IBM Watson Health’s stumble and possible fall

July 21, 2021 | by

This Editor hadn’t thought about or seen news about IBM Watson Health in over a year…and likely, neither did you. Granted, our minds have been Otherwise Engaged, but for the company that was supposed to dominate AI and health analytics, it’s notable that TTA’s last two articles mentioning Watson Health was 25 April 2019, on a report that its Drug Discovery unit was being cut back as the latest in a series of executive cutbacks and lawsuits (MD Anderson on a failed oncology initiative), and 14 Feb 2020 on 3M’s lawsuit on unauthorized use of their software.

The New York Times in an investigative piece (may be paywalled or require signup for limited access), brings us up to date on what is happening at IBM Watson, and it’s not bright for Watson Health. IBM, like so many other companies, badly underestimated the sheer screaming complexity of health data. Their executives believed they could translate the big win on the “Jeopardy!” game show in 2011, based on brute computing power, into mastery of healthcare data and translation into massive predictive models. The CEO at the time called it their ‘moon shot’. Big thinkers such as Clayton Christensen chimed in. IBM managers sang its praises to all in healthcare who would listen. This Editor, on a gig at a major health plan in NJ that was ‘thinking big’ at the time and used IBM consultants extensively, in 2012 was able to bring in speakers from Watson for an internal meeting.

But we haven’t been on the moon since 1972 (though probes have visited Mars). Since the big push in 2011-12, it’s been one stumble after another. According to the Times:

  • The bar was set much too high with oncology. Watson researchers knew early on in their research at the University of North Carolina School of Medicine that their genetic data was filled with gaps, complexity, and messiness. The experience was similar with Memorial Sloan-Kettering Cancer Center. The products growing out of the UNC and MSKCC research, Watson for Genomics and Watson for Oncology, were discontinued last year. These were in addition to the MD Anderson Cancer Center initiative, Oncology Expert Advisor for treatment recommendations, that was kicked to the curb [TTA 22 Feb 2017] after $62 million spent. At the same time, IBM’s CEO was proudly announcing at HIMSS17 that they were betting the company on multiple new initiatives. 
  • Watson Health, formed in 2015, bought leading data analytics companies and then didn’t know what to do with them. TTA noted in August 2018 that Phytel, Explorys, and Truven Health Analytics were acquired as market leaders with significant books of business–and then shrank after being ‘bluewashed’. HISTalk, in its review of the Times article, noted that along with Merge Healthcare, IBM spent $4 billion for these companies. IBM’s difficulties in crunching real doctor and physical data were well known in 2018 with revealing articles in IEEE Spectrum and Der Spiegel. 

Six years later, Watson Health has been drastically pared back and reportedly is up for sale. Smaller, nimbler companies have taken over cloud computing and data analytics with AI and machine learning solutions that broke problems down into manageable chunks and business niches.

What’s recoverable from Watson? Basic, crunchy AI. Watson does natural language processing very well, as well as or better than Amazon, Google, and Microsoft. Watson Assistant is used by payers like Anthem to automate customer inquiries. Hardly a moonshot or even clinical decision support. For business, Watson applications automate basic tasks in ‘dishwashing’ areas such as accounting, payments, technology operations, marketing, and customer service. The bottom line is not good for IBM; both areas bring in a reported $1 billion per year but Watson continues to lose money. 

Saturday summer morning fun: treat yourself (or your boss) to a Dead Startup Toy

July 16, 2021 | by

Making Lemonade Out Of Lemons. Most of our Readers have seen startups come and go. Some this Editor has profiled were regrettable. Some had Cute Factor, but still tanked. Others were high in Stonato Factor. And a few, like Theranos, had Major Fraud Factor, augering in taking hundreds of millions of OPM with it (not including legal fees).

But entrepreneurial hope springs eternal, and why not memorialize these College Trys with a toy? MSCHF of Brooklyn has style, enough to go viral with a unique spin on swag. You can go on eBay, Poshmark, or Etsy to grab a Theranos poster or mug, but you can’t get a Theranos mini MiniLab to put on your shelf as a memento mori. Or a toy Jibo [TTA 18 July 2014]  to remind you to not go up against Google and Amazon. There’s also CoolestCooler, a Kickstarted cooler/speaker/blender that never delivered the goods but burned through $14 million, Juicero, an $400 IoT juicer that laid waste to $120 million in one year, and One Laptop Per Child, a Nick Negroponte-headed $100 laptop full of clunkiness that didn’t make it past the Seven Year Itch of Reality.  (The last two are sold out)

Have some fun reviewing–and shopping.  Hat tip to Reader Dave Albert of AliveCor (KardiaMobile), who definitely has a sense of humor!

Volte-face: VA now puts their Cerner EHR implementation on hold

July 16, 2021 | by

The US Department of Veterans Affairs has pulled a 180° on the Cerner EHR implementation. In a move worthy of the old-time moonshine runners, VA Secretary Denis McDonough went before the Senate Veterans Affairs Committee on Wednesday to announce that the deployment of the Cerner system in the VA is on hold. This is after maintaining two weeks ago [TTA 2 July] that they were sticking with Cerner and the implementation, pending a further review.

In the interim, the VA Office of Inspector General (OIG) issued two reports that criticized the unreliable estimating process for various upgrades to the system, including lack of complete documentation, and the implementation of the Cerner EHR at Mann-Grandstaff VA Medical Center in Spokane, Washington, starting in October 2020. HealthcareITNews

In a classic ‘falling on one’s sword’ in the Wednesday hearing, Secretary McDonough told the committee that the project review found multiple “governance and management challenges” as well as patient safety concerns and system errors. He attributed them to VA and Cerner leadership, or lack thereof. For instance, VA clinicians couldn’t easily find help from Cerner on the initial rollout at Mann-Grandstaff VA Medical Center. The clinician using it called the help desk, reaching a Cerner employee there but a week. The Cerner EHR also generated duplicate prescriptions and confused patients.

The approach to implementing the modernized Cerner EHR approach will be ‘reimagined’ (DC-speak for redoing what should have been done right the first time, which started in 2017). This will start with a new, enterprise-wide governance structure to manage the project and integrate it with other modernizations, according to the Secretary. He admitted that the original plan to roll out the EHR by geographic area was a mistake. It will also not be synchronized with the Department of Defense rollout, which has proceeded without serious hitches. Go-lives will now be based on evidence of readiness, such as training, infrastructure, and management.

The Deputy Secretary has been designated to be directly in charge of the project. Acting undersecretary for health Richard Stone, MD, who had been in charge of the Cerner implementation, resigned in June after not being considered for the deputy secretary post. Secretary McDonough pitched the senators on quickly confirming nominee Donald Remy, with whom he will be speaking on big decisions. (One would hope. Mr. Remy, who was confirmed on 15 July. )

The final straw for the senators was budget. HISTalk summarizes: “The cost of the project, which was originally estimated at $10 billion when Cerner was awarded a no-bid contract in 2017, has risen to over $20 billion. McDonough has ordered a new budget estimate for the entire project, which will include the several billion dollars of infrastructure upgrades that the original estimate missed.”

Looks like the Old Gray Mare of EHRs, VistA, will be lingering for awhile. This Editor lays even money that the senators will be discussing the same issues, such as revenue cycle management, in 2025. Becker’s Hospital Review, Federal News Network

The King’s Fund annual conference returns in November, virtually

July 16, 2021 | by

The King’s Fund has been able this year to maintain a virtual event schedule, of conferences, one-hour free events, and three-hour workshops. Thus it was good news that one of those conferences will be their annual conference 29 November-2 December, but not in person quite yet. It will be full virtual, first live then on demand through the end of the year. Content will center around:

  • the role of the NHS and the wider health and care system in tackling health inequalities
  • what the new health and social care Bill means for the system in England
  • how the recovery from the impact of the Covid-19 pandemic is being managed and plans to meet the backlog challenge
  • how to meet the needs of the health and care workforce.

For more information, registration, and sponsorship opportunities, check their conference page here.

The implications of Teladoc’s integration into Microsoft Teams

July 16, 2021 | by

The Big News this week was the terse announcement by Microsoft and Teladoc that Teladoc’s Solo application for hospitals and health systems will be integrated into Microsoft Teams applications. The integration includes workflows and through Solo, integration into EHRs while remaining in Teams.

During the pandemic, many health systems resorted to Microsoft Teams to communicate internally and one-on-one with patients. Integration means that while on the Teams consult, a clinician can securely access clinical data included within the EHR and workflows via Teladoc Health Solo without leaving it. It can also connect care teams on the consult. The release also mentions the magic words artificial intelligence and machine learning, without giving examples. 

As of now, with telehealth receding to perhaps 5% of visits based on claims [TTA 9 July], it’s a strategic win for Teladoc to integrate with a part of the Microsoft suite widely used by providers. It also builds on an existing relationship between the companies, as Teladoc already uses Azure as one of its cloud providers. Health systems still have to license Teladoc Solo if they do not already, and engineering work is yet to be done. Teladoc has a substantial foothold in this market due to its July 2020 acquisition of InTouch Health. InTouch’s hospital-to-home telehealth is now Teladoc Solo, with a separate line of business into the specialty telehealth consult market through its portable wheeled telehealth carts for in-hospital use. It’s notable that the InTouch brand remains, albeit visibly transitioning to Teladoc.

According to Credit Suisse’s analysis (page 3), 46% of C-Level executives from hospitals and health systems (combined representing 563 hospitals) said that they currently work with Microsoft Teams as a telemedicine vendor. 11% said they already work with Teladoc/InTouch Health.

As for telehealth already used by providers, such as Zipnosis’ ‘white label’ triage/telehealth system (now owned by insurtech Bright Health) and Bluestream Health, can they compete? Also FierceHealthcare

UnitedHealthcare pilots predictive analytics model for SDOH, sets out plan to transform into ‘high-performing health plan’

July 15, 2021 | by

UnitedHealthcare and its parent UnitedHealth Group (UHG) have been busy in the past few weeks. Of most interest to our Readers with an interest in data analytics is UnitedHealthcare’s pilot of a social determinants of health (SDOH) initiative that uses de-identified claims data to identify members at high health risk due to social factors. UnitedHealthcare call center staffers then contact members to further determine needs and to assist them with appropriate community resources. These can include assistance with childcare, obtaining internet access, financial assistance with medical bills, healthy food options, and local support groups. Staffers are also trained to extend the conversation beyond the first call.

SDOH factors can impact up to 80% of a person’s health, according to research performed by the Robert Wood Johnson Foundation.

The predictive analytics model for SDOH was developed with Optum from data gathered from 300 markets and across 100 metrics. Call center staff are also clued to members with needs through keywords or phrases that indicate a need for assistance: “I’m hungry” or “I’m struggling to make ends meet”. The initiative also allows employers to design interventions for their employees.

The pilot is for two employer products, Advocate4Me Elite and Advocate4Me Premier. About half of the contacted members in the pilot have accepted assistance. UnitedHealthcare plans to roll the program out to other fully insured employer plans later this year. Release, FierceHealthcare

UnitedHealth Group, the parent of UnitedHealthcare and Optum, published its annual corporate Sustainability Report. where SDOH has a considerable part. It’s a roadmap for transformation into a high-performing health plan that is part of a modern, high-performing health system–a very high bar for UHG as the largest US health plan. This builds on six points detailed on page 9, most of which SDOH affects:

  • Expanding access to care
  • Improving health care affordability
  • Enhancing the health care experience
  • Achieving better health outcomes
  • Advancing health equity
  • Building healthy communities

SDOH has become significant enough to become the subject of a House bill, HR 2503, the Social Determinants Accelerator Act of 2021, to support community groups in coordinating health and social services through grants, technical assistance, information exchange. It, of course, would not be complete without a federal inter-agency technical advisory council. There is a similar bill in a Senate committee and funding made available to the Centers for Disease Control and Prevention’s Social Determinants of Health Program. FierceHealthcare

News roundup: AliveCor’s latest FDA clearance plus antitrust vs. Apple, VRI on the market, Walgreens’ ‘tech-enabled future’ indefinite plus VillageMD status, monthly telehealth usage drops 12.5%

July 9, 2021 | by

AliveCor disclosed its latest FDA 510(k) clearance for the KardiaMobile 6L, for calculation of patients’ QTc interval by the patient remotely or in the office with a physician or other clinician. QTc interval is, for those of us who aren’t cardiologists, is the total time from ventricular depolarization to complete repolarization. If too long (prolongation) or too short (congenital short) for the heart rate, it can indicate a dangerous ventricular arrhythmia or atrial or ventricular fibrillation. The manual measurement takes 30 seconds. AliveCor also has clearance on software (InstantQT) that measures QT intervals quickly and accurately to detect potentially dangerous QT prolongations in patients. Prolongations can be triggered by medications including anti-arrythmia drugs, anti-fungals, antibiotics, and some psychiatric drugs. AliveCor release. In other recent news, in June they acquired CardioLabs, a monitoring and cardiac diagnostic service provider based in Tennessee, to expand their clinical servies. Release.  

And in David Sues Goliath–Again–News, AliveCor also filed, in that quiet week right before Memorial Day, a Federal antitrust suit in the Northern District of California. This lawsuit is over Apple’s exclusion of other heartrate analysis providers from the Apple Watch, harming AliveCor and consumers, and seeks damages plus an injunction to cease the exclusion. Release  This is in addition to their US International Trade Commission (ITC) complaint on infringement of AliveCor patents held for heart monitoring on the Apple Watch 4, 5, and 6. That seeks to bar importation of Apple Watches [TTA 29 Apr]. No update on that so far. 

‘Insider’ report: VRI on the market. PERS Insider, our newly discovered source for news about the emergency response device market, reported on 22 June that VRI, a PERS and remote patient monitoring provider, is up for sale. It has been majority-owned by Pamlico Capital, a private equity company, since 2014. VRI does not sell direct to consumer but concentrates on health insurance, government programs, and other B2B through its dealer network. No reasons for sale given, but with all things telehealth and most things remote healthtech fetching hefty sums post-pandemic, perhaps Pamlico senses a fortuitous time to test the waters for an exit. Article. (Subscribe here to their weekly free letter)

Walgreens Boots Alliance’s new CEO promises a ‘tech-enabled’ future for the chain, sans details. The incoming CEO, Rosalind Brewer, fresh from her COO position at Starbucks, on WBA’s Q3 earnings call mentioned a buildout of a “previously communicated tech-enabled healthcare initiative” but no further information, as still reviewing the company. Stefano Pessina has retired from the long-held CEO position, but retains the executive chair title in addition to being WBA’s largest individual shareholder. Forbes’ breathless report. More to the profit point, the latest on Walgreens and VillageMD’s full-service Village Medical practices at Walgreens locations: 29 new locations in Houston, Austin and El Paso, Texas this year, staying on track for 600 primary care practices in more than 30 markets over next four years. Business Wire

National telehealth usage dips to 4.9% of US claims in April, a 12.5% drop from March. Analyzing regional and national insurance claims data, non-profit health analytics company FAIR Health in its monthly report tracks telehealth receding as patients return to in-person care. Telehealth is now dominated by mental health procedure codes, accounting for 58.65% of diagnoses, with all other conditions at 3% or lower. Regionally, the Northeast is even higher at 64.2% and the Midwest above 69%. Monthly National report, Monthly Regional Tracker page

An ‘insider’ point of view on the Connect America acquisition of Philips Lifeline

July 9, 2021 | by | 2 Comments

This Editor, through a search initiated due to reader Adrian Scaife’s comment on the article below, happened on a back article from a news source on the Connect America acquisition of Philips Lifeline. Who knew (as they say) that there was a newsletter solely devoted to the PERS business? The article was written from a real insider point of view with a complete background on Connect America, Lifeline, and also why Philips put Lifeline up for sale.

  • It’s likely that Philips bought high and sold low. In 2006, Philips purchased Lifeline for a reported $750 million, then HealthWatch for an additional $130 million. At the time of the announcement, PE Hub put the value of the company in the $200-400 million range. It’s understandable that with the rise of smartphones and mobile, wrist-worn band-type PERS, the value of what is largely a traditional PERS company would suffer, but the best case is a 60 percent loss over 14 years.
  • The industry believes that Philips mismanaged the company. Example: dealers did not have 4G/LTE cellular equipment to replace the 3G in the field. The phrases ‘a mess’ for the organization and ‘run the Lifeline name into the ground’ aren’t used lightly.
  • For the past few years, Lifeline has been in the shadow of Philips’ other clinically-oriented healthcare systems. As this Editor noted, Philips has divested or spun off multiple businesses in North America.
  • Philips ran the business without understanding its unique dynamics, including dealer networks and a B2B +B2C market of home health agencies and senior housing combined with direct-to-consumer sales. They focused on the latter and kept it on short rations for the past few years.
  • They were also slow to market with innovations and had a significant amount of negative publicity on the performance of AutoAlert for fall detection starting in 2011 (Editor Steve) and in 2014.

The Philips Lifeline saga was a longer and more costly version of Tunstall’s acquisition of AMAC. At the time of sale, Lifeline was #1 in PERS, and AMAC was #3. Even with Tunstall’s expertise and the addition of remote patient monitoring, the US market was Too Tough For Tunstall. They sold in 2019 to…drum roll…Connect America.

The article includes excerpts from an interview with CEO Janet Dillione, a review of the Connect America team, and well wishes from those insiders. PERS Insider (Subscription to the weekly newsletter is free and found here.)

Another irony: Just prior to the acquisition, Dennis Shapiro, the former head of Lifeline, passed away on 16 February, aged 87. Mr. Shapiro was responsible for the company creating the first modern PERS radio pendant, telephone-connected base unit, and call center monitored service in 1980.

 

News/deals roundup: Connect America finalizes Philips aging/caregiving buy; Amedisys-Contessa $250M hospital-at-home; UK’s Physitrack $20M IPO, Dutch motion tracker Xsens

July 7, 2021 | by | 2 Comments

Kicking off our week….

Connect America closed today (6 July) the purchase of Royal Philips’ Aging and Caregiving line of business. This includes the top basic personal emergency response system (PERS) device provider, Lifeline. Purchase price by Connect America’s owner, Rockbridge Growth Equity, was not disclosed. For Connect America, they now top 900,000 subscribers to PERS and monitoring services. At this point, the combined business will have 1,500 employees and 3,000 provider partners. Lifeline also includes services such as 24/7 response with their products: the HomeSafe traditional home PERS with and without AutoAlert fall detection and GoSafe2 mobile PERS with AutoAlert.

There is no indication from the company release or the brief Mobihealthnews article on whether the Lifeline brand name or others from Philips will be retained. Lifeline’s history dates back to 1974, with Philips adding the AutoAlert, HomeSafe, and GoSafe product after their purchase in 2006. Other undisclosed considerations are integration and rationalization of the current Connect America PERS and monitoring products with Lifeline. There is also a promotional partnership agreement with AARP that likely–but not necessarily–will transfer with the purchase. This Editor can tell you that a seat at AARP’s poker table requires a tall stack of chips.

Our earlier article on the acquisition profiles Connect America, Lifeline, and the decline of traditional/mobile PERS with the rise of accessible wristwatch and band forms that don’t scream ‘I’m at risk of falling and not being able to get up!’

Home healthcare provider Amedisys announced their $250 million acquisition of Contessa Health, extending into hospital-at-home and skilled nursing-at-home. As our Readers who looked at Ziegler’s analysis [TTA 25 June], this is a hot and tech-driven care area. Amedisys is claiming that they are the first home health, hospice, and personal care service provider to expand into Contessa’s business, which is hospital-at-home and skilled nursing facility (SNF) at-home including palliative care services launched recently with Mount Sinai Health System (NY). Contessa will operate as a separate division of Amedisys, which plans to invest in both the future growth of Contessa and their proprietary informatics platform CareConvergence with the aim of creating a “premier home-based health system”. The acquisition is expected to close on 11 August. Contessa has both hospital partnerships, which are the bulk of Amedisys’s client business, and joint venture/payer partnerships. Amedisys release, Hospice News

The UK’s Physitrack quietly went public with a raise of over $20 million. The IPO was listed on 18 June on the Nasdaq First North Premier Growth Market (Nasdaq Nordic, Sweden and Finland) earlier this month with an original offering of SEK 40 ($4.69) per share with 4.4 million shares in the offering. The market value is estimated at SEK 624 million ($72.5 million). Unfortunately, you cannot look beyond this investor page if you are in the US, Australia, Canada, Hong Kong, Japan, New Zealand, Singapore, Switzerland, South Africa, or South Korea as citizens of these countries cannot invest in their shares. Physitrack is a digital physical therapy plus patient engagement company headquartered in London with offices in Santa Monica, Houston, and Utrecht. It was in the first group of the NHS’ Digital London accelerator program and now is distributed in 100 countries serving 1 million patients. Mobihealthnews, Baker McKensie (legal advisor announcement)

And keeping it physical, Xsens, a Dutch 3D motion capture and attachable sensor company for therapy and ergonomics study, is extending into Automatic Reporting as part of its online MotionCloud platform. A full report, graphs, and a digital recording of an avatar completing the movements can be available to physiotherapists, health specialists, and ergonomic consultants in under two minutes. In addition, they announced a new Awinda Starter system which has their proprietary motion-tracking technology at a more affordable price. Xsens press release, Mobihealthnews

Lightning news roundup: AI for health systems Olive scores $400M, VA’s sticking with Cerner EHR, Black+Decker gets into the PERS game

July 2, 2021 | by

As here in the US we are winding up for our Independence Day holiday (apologies to King George III)….

Olive, a healthcare automation company for healthcare organizations, scored a venture round of $400 million from Vista Equity Partners. To date, it’s raised $856 million through a Series G plus this round and is now valued at $4 billion according to the company release. Olive’s value proposition is automating via AI routine processes and workflows, such as benefit verification discovery, prior authorizations, and billing/payments for health systems. About 900 US hospitals have adopted Olive’s systems. Mobihealthnews.

Breaking: The US Department of Veterans Affairs will be staying with Cerner Millenium for their EHR modernization from VistA. This follows a 12-week review of the implementation following failures within the $16 billion program itemized by the Government Accountability Office (GAO) in February [TTA 19 Feb]. Secretary Denis McDonough is scheduling two further review weeks to determine additional changes to the program. The intent is to build a cloud-based system fully interoperable with the Department of Defense’s Military Health System (MHS) also built with Cerner. FedScoop, Healthcare IT News

And in the What Are They Drinking in Marketing? I want some of that, stat! department…

Black + Decker is now becoming a PERS provider with the introduction of Black+Decker Health and the goVia line of mobile and home-based PERS with optional fall extension and call center monitoring through Medical Guardian . The devices are a fairly predictable line of cellular-connected (Verizon, AT+T) with a ‘classic’ home landline unit. The units are being sold through Amazon. B+D release

From a marketing perspective, the Black+Decker name, identified for decades with home and power tools, on a PERS line is also a classic–a classic mistaken line extension like Cadbury mashed potatoes or Colgate frozen entrees. Buy a PERS, get a drill? Relevance and fit to a older, female-skewing group?  It surely looks like their parent Stanley, which is a leading company in institutional alarm and location services. offloaded this legacy business to them. (Judging from the website, someone’s in a rush as some pages still have ‘greek’ copy under headings.) Hat tip to a Reader who wishes to remain anonymous.

Tunstall under fire in Swedish court on appeal of Adda procurement exclusion

July 2, 2021 | by

Tunstall appeals Swedish procurement exclusion. Tunstall has gone to a Swedish administrative court to fight the exclusion by Adda Inköpscentral from the Swedish framework agreements for the municipal procurement of telehealth and security alarms,  In April, Adda, the strategic supply consultant and agreement manager, announced that Tunstall would be excluded from two 2018-2019 framework procurement agreements as well as the new four-year framework agreement on performance issues, including a major problem with alarm responses last October [TTA 22 May]. 

What is being debated in court in the action between Tunstall and Adda is the following, according to SVT Nyheter (disclosure: translated from Swedish to English via Google Translate):

  • Certain municipalities received compensation from Tunstall, which the company has refused to disclose nor what the agreements look like, other than they were based on a template. Municipalities also refused to send Adda copies of the agreements, citing confidentiality. In Sweden, municipalities can negotiate agreements on their own with suppliers, but if they choose to work under the framework agreement, the municipalities create their own detailed contracts using the framework as a basis. Adda apparently received copies of agreements that included ‘silence’ (presumably non-disclosure or confidentiality) clauses. According to Adda, this violates both the framework agreement and ‘publicity legislation’.
  • According to SVT quoting Adda’s filing, “Tunstall “consistently deliberately withheld information from Adda, probably in order to avoid exclusion in the Procurement” and now “deliberately tries to mislead not only Adda, but also the administrative court.” This also refers to data files that contained information about when alarms stopped working in over 100 municipalities in October 2020 due to, apparently, a bad software update. The translation in the article subhead refers to “lying and misleading the court”.
  • Municipalities had delays in implementation going back to 2018. Ystad demanded a fine of half a million for its delays, where it turne out that response times had been calculated in different ways, After Tunstall promised improvement, Ystad dropped the demand. Götene signed an agreement on security alarms for nursing homes in spring 2020 but only a limited number were operative by December well into this year. This municipality remains unhappy according to SVT, contradicting Tunstall’s official statement to the publication, which closes the SVT main article.

There is no indication in the article when a decision will be made by the administrative court.

There is a second SVT article on the disagreement on the handling of an alarm call in Lidingö. The Tunstall call center did not call for an ambulance, the city was delayed for two hours, and the person died. Neither Tunstall nor Adda were interviewed for the 24 June SVT articles. Hat tip to two of our Readers who wish to remain anonymous. One also referred, with a certain gimlety turn, to two 2018 interviews with CEO Gordon Sutherland on the subject of building trust both as an organization and with their customers. PwC (January 2018) and The Trusted Executive (June 2018).

Four ‘moonshot’ health tech startups aiding cognition and brain health (podcast)

July 1, 2021 | by

This 30 minute podcast interviews four tech entrepreneurs in the StartUp Health Health Transformers accelerator/funding ‘moonshot’ program. Their focus is on technologies designed to improve brain health and address issues around cognitive impairment and disease.

  • Amir Bozorgzadeh, CEO & Co-founder of Virtuleap, a Lisbon-based company that uses VR and gamification in the Enhance VR brain training app for a daily cognitive workout of short, intense, and fun games
  • Kate Rosenbluth, PhD, Chief Science Officer & Founder at Cala Health, Cala Trio is a wrist-worn stimulator that reduces hand tremor for people with essential tremor (ET). Up until this therapeutic device, the only option for ET was a stimulator inserted in a key portion of the brain. 
  • Maor Cohen, CEO & Co-founder of n*gram health, uses immersive digital experiences and augmented reality delivered via smartphone and tablet for assessment, evaluation, and improvement in older adults with cognitive impairment.
  • Mark Cavicchia, RC21X co-founder. RC21X has developed two brain and human performance assessment tools, Roberto and RC21X. These provide brain performance trend data that can be used in healthcare, for monitoring treatment and recovery plan effectiveness, as well as industrial safety.

All these businesses are well along in proven technology and funding, a trend we’ve been finding with accelerators that once specialized in startups barely out of seed and still proving their models. Cala Health, for example, we noted in 2016 with its $18 million raise, but has been around since 2013. RC21X, once Home Base, also has been around since 2013.

The podcast is hosted by India Edwards and Logan Plaster. Mr. Plaster, StartUpHealth’s media director, and this Editor worked together on an article about the late Viterion Digital Health in his previous venture with Telemedicine Magazine. 

‘Insurtech’ Bright Health’s IPO second largest to date, but falls slightly short of estimates (updated)

June 30, 2021 | by

Bright Health Group’s IPO last Friday (23 June) fell a little short of the $1 billion+ raise and valuation projection two weeks ago, but not by much on a bad market day. Their $924 million raise was based on a float of 51.3 million shares at an opening price of $18 per share, with a targeted price range of $20 to $23. (Thursday 1 July’s BHG close: $16.85, a typical pattern.)

The raise compares favorably to Oscar Health’s blockbuster $1.44 billion IPO, Clover Health’s controversial but lucrative SPAC [TTA 9 Feb]. and Alignment Health’s $490 million.  Bright Health also acquired Zipnosis, a telehealth/telemedicine ‘white label’ triage system for large health systems, in April [TTA 6 Apr].

The IPO now creates a company value of $11.23 billion, down from the expected $14 billion. Bright Health is unique in its category in not only offering exchange and Medicare Advantage plans but also NeueHealth, 61 advanced risk-bearing primary care clinics delivering in-person and virtual care to 75,000 unique patients. FierceHealthcare, Reuters, Bright Health Group release. Also see TTA 18 June and 28 May.

Telehealth usage going flat, off by 1/3 and declining: Trilliant Health study

June 30, 2021 | by

Trilliant Health, a healthcare data analytics and advisory shop based in Tennessee, has run some projections on the US healthcare market and telehealth, and they’re not as bright as many of us–and a lot of investors plus Mr. Market–have believed. It opens up on page 4 of the electronic document (also available in PDF) with this ‘downer’–that the largest sector of the largest global economy is overbuilt and unsustainable. Hospitals and health systems have operated for decades that basic economic factors–demand, supply, and yield–don’t apply, and there are more companies competing with them for the consumer healthcare dollar than they realize–with more proliferating every day. 

Sledding through their 160-page report, we turn to our sweet spot, telehealth, and Trilliant is not delivering cheerful news (pages 32-43). 

  • Unsurprisingly, demand for telehealth is tapering off. Based on claims data for face-to-face video visits, excluding Medicare fee-for-service (Original Medicare) and self-pay visits, they peaked above 12 million in April 2020 and, save for a bump up in December 2020-January 2021, steadily declined to about 9 million by March 2021.
  • Teladoc, the leading provider, is projecting that 2021 volume will only represent 4 percent of the US population–a lot more than before, but not growing as it did in 2020.
  • Telehealth’s growth was astronomical on both coasts–California, Massachusetts, Vermont, Oregon–and Hawaii–but relatively lower in middle and Southern America in places like Wyoming, North Dakota, Mississippi, and Iowa. Telehealth usage is declining sharply in that region as well but across the board in all states including California. In fact, Phoenix and Dallas had higher telehealth utilization pre-pandemic than during it.
  • Mental health drove telehealth growth during the pandemic, representing 35 percent of claims, almost four times the next group of categories at 8 percent. The largest group of diagnoses were for anxiety and depression among women 20-49. With the reopening of the US economy and children heading back to school, will this sustain or decline?
  • Women 30-39 are the largest users of telehealth–pre, during, and post-pandemic

Telehealth is not only proliferating, it is going up against now-open urgent care, retail clinics from Walgreens, Walmart, and CVS, plus tech-enabled providers that blend virtual care with home care, such as Amazon with a full rollout of Amazon Care and other employers. The cost of care is also a negative driver. FierceHealthcare analyzes other parts of the report impacting practices, health systems, and hospitals.

 

Weekend reading: 1/3 of global healthcare orgs ransomwared, 50%+ mobile privacy problems–BMJ study, med device insecurity

June 25, 2021 | by

Weekend reading to make you feel insecure, indeed. Healthcare continues to be one of the most vulnerable sectors to hacking, breaches, ransomware. (It likely was one of the top 5 on the list handed to Mr. Putin in Geneva a week ago.) It doesn’t help that many organizations from providers to payers, legacy devices to apps, figuratively have a ‘Welcome Hackers’ neon sign on their doors, virtual and otherwise.

Three articles from the always interesting Healthcare Dive, two by Rebecca Pifer and the third by veteran Greg Slobodkin, will give our Readers a quick and unsettling overview:

  • According to cybersecurity company Sophos in their 16-page report, 2020 was an annus horribilis for healthcare organizations and ransomware, with 34 percent suffering a ransomware attack, 65 percent confirming the attacks encrypted their data, but only 69 percent reported that the encrypted data was restored after the ransom was paid. Costs were upward of $1 million. Their conclusion: assume you will be hit, and at least three backups. Dive 24 June
  • The BMJ found that lax or no privacy policies were a key problem with over half of mobile health apps. 23 percent of user data transmissions occurred on insecure communication protocols and 28.1 percent of apps provided no privacy policies. There’s a lot to unpack in the BMJ study by the Macquarie University (Sydney) team. Our long-time Readers will recall our articles about insecure smartphone apps dating back to 2013 with Charles Lowe’s article here as an example. Dive 16 June
  • Old medical devices, continuing vulnerability that can’t be fixed. Yes, fully functioning and legacy medical devices, often costing beaucoup bucks, are shockingly running on Windows 98 (!), Windows XP, outdated software, and manufacturers’ passwords. It’s hard to believe that Dive is writing about this as it’s been an issue this Editor’s written about since (drumroll) 2013 when TTA picked up on BBC and other reports of ‘murderous defibrillators and pacemakers’. If too far back, try 2015 with Kevin Fu’s and Ponemon’s warnings then to ‘wash their hands’ of these systems even if they’re still working. Chris Gates quoted in the article: “You can’t always bolt-on security after the fact, especially with a legacy piece of equipment — I’ve literally handed checks back to clients and told them there’s no fixing this.” Dive 23 June

What to do?

  • If you are a healthcare organization, think security first. Other organizations in finance and BPO do, locking down to excruciating points. And yes, you’ll have to pay a premium for the best IT security people, up your budgets, and lower your bureaucracy to attract them. Payers are extremely vulnerable with their wealth of PHI and PII, yet tend to skimp here.
  • Consider bringing in all your IT teams to your home country and not offshoring. Much of the hacking occurs overseas where it’s tougher to secure servers and the cloud reliably and fully.
  • Pay for regular and full probes and audits done by outside experts.
  • If you supply a mobile app–design with security and privacy first, from the phone or device to the cloud or server, including data sharing. There are companies that can assist you with this. One example is Blue Cedar, but there are others.
  • If you supply hardware and software for medical devices, think updates, patches, and tracking every bit you sell to make sure your customers do what they need to do. Even if your customer is a past one.

(Side message to NHS Digital–don’t rush your GPDPR upload to the summer holidays. Make it fourth quarter. Your GPs will thank you.)

Suggestions from our Readers wanted! While your Editor has been covering security issues since early days here, she is not an expert, programmer, or developer, nor has stayed at a Holiday Inn Express lately.

News/deals roundup: Amazon’s health accelerator, digital health library opens, Ziegler’s ‘Hospital at Home’ paper, SEHTA announces MedTech event; $670M in funding for Talkspace, Pear, DrChrono, NuvoAir

June 25, 2021 | by

First, the news….

Another Amazon angle on healthcare. This time, it’s the Amazon Web Services (AWS) Accelerator for healthcare startups. It’s designed as a virtual four-week technical, business, and mentorship for 10 select companies. Naturally, it’s targeted to cloud-based operations for companies with ‘demonstrated commercial traction’ in remote patient monitoring, voice technology, analytics, patient engagement, and virtual care technologies and systems. Applications opened on 21 June and proposals are due 23 July. It’s limited to US-based healthcare startups or international startups with existing US operations. This round is in collaboration with KidsX, the world’s largest pediatrics digital health accelerator formed by a consortium of over 50 children’s hospitals from North America, Europe, and Australia. AWS blog announcement, FierceHealthcare

A crowdsourced library exclusively for digital health resources and research now open. The Clinical and Translational Science Institute (CTSI) and Center for Health + Technology (CHeT) at the University of Rochester have created a crowdsourced library for the digital health community. It’s hosted by the Digital Medicine Society (DiMe); the link to the library is here. “Resources” are defined as specific pieces of specific regulations, guidances, policy, or literature that are relevant and useful “as-is”. 

Another free resource is investment bank Ziegler’s white paper on ‘Hospital at Home’. The paper addresses the leading Hospital at Home models, providers, and the reimbursement dynamics for this growing tech-enabled option serving acute patients requiring higher medical care. A worthwhile read (24 pages)-see if your tech can fit into these models.

In the UK, SEHTA (South East Health Technology Alliance) announced their 2021 International MedTech conference on 8 October in a hybrid live and virtual event format. The live portion will be at the Hilton London Tower Bridge Hotel. They’ve also added a new director, Sven Bunn, Life Sciences Programme Director at Barts NHS Health Trust & Queen Mary University of London. SEHTA news page

A lightning roundup of $670 million in deals that aren’t taking the summer off….

Talkspace finally executing its SPAC with Hudson Executive Investment Corp., with a deal expected to give the company $250 million in capital. It was originally announced in mid-January [TTA 14 Jan]. Talkspace is a consumer mental health app that helps a user assess their concerns, then matches them with a therapist. Shares are listed at $8.90 on Nasdaq with approximately 152 million shares outstanding for a valuation of $1.4 billion. Mobihealthnews

Pear Therapeutics is planning a hefty SPAC towards the end of this year with Thimble Point Acquisition Corp., backed by Pritzker family interests. It’s estimated that it will round up about $400 million giving it a valuation of $1.6 billion. The new Pear Holdings will trade on Nasdaq as “PEAR”. Pear develops end-to-end platforms for prescription digital therapeutics (PDTs) for serious diseases as stand-alone software treatments or jointly with pharmaceuticals. Pear release, FierceBiotech

Mobile-friendly EHR DrChrono now has a friendly $12 million in growth funding from ORIX Growth Capital. DrChrono also handles practice billing and management. This is on top of their January funding of $20 million, also by ORIX. Mobihealthnews (exclusive)

Stockholm-based digital respiratory care management system NuvoAir also raised $12 million (€10 million) to expand its chronic disease management and clinical trial platforms. It combines an app with data from a spirometer and sensors that attaches to asthma and COPD inhalers plus NuvoAir Cough, which assesses changes in nighttime coughing. The Series A was led by AlbionVC. Mobihealthnews, TechCrunch