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

April 17, 2020 | by

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

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

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

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

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

April 16, 2020 | by | 1 Comment

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

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

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

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

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

April 15, 2020 | by

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

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

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

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

FAQs are linked here. Also HISTalk.

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

April 15, 2020 | by | 2 Comments

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

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

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

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

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

April 10, 2020 | by

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

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

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

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

Release

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

April 10, 2020 | by

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

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

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

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

Your Editor will add:

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

Tunstall Healthcare secures funding from Barings, M&G

April 10, 2020 | by

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

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

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

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

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

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

Care Innovations sold to PRA Health Sciences; launches COVID-19 patient monitoring program

April 8, 2020 | by

Care Innovations, formerly Intel Care Innovations, formerly Intel-GE Care Innovations, was apparently sold at the end of 2019 to giant drug CRO PRA Health Sciences of Raleigh, NC.  This is based on an early termination notice published on 17 Dec 2019 of an FTC pre-merger notification . The notice is interesting as Care Innovations is listed as a holding of Hong Kong-based Essence International Financial Holdings Limited, with no mention of Intel.

It also appears from the website and a quick check on LinkedIn that some of the leadership, such as Marcus Grindstaff, the former COO, has been retained by PRA. And yes, they are still marketing QuietCare (developed by Living Independently Group, this Editor’s employer some years ago).

In recent years, CROs have used remote monitoring as part of clinical drug trials, but this may be the first purchase. PRA’s relationship with Care Innovations dates back to 2017 with a strategic partnership for clinical trials.

The latest iteration of Care Innovations’ Health Harmony is as a turnkey remote monitoring system for COVID-19, to be deployed by employers, payers, providers and health systems to track individuals who may be asymptomatic, exposed or diagnosed with coronavirus. It is designed in three stages: education, quarantine, and in-depth monitoring/care coordination with a healthcare professional. Patients report on a tablet or smartphone vitals such as temperature, heart rate, pulse oximetry and COVID-19 symptoms like shortness of breath, fatigue, and changes in coughing. This information uploads to a dashboard monitored by a clinical call center. Release Hat tip to reader Paul Costello

Tyto Care telehealth diagnostics raises $50 million in venture round

April 8, 2020 | by

Tyto Care today (7 April) announced a venture round investment of $50 million by Insight Partners, Olive Tree Ventures, and Qualcomm Ventures LLC plus previous investors. The new investment will pay for commercialization throughout the US, Europe, and Asia as well as to introduce new advanced product capabilities including AI and machine learning-based home diagnostics solutions and other patented technologies. 

Tyto’s timing could not be better for the raise. In the US, led by CMS with private payers following in near lockstep, the past month has seen the rapid unrestricting of payment for telehealth services like virtual visits of the audio-visual type and short asynchronous and synchronous image and audio/telephonic short visits. Tyto’s remote medical exams of the lungs, heart, throat, ears, abdomen, and body temperature fits into the current and likely future need. Both live exams and asynchronous forwarding of data are part of a platform that integrates with EHRs and third party exam tools.

Tyto Care works with hundreds of hospitals and over 100 health organizations including health systems, payers and strategic partners, primarily in North America, Europe, and Israel. In 2019, they had over 200,000 examinations.

If, like your Editor, you believe that the tidal wave of telehealth has changed the office visit model for keeps, adding remote diagnostics can be a winner–if Tyto can navigate the tricky shoals of a largely consumer-based marketing strategy (Best Buy) and gain adoption by health systems and payers, as they have in Israel with Sheba Medical Center [TTA 28 Feb]. Release, FierceHealthcare

The Theranos Story, ch. 62: Holmes’ attorneys request breaking ‘shelter in place’ orders for trial prep, charges shrink–and a coronavirus testing patent twist

April 8, 2020 | by

Even the ‘Bad Blood’ trial has a Coronavirus Twist. The trial of Theranos former CEO Elizabeth Holmes surfaced last week in the midst of the Public Health Emergency in the US District Court in San Jose, where Holmes is scheduled to go on trial in August. Williams & Connolly lead attorney Lance A. Wade filed a motion with Federal Judge Edward Davila to permit Holmes’ attorneys to travel, serve subpoenas and meet with potential witnesses, which would include health care professionals and testing laboratories, all in preparation for the trial. Judge Davila basically swatted it aside, stating “I have to tell you sir, I read [the document] and I was a little concerned,” the judge said. “You’re basically filing a motion in essence asking the court to violate orders in the midst of a national crisis.” Wade stated that it would be nearly impossible to prepare Holmes’ defense without violating shelter-in-place orders and public health warnings. While both the judge and the lead counsel agreed that much could be done remotely to prepare for trial, Wade maintained that it would be ‘almost impossible’ to complete it. 

The trial date may change at the next hearing on 15 April, since the judge has requested both the prosecution and defense to propose alternative trial schedules. Jury selection is scheduled to start in late July. 

A prosecutorial deteriorata? In February, the nine counts of wire fraud and two counts of conspiracy were reduced by the judge, who dismissed the two conspiracy charges related to defrauding patients and directing doctors to misrepresent Theranos to patients. He also severed Holmes’ trial from former president and live-in Sunny Balwani’s. One wonders that, between the reduction of charges and the delay which has made The Biggest Healthcare Fraud of the 21st Century old news, whether Holmes and Balwani will serve any significant Club Fed time at all. Law360. CNBC, Observer

Another Corona Twist is that a SoftBank/Fortress Investment shell company, Labrador Diagnostics LLC, which happens to own several Theranos patents, sued a small company, BioFire, developing COVID-19 tests. Labrador now states that the patent infringement doesn’t entail the COVID tests but others over the past six years. Our Readers will recall that SoftBank/Fortress was a ‘last ditch’ investor in Theranos in December 2017, collateralized by the patent portfolio. The Verge

Virus-(almost) free news: Cera’s $70m raise, Rx.Health’s RxStitch, remote teledentistry to rescue, Alcuris responds, Caravan buys Wellpepper, and Teladoc’s heavy reading

March 21, 2020 | by

Keeping calm and carrying on (but taking precautions, staying inside, and keyboarding with hands that resemble gator hide), yes, there IS some news that isn’t entirely about COVID-19:

This Editor had put aside the $70 million funding by the UK’s Cera at end of February. What is interesting is that Cera Care is a hybrid–specializing in both supplying home-based care, including dementia care, and providing tech-enabled services for older adults. The funding announcement was timed with the intro of SmartCare, a sensor-based analytics platform that uses machine learning and data analytics on recorded behaviors to personalize care and detect health risks with a reported 93 percent accuracy. It then can advise carers and family members about a plan of action. This sounds all so familiar as Living Independently’s QuietCare also did much the same–in 2006, but without the smartphone app and in the Ur-era of machine learning (what we called algorithms back then).

The major raise supports a few major opportunities: 50 public sector contracts with local authorities and NHS, the rollout of SmartCare, its operations in England and Wales, and some home healthcare acquisitions. Leading the round was KairosHQ, a US-based startup builder, along with investors Yabeo, Guinness Asset Management, and a New York family office. Could a US acquisition be up next?  Mobihealthnews, TechEU

Located on NYC’s Great Blank Way (a/k/a Broadway), Rx.Health has developed what they call digital navigation programs in a SaaS platform that connect various programs and feed information into EHRs. The interestingly named RxStitch engine uses text messages (Next Gen Reminder and Activation Program) or patient portals to support episodes of care (EOC), surgeries, transitions of care (TOC), increasing access to care, telehealth, and closure of care gaps. Their most recent partnership is with Valley Health in northern NJ. Of course they’ve pitched this for COVID-19 as the COVereD initiative that supports education, triage, telehealth, and home-based surveillance as part of the workflow. Rx.Health’s execs include quite a few active for years in the NY digital health scene, including Ashish Atreja, MD.

Teledentistry to the rescue! Last summer, we focused on what this Editor thought was the first real effort to use telemedicine in dentistry, The TeleDentists can support dentists who are largely closing shop for health reasons to communicate with their own patients for follow up visits, screen new patients, e-prescribe, and refer those who are feeling sick to other telehealth providers. For the next six weeks, patients pay only $49 a visit. More information in their release. Hat tip to Howard Reis.

What actions are smaller telehealth companies taking now? Reader and commenter Adrian Scaife writes from Alcuris about how their assistive technology responds to the need to keep in touch with older people living alone at home. Last week their preparations started with giving their customers the option to switch to audio/video conferencing with their market teams. This week, they reviewed how their assistive technology and ADL monitoring can keep older people safe in their homes where they may have to be alone, especially after discharge, yet families and caregivers can keep tabs on them based on activity data. A smart way for a small company to respond to the biggest healthcare challenge of the last 30 years. Release. 

Even Caravan Health, a management services company for groups of physicians or health systems organizing as accountable care organizations (ACOs) in value-based care programs, is getting into digital health with their purchase of Wellpepper. The eight-year-old company based in Seattle works with health plans to provide members with outpatient digital treatment plans, messaging services, and an alert system to boost communication between care teams and patients. Purchase price was not disclosed, but Wellpepper had raised only $1.2 million in debt financing back in 2016 so one assumes they largely bootstrapped. Mobihealthnews

And if you’re stuck at home and are trying to avoid chores, you can read all 140 pages of Teladoc’s Investor Day presentation, courtesy of Seeking Alpha. 

Further ‘virtualization’ of industry meetings: DHACA Day, HITLAB, NAACOS, HXD, now ATA 2020 (updated)

March 18, 2020 | by

Practically all events that this Editor has noted on the calendar for the next few months have been converted to virtual events or postponed due to emergency restrictions around COVID-19. 

Close to our Editors’ hearts is DHACA Day–a must-read update. Originally set for tomorrow 18 March, it is now planned as a virtual event on Wednesday the 25th starting at 10am. Editor Charles Lowe has an update on the DHACA website in his mid-March newsletter. The tentative theme is ‘The silver lining in the COVID-19 cloud’.

  • Charles is also compiling a list of “all the products that members make and services that members provide that will help the health services and patients cope with Covid.19 and the subsequent lockdown.” There are more ‘calls for assistance’ in the newsletter for everything from ventilators to technical help at Public Health England.

HITLAB is going virtual indefinitely. Dr. Stan Kachnowski’s emailed update today notes that the Women’s Health Tech Challenge on 16 April is on as a virtual event, and virtually free. Remaining Seminar Series events will be virtual–and these extend into August. This Thursday’s (19 March) seminar will be a virtual town hall to discuss digital solutions which can help patients and physicians in the age of the coronavirus, with an international cast–panelists from Scripps Translational Institute, Ugandan Health, and more. Registration here (free).

The National Association of Accountable Care Organizations (NAACOS) has officially converted its annual meeting scheduled for 1-3 April to a virtual event, date TBD.

MAD*POW Health Experience Design Conference 2020 (HXD) 14-15 April will be fully virtual. Quite relevant is a webinar being held noon ET Wednesday 18 March on Interventions to Encourage Social Distancing, based on a 12 March survey of Italians to gauge the effectiveness of government communications on staying at home and social distancing.

UPDATE: The sole outlier up until mid-week was the American Telemedicine Association’s ATA 2020 that was going to be in Phoenix 3-5 May. It won’t be a cure for cabin fever in the sun, as ATA’s announcement of a 100 percent virtual conference is up here. Details to come.

CMS clarifies telehealth policy expansion for Medicare in COVID-19 health emergency, including non-HIPAA compliant platforms (US)

March 18, 2020 | by

Today (17 March), the Center for Medicare and Medicaid Services (CMS) issued a Fact Sheet and FAQs explaining how the expanded telehealth provisions under the Coronavirus Preparedness and Response Supplemental Appropriations Act and the temporary 1135 waiver will work. The main change is to (again) temporarily expand real-time audio/video telehealth consults in all areas of the country and in all settings. The intent is to maintain routine care of beneficiaries (patients), curb community spread of the virus through travel and in offices, limit spread to healthcare providers, and to keep vulnerable beneficiaries, or those with mild symptoms, at home. Usage is not limited to those who suspect or already are ill with COVID-19.

Previously, only practices in designated rural health areas were eligible for telehealth services, in addition to designated medical facilities (physician office, skilled nursing facility, hospital) where a patient would be furnished with a virtual visit. 

The key features of the 1135 telehealth waiver are (starting 6 March):

  • Interactive, real-time audio/video consults between the provider’s location (termed a ‘distant site’) anywhere in the US and the beneficiary (patient) at home will now be reimbursed. The patient will not be required to go to a designated medical facility.
  • Providers include physicians and certain non-physician practitioners such as nurse practitioners, physician assistants and certified nurse-midwives. Other providers such as licensed clinical social workers (LCSW) and nutritionists may furnish services within their scope of practice and consistent with Medicare benefit rules.
  • Surprisingly, there is ‘enforcement discretion’ on the requirement existing in the waiver that there be a prior relationship with the provider. CMS will not audit for claims during the emergency. (FAQ #7)
  • Even more surprisingly, the requirement that the audio/visual platform be HIPAA-compliant, as enforced by the HHS Office of Civil Rights (OCR), is also being waived for the duration (enforcement discretion again), which enables providers to use Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype–but not public-facing platforms such as Facebook Live, Twitch, or TikTok. Telephones may be used as explicitly stated in the waiver in Section 1135(b) of the Social Security Act. (FAQ #8) More information on HHS’ emergency preparedness page and OCR’s Notification of Enforcement Discretion.
  • On reimbursement, “Medicare coinsurance and deductible would generally apply to these services. However, the HHS Office of Inspector General (OIG) is providing flexibility for healthcare providers to reduce or waive cost-sharing for telehealth visits paid by federal healthcare programs.”

Concerns for primary care practices of course are readiness for real-time audio/video consults, largely addressed by permitting telephones to be used, as well as Skype and FaceTime, and what services (routine care and COVID-19 diagnosis) will be offered to patients.

This significant expansion will remain in place until the end of the emergency (PHE) as determined by the Secretary of HHS.

In 2019, CMS also expanded telehealth in certain areas, such as Virtual Check-Ins, which are short (5-10 minute) patient-initiated communications with a healthcare practitioner which can be by phone or video/image exchange by the patient. This could be ideal for wound care where this Editor has observed, in one of her former companies, how old phones are utilized to send wound images to practices for an accurate ongoing evaluation via special software. E-Visits use online patient portals for asynchronous, non-face-to-face communications, initiated by the patient. These both require an established physician-patient relationship. Further details on both of these are in the Fact Sheet, the FAQs, and the HHS Emergency Preparedness page with links.

The American Medical Association issued a statement today approving of the policy changes, and encouraged private payers to also cover telehealth. The American Telemedicine Association didn’t expand upon its 5 March statement praising the passage of the Act but advocated for increased cross-state permission for telehealth consults.

Additional information at HISTalk today and Becker’s Hospital Review.

News roundup: Kompaï debuts, Aging Tech 2020 study, Project Nightingale may sing to the Senate, Amwell, b.well, Lyft’s SDOH, more on telehealth for COVID-19

March 13, 2020 | by

Believe it or not, there IS news beyond a virus!

France’s Kompaï assistance robot is finally for sale to health organizations, primarily nursing homes and hospitals. Its objective, according to its announcement release, is to help health professionals in repetitive daily tasks, and to help patients. It’s interesting that the discussion of appearance was to achieve a ‘slightly humanoid’ look, but not too human. The development process took over 10 years. (Here at TTA, Steve’s first ‘in person’ with the developers was in May 2011!) Kompaï usage mentioned is in mobility assistance and facility ‘tours’ and public guidance. Here’s Kompai in action on what looks like a tour. Press release (French/English)

Not much on robotics here. Laurie Orlov has issued her 2020 Market Overview Technology for Aging Market Overview on her Aging and Health Technology Watch, and everyone in the industry should download. Key points:

  • In 2020, aging technologies finally nudged into the mainstream
  • The older adult tech market has been recognized as an opportunity by such companies as Best Buy, Samsung, and Amazon. Medicare Advantage payers now cover some tech.
  • Advances plus smart marketing in hearing tech–one of the top needs in even younger demographics–is disrupting a formerly staid (and expensive)
  • The White House report “Emerging Technologies to Support an Aging Population” [TTA 7 March] first was an acknowledgment of its importance and two, would also serve as a great source document for entrepreneurs and developers.

The study covers the demographics of the older adult market, where they are living, caregiving, the effect of data breaches, optimizing design for this market, the impacts of voice-driven assistants, wearables, and hearables.

Project Nightingale may be singing to some US Senators. The 10 million Ascension Health identified patient records that were transferred in a BAA deal to Google [TTA 14 Nov 19], intended to build a search engine for Ascension’s EHR, continue to be looked into. They went to Google without patient or physician consent or knowledge, with major questions around its security and who had access to the data. A bipartisan group of senators is (finally) looking at this ‘maybe breach’, according to Becker’s. (Also WSJ, paywalled)

Short takes:  b.well scored a $16 million Series A for its software that integrates digital health applications for payers, providers, and employers. The round was led by UnityPoint Health Ventures….Lyft is partnering with Unite Us to provide non-emergency patient transportation to referred health appointments. Unite Us is a social determinants of health (SDOH) company which connects health and community-based social care providers….What happens if you’re a quarantined physician due to exposure to the COVID-19 virus? Use telehealth to connect to patients in EDs or in direct clinic or practice care, freeing up other doctors for hands-on care. 11 March New England Journal of Medicine….American Well is finally no more, long live Amwell. Complete with a little heart-check logo, American Well completed its long journey to a new name, to absolutely no one’s surprise. It was set to be a big reveal at HIMSS, but we know what happened there. Amwell blog, accompanied with the usual long-winded ‘marketing’ rationale They are also reporting a 10 to 20 percent increase in telehealth consults by patients (Becker’s)….Hospitals and health systems such as Spectrum Health (MI), Indiana University Health, Mount Sinai NY, St. Lukes in Bethlehem PA, and MUSC Health, are experimenting with COVID-19 virtual screenings and developing COVID-19 databases in their EHRs. The oddest: Hartford (CT) Healthcare’s drive-through screening center and virtual visit program. Is there an opportunity to cross-market with Wendy’s or Mickey D’s? After all, a burger and fries would be nice for a hungry, maybe sick, patient before they self-quarantine.

Update: healthcare/digital health conferences canceled/postponed due to COVID-19 include SXSW, Naidex, EPIC (updated 13 Mar).

March 12, 2020 | by

Your Editor has been offline since Monday to this afternoon (EDT) due to a Fios network outage, not a health outage due to COVID-19. Since last week and the HIMSS20 cancellation, major conference and meeting cancellations and reschedulings are multiplying like fig buttercups in the spring. And yes, WHO has declared it a pandemic as Italy closes down and the US bans travel and even trade from Europe for the next 30 days, but not the UK. (There are additional relief measures including a requested payroll tax reduction, tax deferrals and assistance to small businesses. Many schools and businesses are going remote and long-term care residences, a nexus of infection, are being strongly encouraged to defer non-medically necessary visitors.)

Below are some of the majors and of interest to Readers in the digital health area. Most are the largest conferences with international attendees:

What’s on? The DHACA Day on 18 March at Brown Rudnick in London. Agenda and registration here.  Updates at @DHACA_org.

Additional updates 13 March

Running lists are up at Forbes (including sporting events such as the NBA, Broadway, and every major St Patrick’s Day parade; happily the NY International Auto Show is moved to 28 August) and MedPage Today. Healthcare IT News has a list of government and academic information resources led by the CDC, the WHO, and the NHS. We’ll repeat the NHS pages from our earlier article:

The UK Department of Health and Social Care and Public Health England has provided the following links to coronavirus guidance (hat tip to DOHSC via LinkedIn):

👩‍⚕️ Health: 
🚂 Transport: 
👩‍🎓 Education:
👨‍💼 Employers:
🏡 Social care:

$8bn COVID-19 supplemental funding House bill waives telehealth restrictions for Medicare beneficiaries (US)

March 6, 2020 | by

The House of Representatives, which controls appropriations, has passed H.R. 6074, the Coronavirus Preparedness and Response Supplemental Appropriations Act. The bill provides $8.3 billion in new funding that includes a significant telehealth waiver for Medicare. From the bill summary on Congress.gov:

Within the Department of Health and Human Services (HHS), the bill provides FY2020 supplemental appropriations for

the Food and Drug Administration,
the Centers for Diseases Control and Prevention,
the National Institutes of Health, and
the Public Health and Social Services Emergency Fund.

In addition, the bill provides supplemental appropriations for

the Small Business Administration,
the Department of State, and
the U.S. Agency for International Development

The supplemental appropriations are designated as emergency spending, which is exempt from discretionary spending limits.

The programs funded by the bill address issues such as

developing, manufacturing, and procuring vaccines and other medical supplies;
grants for state, local, and tribal public health agencies and organizations;
loans for affected small businesses;
evacuations and emergency preparedness activities at U.S. embassies and other State Department facilities; and
humanitarian assistance and support for health systems in the affected countries.

The bill also allows HHS to temporarily waive certain Medicare restrictions and requirements regarding telehealth services during the coronavirus public health emergency.

Sponsored by retiring Rep. Nita Lowey (D-NY), it was introduced and passed in the House 415-2.

In the text of the bill, the telehealth-pertinent portion permitting CMS to waive restrictions on telehealth for Medicare beneficiaries during this emergency is Division B, Sections 101-102. This cost is estimated at $500 million by The Hill.

The bill went to the Senate yesterday (4 Mar) for final approval. There is already an amendment proposed by Senator Rand Paul (R-KY) to offset the $8 bn of the bill with unobligated, non-health related foreign aid funds (FreedomWorks). Whether this is the ‘offset’ for telehealth that is mentioned in The Hill as under negotiation is not revealed.

The American Telemedicine Association (ATA) approved of the waiver. Ann Mond Johnson, the ATA’s CEO, urged “CMS to implement its waiver authority as soon as possible to ensure health care providers understand any requirements and help speed the deployment of virtual services” and pledged “The ATA and its members will continue to work with federal and state authorities, including HHS and the CDC, to address the COVID-19 outbreak and ensure resources are appropriately deployed for those individuals in need of care and help keep health care workers safe.” ATA press release, Hat tip to Gina Cella for the ATA heads-up