Chatbots to follow up on patient satisfaction surveys, freeing critical staff to focus on in-office patients and higher priority, higher quality services.

A Secure and Flexible Platform

To avoid the security pitfalls of Bring Your Own Device (BYOD), healthcare provider staff need a “one-device, two numbers” experience that enables them to securely use one device for both personal and business. And lastly, a communications solution should be able to seamlessly integrate with the most common digital systems used by healthcare professionals.

With the cloud, communication and collaboration can become integrated into one solution that works the way patients and providers work—across any device, anytime, anywhere. Most importantly, the flexibility of cloud communication—particularly when it comes to solutions with open platforms—means providers can add new capabilities in minutes, with almost immediate access to the latest innovations. Look to partner with a solutions provider that has proven experience in patient engagement and experience solutions.

Theranos, The Trial of Elizabeth Holmes, ch. 11: Holmes’ widening gyre of diffusion of blame–and abuse

Turning and turning in the widening gyre
The falcon cannot hear the falconer;
Things fall apart; the centre cannot hold;
Mere anarchy is loosed upon the world,
The blood-dimmed tide is loosed, and everywhere
The ceremony of innocence is drowned;
The best lack all conviction, while the worst
Are full of passionate intensity.

The Second Coming, William Butler Yeats 

Elizabeth Holmes’ defense continues its strategy of deflection, diffusion of blame, and now psychological abuse. Ms. Holmes and her defense hit its stride today with Holmes recounting, in this lurid Mercury News headline, “Theranos president Balwani forced sex on Holmes, she testifies” (PDF attached if paywalled). This is far more interesting and clickbaitable than, say, her fan dance around regretting tacking on Pfizer and Schering-Plough logos on falsified reports, or denying that she ever said to investors, repeatedly, that the Theranos labs were being used by the US military in medevacs and in the field. The jury, ground down to numbness by the prosecution’s mile-high-pile of false documents and claims, surely woke up with Holmes’ upset and tears on the stand.

It started with her meeting Sunny Balwani on a trip to China when she was 18 (and he was 38), entering and then departing Stanford because she had been raped, compensating by dedicating herself to developing her high school idea on blood testing, and moving in with him. There was more than a bit of Svengali dynamic here, with her quoting Balwani’s rough talk of transforming her into ‘the new Elizabeth’ who’d be savvy about business and successful, versus “I didn’t know what I was doing in business, that my convictions were wrong, that he was astonished at my mediocrity and that if I followed my instincts I was going to fail, and I needed to kill the person who I was in order to be what he called the new Elizabeth”. She needed to work seven days a week, eat prescribed crunchy vegetables and grains (reading like a trendy SF restaurant menu), and see her family less. He would guide her and tell her what to do.

Holmes looked up to Balwani as a successful entrepreneur; he had joined a reverse auction startup called CommerceBid, eventually becoming president, and cashed out with $40 million as part of its $200 million sale to Commerce One in 2002. Between that and Theranos a few years later, however, Balwani left nary a shadow on Silicon Valley. At Theranos, Holmes became the public founder/face and Balwani the behind-the-scenes business planner–plus a bare knucks ‘enforcer’ on the daily life of the company, according to John Carreyrou. Business Insider

The rest of the story is about Balwani’s getting rough with her when she ‘displeased’ him, rough enough to be hurt, swollen, and not able to get up, in her account from a 2015 incident. She moved out the following year and he left the company in May 2016. Not all Pygmalion stories end well and all too often, they end like this.  

Yet the prosecution has provided another pile–of texts between Holmes and Balwani which, in between the mundane, are effusive in pronouncements of eternal love and support. These continued after his departure. Business Insider and full texts here

The defense has its own pile of deflection going, with the aim of creating doubt that Holmes was really at the center of the fraud, and more of a pawn, in Holmes’ own words:

  • Balwani was in charge of the financial projections and operations. Holmes testified that Balwani’s financial modeling produced discrepancies in revenue projections in 2014 and 2015. The Walgreens relationship also cratered at that time. This reinforces the defense opening back in September that relying on Balwani as president was one of her mistakes.
  • Validation? Adam Rosendorff, a former lab director, was less than competent [TTA 6 Oct]
  • Not disclosing about using third-party devices? A ‘trade secret’ recommended by legal counsel.
  • And the marketing/PR claim about Theranos using only ‘a single drop of blood’? (And all that ‘passionate intensity’ Holmes exhibited at investor conferences and interviews?) Blame TBWA/Chiat/Day, the ad agency! And Patrick O’Neill, who went from executive creative director there to creative director of Theranos and prepped her for the press including her 2014 TED speech. (Take a trip back and watch a few Theranos spots, courtesy of Refinery29. High on image, low on reality.)

Diffusion of responsibility is common in fraud cases. Wired quoted David Alan Sklansky, a professor of criminal law at Stanford. “It’s probably the most common kind of defense mounted in cases involving allegations of large-scale financial fraud,” he says. “Whether it works depends on how credible it seems to the jury.”

The hazard is that it makes Holmes appear incompetent, but incompetence beats 11 counts and 20 years in Club Fed.

What is the jury to believe about her competence? From the Mercury News again: “Asked by Downey whether Balwani ever forced her to make statements to investors or journalists that the prosecution has focused on, or whether he controlled her interactions with board members or executives from companies Theranos sought to work with, she said no. Asked what impact her relationship with Balwani had on her work, she responded, “I don’t know. He impacted everything about who I was, and I don’t fully understand that.” Holmes made statements on her own, frequently and over many years. She stated she wasn’t controlled by Balwani when it came to the board or business partnerships–and continued running the company after his departure and attempting to fix a myriad of problems. But what will the jury take away from this day? This, or Sunny getting blue on her?

Also Fortune 23 Nov and 25 Nov

To be continued…

TTA’s earlier coverage: Chapter 10, Chapter 9Chapter 8Chapter 7Chapter 6Chapter 5Chapter 4 (w/comment from Malcolm Fisk)Chapter 3Chapter 2Chapter 1

Theranos, The Trial of Elizabeth Holmes, ch. 10: Holmes testifies about the salad days of Theranos, setting up cognitive dissonance

Setting up a defense of cognitive dissonance. Today, in a brief appearance in Federal District Court in San Jose, Elizabeth Holmes returned to the stand to testify in her defense after a start last Friday. Her attorney Kevin Downey walked her through Theranos’ salad days, when the labs were numbered 1.0, cartridges stuck together, and the drug company studies were preliminary. Returning to her deep voice according to reports, she recalled Theranos’ Completed Successes, circa 2009, as many, and the performance as “really good.”

But 2009 was before the fraud with investors really got going. The falsifying of reports from Pfizer and Schering-Plough, for instance, was later. But every single drug company approached for the preliminary studies in those early days, including AstraZeneca at London’s Royal Marsden Hospital, never followed through with Theranos for more, such as a clinical trial or advanced study. Whether Holmes knew from an employee that Constance Cullen of Schering-Plough was less than enthusiastic about Theranos and found Holmes ‘cagey’ is beside the point, when the company later forged the Schering-Plough logo on a report to make it look as if Schering found Theranos’ labs acceptable. Downey took some care with Holmes not to introduce the later forgeries. Yet she was nothing if not persistent with other companies. Holmes pursued a partnership with Pfizer as late as 2015, in conjunction with Walgreens’ Theranos locations as clinical trial sites. 

She also testified that the series 4 lab could run any test, despite testimony from her last lab director Kingshun Das, MD that the series 3 could run perhaps a dozen at best and not reliably, leading him to void all tests made in 2014 and 2015. Earlier testimony stated that the series 4 never ran tests on patients.

Holmes’ testimony will continue tomorrow. Then the courts will be in recess for the Thanksgiving holiday until the 29th, which is when the prosecution will have its turn to cross-examine.

“Trying your hardest and coming up short is not a crime,” Lance Wade, another of Holmes’ many attorneys, said during opening arguments. But Holmes has already admitted to a repeated fraudulent claim of legitimacy–having the Department of Defense as a customer where the labs were on medevacs and the battlefield. But if the defense can introduce enough reasonable doubt, also known as cognitive dissonance or plain confusion, about Holmes and her ‘long con’ in the minds of the jury–that she was an entrepreneur with a dream just ‘trying harder’ and she didn’t know or mean to defraud investors as the prosecution claims but caught up in pursuing her noble aims–and add to that mind control by Sunny Balwani, Holmes does not have to be innocent to, as they say downtown, skate. CNBC, The Verge, FT, Mercury News (paywalled)

TTA’s earlier coverage: Chapter 9, Chapter 8Chapter 7Chapter 6Chapter 5Chapter 4 (w/comment from Malcolm Fisk)Chapter 3Chapter 2Chapter 1

Short takes: Athenahealth close to sold, Teladoc wants More of the Patient, CVS fewer store customers

Some thought starters for your weekend…

Reportedly, EHR and systems provider Athenahealth is thisclose to being sold. Via Becker’s Health IT, Seeking Alpha, a stock analysis site, connects the dots. In September, Bloomberg reported that private equity firms Veritas Capital and Elliot Investment Management (Evergreen Coast Capital) were considering selling Athenahealth for $20 billion or filing an initial public offering (IPO), two dramatic ways to exit. They entered in 2019 for $5.7 billion when it was already public, taking it private and combining it with a GE acquisition, Virence Health.

Timing is now Q1 2022. The most interested investors apparently are Hellman & Friedman, Bain Capital, KKR, Thoma Bravo, and Brookfield Asset Management. While no longer the powerhouse it once was in EHRs and related systems, it still can fetch a good return and provide a favorable exit for the two companies. Athenahealth had no comment for Becker’s. 

Teladoc and Big Telehealth wants More of the Patient, but will it be profitable? Our Readers are well aware of the War of the Roses (because it’s gone on so long) among the traditional telehealth players: Teladoc, Amwell, Included Health (Grand Rounds-Doctor on Demand), MD Live, with other smaller players jumping out of the juggernauts’ way and sticking to their knitting. With the addition of primary care (and, one can assume, the pandemic push), health systems and companies like Amazon Care and Babylon Health have jumped into the mix with ‘hit them where they ain’t’ offerings–Amazon offering house calls and services direct to employers, and Babylon 360 being offered to health plans and employers. Babylon and Teladoc’s Primary360 cover much the same ground, though, in connecting the patient users with an assigned doctor and primary care team for ongoing care.

As noted last month [TTA 7 Oct], the walls between payer and provider in primary care are collapsing in multiple ways in telehealth and payer models like insurtechs. Another model is Amwell’s reinforcing behavioral health capabilities (SilverCloud) and sliding into care management (Conversa and Amwell’s Converge platform).

Readers do not have to go far for confirmation that Teladoc aggressively wants most or all of the patient and isn’t going to settle for less. This is conveniently summarized by HISTalk from Teladoc’s Investor Day (with Editor’s emphasis)

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Teladoc’s investor day presentation predicts that consumers will expect virtual-first encounters whose quality equals in-person ones and that offer them a variety of coordinated care services. The company says it has evolved from fee-for-service video visits and will become a partner with its customers in offering whole-person care at under value- and risk-based arrangements. It says it will be “the first place consumers turn to for all healthcare needs” for “whole-person care that is personalized, convenient, and connected.” TDOC shares dropped 8% on the day and have shed 25% in the past 12 months, with the company’s market value being $20 billion versus the $18.5 billion in cash it paid to acquire Livongo in late October 2020.

As we’ve previously noted, Teladoc has never made a profit. Many felt it overpaid for Livongo and cut loose too many in the leadership with truckloads of gold. Investors weren’t quite on board with the whole-person vision either, looking at the share price trends. 

CVS Aetna, on the other hand, wants fewer store customers, more patients. Their announcement this week is that they are closing 10% of their stores (900 of 9,900) to focus on urgent/chronic care HealthHUBs, expand those services, and cut down on the brick-and-mortar. This responds to Walgreens buying a majority interest in VillageMD/VillageHealth with adjacent full-service primary care practices and CareCentrix for home care [TTA 14 Oct]. Reuters

Say goodbye to the local, easily navigated ‘boulevard’ CVS, often furnishing food, writing tablets, wrapping paper, and paper towels along with prescriptions and shampoo, often patronized by an older age group, for a barn-like, coldly-lit superstore that you have to drive to. (And say goodbye to pharmacy head Neela Montgomery.) And why is every HealthHUB this Editor has seen unimpressive–strangely under-staffed or no-staffed, tatty waiting areas with a couple of plastic chairs, expanded with ugly outside trailers that cut down on parking spaces?

Cui bono? According to CNN Business, it’s Dollar General, which loves those local locations and has been planning to beef up its health-related OTC meds. They also now have a chief medical officer who is evaluating in-store eye exams, telemedicine, and partnerships with local pharmacies. Given inflation, more customers will be checking Dollar General out.

Alcuris acquired by the Access Group (UK)

The Access Group and social care digital connectivity/alarm developer Alcuris announced Thursday that Alcuris has been acquired by the Access Group to be part of their Health and Social Care business. The Access Group is a diversified business management software company with products in construction, education, not-for-profit, hospitality, legal, recruitment, and visitor attraction management. Alcuris founder and head Alex Nash said that “The Alcuris team is thrilled to be joining The Access Group, whose Health and Social Care division is the leading provider to the local government, health and social care sectors in the UK. Earlier this month we announced our partnership with Medequip Assistive Technology Ltd and Wirral Council; the first local authority to deploy next generation telecare services at scale. As part of the Access family, we look forward to setting the standard in a digital care system that connects people, data and services and enables intelligent care decisions at the speed of life.” 

The connection between Alcuris and the Access Group is an interesting one, through Loughborough University Science and Enterprise Park (LUSEP). Alcuris started up there in 2017 and Access one year earlier. Mr. Nash is a Loughborough graduate who studied Product Design Engineering and started Alcuris in 2015 during his studies there, following his grandfather’s diagnosis of dementia. Access is based at LUSEP and opened a £20 million headquarters there earlier this week, though it has operations outside the UK in Australia, New Zealand, Singapore, and Malaysia. Transaction cost and management transitions were not disclosed.

We wish them both bonne chance! Access (short) release, Loughborough University news site

News and deal roundup: Amazon Care lands Hilton, Lightbeam buys CareSignal RPM; aptihealth’s $50M, MedArrive’s $25M, Ribbon Health’s $43.5M

Amazon Care nabs a big one in Hilton Hotels (US). Hilton Worldwide Holdings Inc. will now offer Amazon Care to its US employees on a corporate health plan starting in 2022.  Text chats will be free, with virtual or home visits with providers available for a small fee. Availability will depend on where the employee is. Care Medical will provide national virtual visits, while house calls are in limited metro areas: greater Seattle and the Washington-Baltimore metro area at present, with expansion plans to Los Angeles, Chicago, Dallas, Philadelphia, and Boston. Hilton is only the second company (after Precor) disclosed by Amazon. At the end of 2020, Hilton had 141,000 employees, but that includes worldwide properties so the US number remains in Amazon style–opaque. Amazon’s Kristen Helton announced it at Reuters Total Health on Monday. FierceHealthcare

Lightbeam Health buys CareSignal. Lightbeam, a population health analytics and management platform, closed its acquisition of CareSignal, a ‘deviceless’ remote patient monitoring (RPM) system that uses phones for patient reporting via SMS and (hold your beer or wine!) interactive voice response (IVR). CareSignal adds direct RPM reporting data for chronic conditions, behavioral health, social determinants of health, maternal health, and additional monitoring to the Lightbeam platform used by ACOs, payers, provider groups, health systems, and other healthcare organizations. Financial and organizational terms were not disclosed. Lightbeam’s backers are Hearst Health Ventures and 7wire Ventures through a Series A and undisclosed venture round five years ago (!), with CareSignal barely out of seed with $7.5 million invested. Release

And Series A and B raises continue… 

Behavioral health tech continues to attract substantial investment. Boston-based aptihealth’s (not a typo) $50 million Series B will be expanding its clinical science, technology, and services for higher acuity behavioral health conditions. Funding was from Takeda Digital Ventures, Pivotal Life Sciences, Vista Credit Partners, Olive Tree Ventures, Claritas Capital, and What If Ventures for total funding of $65 million. aptihealth coordinates patient access to care teams from any point of care. The company has signed 27 health plans, health systems, and physician practice customers to date. Release

MedArrive’s $25 million Series A continues home care’s hot streak. Section 32 led the round with participation from new investors, 7wireVentures and Leaps by Bayer, and existing investors Define Ventures, Kleiner Perkins, and Redesign Health. MedArrive connects telehealth from payers and providers to a network of EMTs, paramedics, and other skilled healthcare workers for hands-on care. The New York-based company currently operates in California, Florida, New Jersey, North Carolina, and Texas, partnering with SCAN Health Plan, Clover Health, Bright HealthCare, Molina Healthcare as well as ACOs and government entities such as the LA Department of Health. Release, FierceHealthcare  Hat tip to HISTalk for this and aptihealth

Ribbon Health’s Series B funding of $43.5 million will be used to further develop team expansion and technology investments around their API layer, using data on doctors, insurance plans, costs, and quality of care for predictive care decisions. The raise was led by General Catalyst, with participation from Andreessen Horowitz (a16z), BoxGroup, Rock Health, and Sachin Jain. Since 2016, the company has raised $53.8 million. Release, FierceHealthcare

Theranos, The Trial of Elizabeth Holmes, ch. 9: the cold $96 million (updated 19 Nov)

On which may well hang how many years Elizabeth Holmes spends in prison. Yesterday’s testimony by Brian Grossman, chief investment officer at PFM Health Sciences, may be the prosecution coup de grace in drawing a picture in bold colors, no pale pastels, of deliberate deception and fraud.

Previous testimony spun tales of family offices and highly wealthy individuals such as Rupert Murdoch (and not so wealthy such as Alan Eisenman) being easily lulled by the Social Network spinning. They were gulled by the whiz-bang technology–Elizabeth Holmes’ and Sunny Balwani’s nanotainers, miniature Edison labs–as well as their fake claims of Theranos labs on Army medevacs and false letters from multiple international pharmaceutical manufacturers vetting their technology. Safeway and Walgreens executives had a more complicated tap dance, coming on board at not much past the idea stage, and staying in through a combination of Wanting To Believe, Competitive Embarrassment, and Heads Wanting To Stay In Place at having to write off hundreds of millions of dollars in public companies. 

Mr. Grossman in fact was and is the managing and founding partner, as well as CIO, of PFM. It’s located not on Sand Road but in (relatively) sober San Francisco. Founded in 2004, PFM specializes in early-stage and diversity health-focused investment, and currently manages over $2 billion in public and private funds. Lark Health is one of their recent investments [TTA 14 Oct]. Their Crunchbase profile demonstrates active investment in multiple operating companies. He and his firm are of some substance.

Something about Theranos got his attention–not the social networking, but the all-in-one miniature labs that condensed thousands of feet of lab into a small box. He was told that the entire Phoenix market could be served with labs fitting into about 200 square feet. Grossman knew a competitor, Quest Diagnostics, would need hundreds of thousands of square feet of space to match that. 

What caused him not to be skeptical? Of course, the mythical military involvement and pharma endorsements first, but then….

  • Projections of $30 million in 2014 income from pharma companies–alone. Needless to say, no income in 2012 or 2013 would raise a red flag for some, but not necessarily for PFM in early-stage companies.
  • Four-hour turnaround on lab results in retail, one hour in hospitals–carefully concealing the wildly uneven results from the Edison labs resulting in third-party labs being used for retail, and his own personal result of over a day on a full venous draw, not a finger stick.
  • Holmes was “very clear that this technology was not a point-of-care test, not a point-of-care testing platform, it was a miniaturized lab,” he said. That alone smelled like a 20-ounce porterhouse steak off the grill. 
  • While Balwani nixed Grossman speaking with Walgreens and UnitedHealth, Channing Robertson of Stanford, who helped Holmes start Theranos, vetted their labs as extremely advanced technology–one with which competitors would spend years catching up–for a serious investor, sauce, potato, vegetables, and trimmings on that sizzling steak

Unlike the picture the defense is painting of Balwani controlling Holmes, Grossman took care to note that Holmes, not Balwani, did most of the talking at the time. While he found the company highly secretive, he, unfortunately, discounted it. So in went PFM’s $96 million in February 2014, which included $2.2 million from a designated ‘friends and family fund’ which had investments from low-income people.

Three years later, PFM also won its own fraud case against Theranos, settling its lawsuit for about half–an estimated $40-50 million (WSJ; CNBC claims $46 million). The timing was good–it was while the company still had some money to claw back [TTA 26 June 2017].

What happened to PFM and other investors shook up Silicon Valley for years and, as much as some may deny it, health tech investment plus tarnished the image of women heading health tech companies. Some of the reasons why this case has received international attention. CNBC, The VergeNBCBayArea

Updated. Where the prosecution would go in its final days of its case–they may be wrapping this week–would they have trouble topping this for the jury, after piling similar fraud high and wide? But, in this Editor’s estimation, they brought it all back home for the jury by putting Roger Parloff, author of the 2014 Fortune cover story, ‘This CEO Is Out For Blood”, on the stand. His articles, recordings, and notes put into sharp relief and in summary the full fraud–all the fraudulent statements the company presented, versus the reality presented by the witnesses and evidence in the courtroom. At the time, the Fortune article fueled the current investors and served to bring in more, such as the DeVos family. Parloff over a year later wrote a column stating that he had not only been misled, but also failed to get to the bottom of what he termed “certain exasperatingly opaque answers that I repeatedly received”. Parloff was also the “beating heart” of a 2019 HBO documentary, “The Inventor”. CNN Business

Updated 19 Nov: But now it will be the defense’s turn to surprise. 

The New York Times, in a well-padded piece, speculates on the obvious–whether Holmes will be put on the stand to directly testify about  “how Sunny made her do it”–Sunny Balwani’s private psychological manipulations, all of which seemed to be well-hidden at the time. Stand by, it may get lurid.

But first for hilarity. The prosecution rested. The defense’s first move was to request that the court acquit Holmes on the grounds of insufficient evidence. Then amazingly, Holmes took the stand. Judge Davila dismissed one fraud count against Holmes, leaving only 11. We’ll pick this up next week.

To be continued….

TTA’s earlier coverage: Chapter 8, Chapter 7, Chapter 6Chapter 5Chapter 4 (w/comment from Malcolm Fisk)Chapter 3Chapter 2Chapter 1

Theranos, The Trial of Elizabeth Holmes, ch. 8: choosing investors with more money than sense a winning strategy

The prosecution continues to pile up defrauded investors–but this one may backfire on them. Alan Eisenman invested about $1.2 million in Theranos in 2006 on behalf of himself and his family–after a five-minute phone call with Elizabeth Holmes. As an early investor, he also believed he was entitled to special treatment, such as direct talks with Holmes, frequent enough to the point where she offered to buy out his shares for five times their value and cut off contact. 

Later, he had other opportunities to sell his shares up to nearly 20 times their purchase price, but held on stating he didn’t have enough information on what was apparently a ‘liquidity event’. Lack of information was a persistent red flag, with gaps in communication from 2010 to 2012 and a contentious relationship with Sunny Balwani. Despite this, when Theranos needed money in 2013, he then invested an additional $100,000 despite no audited statements since 2009. This last investment became one of the government’s counts of wire fraud.

In his testimony, Eisenman testified that like others, he was initially impressed that Oracle founder Larry Ellison was involved with the company and that Theranos had contracts with six international pharmaceutical companies including Pfizer and Novartis–which was blatantly false.

This incredible narrative becomes more understandable when you understand Holmes’ strategy of choosing only ‘high-quality investors’ of the family fund sort. She targeted funders who weren’t knowledgeable and meticulous in examining the company books and the technology. The funders were also oh-so-socially connected. According to The Verge, Eisenman was ‘wired’ into Theranos–“he was friends with the Holmes’ family’s financial advisor [David Harris], who had also invested. Plus, his wife’s father, who had also invested, was friendly with [Bill] Frist, who was on the board.” Eisenman contacted Frist as well when he was essentially cut off from Holmes about 2010. 

Surely Eisenman was entitled to be upset and more than a little embarrassed, as a former money manager and financial planner. But then his actions dealing with the prosecution left a Mack truck-sized opening for the defense on the cross-examination. He sent an email to the prosecution team perhaps 15 hours after he finished his direct examination last Wednesday, strictly against instructions. He did it again on Friday, ostensibly about travel plans. An assistant US attorney called him to remind him not to contact them again. The defense leveraged this into the compromising position of being biased against Holmes beyond his actual loss, for instance a purported statement he made “upon entering the courtroom” about wanting Holmes to go to prison.

Coming so late in the trial–the prosecution may rest this week–the abrasive impression that Alan Eisenman left may leave an opposite impression on the jury that favors the defense interpretation of naïve investors who didn’t do their due diligence homework, and by extension, deserved to lose their money. CNBC 15 Nov, 10 Nov

To be continued….

TTA’s earlier coverage: Chapter 7, Chapter 6Chapter 5Chapter 4 (w/comment from Malcolm Fisk)Chapter 3Chapter 2Chapter 1

Short takes: Now J&J splits up, a Color(ful) $100M, Cue Health goes DTC, Amwell’s busy Q3, Teladoc’s Investor Day 19 Nov

Breaking up seems to be the thing this month. Now Johnson & Johnson is spinning off its consumer brands into a separately traded public company, retaining the pharmaceutical and medical device businesses. The consumer business includes such J&J global signature products such as Band-Aids, Neutrogena, Q-tips, Baby Powder and Shampoo, and the Listerine line of products. It’s expected to take 18 to 24 months. The pharma/med device business will retain the J&J brands, sub-brands like Janssen, and development in AI and robotics. The consumer products divisions will have to hunt around for a new one. Outgoing CEO Alex Gorsky must be heaving a sigh of relief and dreaming of a long vacation, as he won’t have to shepherd this one– incoming CEO Joaquin Duato starts in January. Pharma/med device is much larger, with $77 billion in revenue. Consumer accounts for $15 billion, with four products alone accounting for $1 billion each. The reason behind it, of course, are the talc lawsuits around Baby Powder and Shower to Shower which have been adroitly hived off, but continue. CNBC, Reuters

Population health and genomics is more Color(ful) than ever, with the company’s $100 million Series E topping off last year’s $167 million Series D for a total of $497 million since 2014 (Crunchbase). Valuation of the company is now at $4.6 billion. Color’s platform is targeted primarily to the public sector–health agencies, research institutions, employer organizations, health systems, and others for custom-built software that can integrate patient information and genomics with lab results and education.  It previously teamed up with the National Institutes of Health for the ‘All of Us’ project collecting research data from a broad scope of the US population. Mobihealthnews

San Diego-based Cue Health, which up to now was known for a molecular COVID-19 at-home test, is expanding its direct to consumer market with a virtual health platform featuring their COVID-19 test (on FDA EUA, CE marked) starting on 15 November. It’s expanding ‘on cue’ with a membership offering, Cue+, with 24/7 online medical consults, e-prescriptions, what they term CDC-compliant test results for travel through in-app video proctoring, and same-day delivery of their products. Membership starts at $49.99 per month for the lowest level plan, escalating to $89.99/month for supervised COVID-19 testing. To make this work requires a Cue Reader that costs $249 along with testing packs priced at $225 for three. Cue also has in development testing for other factors–where it started prior to the annus horriblis of 2020. Not for those on a tight budget, but if you need it…. Cue release, Mobihealthnews

Amwell’s busy Q3 in visits reflected the uptick in the ‘delta’ variant of COVID-19, but was disappointing on the earnings side as urgent care brings in less revenue than behavioral health or specialty care. Amwell’s year-to-year revenue was down less than 1% to $62.2 million, but the decrease is forcing a revision in 2021 full year forecasted revenue. The Converge platform [TTA 29 April] has reached 4,000 providers and 43 enterprise clients which was far more than forecasted. Newly acquired SilverCloud and Conversa Health [TTA 29 July] are integrated into Converge and already cross-selling. Amwell, however, remains in the red with a quarterly net loss of $50.9 million. Healthcare Dive  

The Telehealth Wars continue to see-saw, with Teladoc’s Investor Day on Thursday 19 Nov next week. According to Seeking Alpha, a stock analysis site, “Bank of America is cautious on TDOC ahead of the event, citing questions about the near-term margin trajectory and competition. Shares of Teladoc rose 22% in the three weeks following its last investor day.”

News roundup: GE Healthcare spins off, Mercy Health accused of telehealth tech theft, NHS’ proposed $8.1bn bump for backlogs–with a 83 y/o in a 7am queue

Breaking up GE is so very hard to do–or is it? The long-rumored spinoff of GE Healthcare will be happening by early 2023. Leadership will also be changing, with Integra LifeSciences CEO Peter Arduini becoming president and CEO on 1 January, replacing Kieran Murphy who came from the Life Sciences business and the UK. A GE connection will remain since GE chairman and CEO Lawrence Culp will serve as non-executive chairman of GE Healthcare after spinoff. Also spinning off by 2024 will be the power and energy business. What remains of General Electric will be the commercial aviation and defense aviation business. 

A spinoff of GEHC was in the works in 2018, but faltered when the then-CEO left. It currently is a $17 billion business which, like its competitors Siemens Healthineers, Philips, Fujifilm, Toshiba, and Hitachi, has been affected by supply chain disruption. In third quarter, there was a 6% decline in revenue to $4.3 billion in the period compared to a year ago. Barron’s estimates that the valuation of GEHC would be about $54 billion after spinoff, even with debt and related costs.

For GEHC and its people, at least one decision about the future is resolved. And one could hope that GEHC could finally free itself of the Welch (and later) ‘take it or leave it’ legacy that never seemed to fit healthcare, the brutal GE internal culture, and chart its own course of innovation and improved customer service.  CNBC, Healthcare Dive

Mercy Health, a health system headquartered in St. Louis, is being sued by former telehealth provider LifeScience Technologies LLC (LST) for misappropriation of trade secrets, breach of contract, civil conspiracy, and more . LifeScience’s m.Care was being used by Mercy from 2015. In the lawsuit filed by LifeScience, Mercy is being accused of giving Myia Health’s software development team improper access to LST’s virtual health software using @Mercy.net credentials. Mercy then invested $5 million in Myia Health and replaced m.Care with Myia’s ‘derivative’ software. The lawsuit was filed in the United States District Court for the Eastern District of Missouri, Eastern Division on 25 October. Springfield News-Leader, LST release

Last month’s proposed NHS budget from the Finance Ministry included a $8.1 million boost to help resolve patient waiting lists and modernize technology. The ‘boomerang’ of cases from the pandemic lingers on. The increase represents $3.2 billion for testing services, $2.9 billion to improve technology, and $2 billion to increase bed capacity. VOA. Perhaps the increase will help a gentleman like Keith Pratt, aged 83, who faced at London Road Community Hospital first a lost blood test that was part of his diabetes checkup, and then, because he had no computer nor access to log in for a new appointment, was forced to queue at 7am at the walk-in clinic. Derbyshire Live reported that “Keith feels that people without internet access are being overlooked when it comes to accessing NHS services in Derbyshire. He said: “I’ve not got a computer and I am like thousands of other people who haven’t got a computer, not just older people like myself.” Will the technology improvements include not losing tests, and phone backup for appointments? Wouldn’t that be nice?