DOJ drops appeal to block UHG-Change; more hints that FTC will be hunting big game with Amazon

March 23, 2023 | by

DOJ has walked away from trying to stop the already-closed UHG-Change Healthcare merger. The US Department of Justice, which had appealed in November the District Court of DC approval in late September of UnitedHealth Group’s acquisition of Change Healthcare, on antitrust grounds, decided ‘enough egg on face’ and dropped its appeals court filings on 21 March. DOJ did not respond to Reuters’ report. Change is being integrated into OptumInsight and will be kept separate from the health plans. The DC District Court ruling found that DOJ did not conclusively prove its allegations of antitrust and loss of competition in services to hospitals and other providers. Statements from UHG’s competitors such as Cigna, Aetna, and Elevance (Anthem) that the acquisition would not lead them to ‘stifle innovation’ also weakened the DOJ’s case. Had the appeal been successful, it would have forced separation of Change Healthcare’s businesses, which are being quickly integrated into OptumInsight.  Healthcare Dive, Becker’s. Also TTA 4 Oct and 22 Nov 22.

Elsewhere in DC, it’s hunting season for the FTC, and its sights are fixed on Big Game called Amazon. POLITICO confirmed the speculation (or gave advance notice) [TTA 3 Mar], that FTC was building a multi-layered case beyond the Amazon-One Medical buy and warnings about failing to maintain consumer privacy [TTA 3 Mar] to include multiple practices. The POLITICO report indicates that there are at least six ongoing investigations by the FTC’s competition and consumer protection teams, with three apparently near the boiling point of action:

  • Blocking the acquisition of iRobot, famous for its Roomba robot vacuums. Amazon’s $1.7 billion acquisition has stalled with FTC rumoring action and Amazon apparently shutting down any further information. It does not have UK or EU approvals, which gives the FTC some more time to build a case. iRobot is the largest maker of robot vacuums. An acquisition would be expected to shut out competitive manufacturers marketing on Amazon such as Samsung. Their report indicates that FTC’s staff attorneys are leaning toward suing to stop the deal. Court action is expected in the next few months or sooner. 
  • Privacy investigations involving data security from their Ring camera/security system business and the Alexa voice assistant. The Alexa investigation also involves potential violations of the Children’s Online Privacy Protection Act. iRobot, Ring, and Alexa also tie into another FTC concern that Amazon is cornering the market on connected home devices.
  • Retail operations. These possibly could be around bundling services through the Prime subscription business and how competitor data is used on the Amazon platform to ‘outmuscle’ them. There is also a deceptive advertising probe around the use of the “Amazon Choice” label for certain products, including pay-to-play practices.

There is also scrutiny of how Prime and other Amazon services entice customers in with offers for expensive subscriptions, then make it extremely difficult or opaque to unsubscribe. This deceptive practice is called a “dark pattern”. Stay tuned.

Weekend wrapup & reading: Amazon Health on talent hunt, Practice Fusion fined $200K for violating $145M prosecution agreement, and must-read studies and articles on older adults tech

April 2, 2022 | by

Resumes and networking up! A writer at Becker’s Hospital Review tired of their usual diet of healthcare departures, ‘alarming’ rises of COVID rates by state, and cyber-attacks on hospitals to publish six top-level jobs opening up in Amazon’s healthcare areas. The lead is Head of worldwide health technology solutions to lead strategy in that area at the C-level. Two are in UX and software development at Alexa Health, a senior solutions architect, health artificial intelligence , a principal of behavioral health for digital health benefit programs, and a health information exchange specialist. So if your spring brings a yen for change….

Physician EHR Practice Fusion, now Veradigm owned by Allscripts, got another $200,000 spanking from the Feds. Back in January 2020, right before Pandemic Hell really broke loose on the world, the Department of Justice successfully resolved both criminal and civil charges against the EHR company. Practice Fusion was charged with “soliciting and receiving kickbacks in return for embedding electronic prompts in its electronic medical record (“EMR”) to influence the prescribing of opioid medications” as part of the platform’s clinical decision support (CDS) alerts. The kickback was $1 million from an unnamed ‘opioid company client’, The deferred prosecution agreement (DPA) was accompanied by 1) a $145 million fine and 2) maintenance of an Oversight Organization based on three specific requirements. DOJ in the District of Vermont found that Practice Fusion did not comply with the terms of the latter, charges that Practice Fusion denied. They settled with the DPA extended by 11 weeks with a fine of $200,000. Release, US Attorneys Office, District of Vermont 29 March, US DOJ release 27 January 2020

Weekend Reading. Laurie Orlov of Aging and Health Technology Watch has been hard at work, recently updating her Market Overview Technology for Aging and releasing The Future of Smart Homes and Older Adults. No time with spring cleaning to tackle long-form? Try three tart short takes on PERS smartwatches (not getting the ‘why’), did ‘voice first’ technologies meet their 2018 promises (not quite), and what she sees as the Seven Top Trends for tech to reach older adults–with the first being hospital to home (Optum and Humana have voted ‘yes’). 

It’s Official: CES is now a health tech event (updated)

January 17, 2019 | by

CES is now, officially, a health tech event. It’s not just the timing before CES of the flashy but apparently cratering JP Morgan annual healthcare investment conference in the absurdly pricey venue of San Francisco (FierceBiotech on the #MoveJPM backlash; the general disillusion with it expressed well here). It’s the fact that whatever mainstreaming health tech has actually accomplished, it’s far better represented in Las Vegas. Always a place of beginnings, endings, fun, gambles taken, lack of sleep, and sore feet, health tech fits right in, big or small.

CES reported that 2019 boasted an increase of 25 percent health-related exhibitors and a 15 percent increase in the amount of floor space dedicated to health tech. One winner was a big gamble by a small company–Living in Digital Times, which organizes and stages the Digital Health Summit. Ten years later, it turned out to be right place, right time for the founders who work hard to keep it on trend. Lifestyle, robotics, self-care, assistive tech (even exoskeletons), wearables, cosmetic “wellness” devices like P&G’s Opté, and Alexa-type home assistants/robots all now fit into the CES purview. Trial balloons by young companies, AI-powered concept devices from big companies, watches (including the Apple-beater Move ECG from the revitalized Withings TTA 10 Oct 18 and Omron’s HeartGuide), and robots all appeared. Samsung again brought out a brace of concept robots. Last year’s Best of CES ElliQ is finally available for pre-order after three years at a measly $1,500. The humanoid Sophia brought a kid sister, the equally creepy Little Sophia, both of whom failed during this CNET video. Yes, Pepper from Softbank made its appearance and apparently didn’t wilt as it did last year.

Sleep tech was another hot item, with a spin on sleep diagnostics or improvement from many products. A brainwave product, Urgonight from France, claims to be able to train your brain to sleep better. (Send one to Rick Astley who was a poster child for not Sleeping.)  Mental health is a natural crossover into sleep tech and robots, with a $5,000 Japanese robot, Lovot, capable of responsive cuddling and comfort.

Best of the coverage:

  • CNET has probably the best coverage and articles on health which stick to the facts (slim in some cases as they are); anyone who wants to catch up with the feel and flavor of this three-ring circus can start and stay there. Their full show coverage is here.
  • Dr. Jayne at HISTalk also did an excellent health-related product roundup in her Curbside Consult column.
  • Mobihealthnews also has a very long running list of health tech pictures and announcements as part of its limited coverage, including the mea culpas and promised transparency of onetime health ed unicorn Outcome Health [TTA 29 Jan 18].

Beyond the plethora of products encouraging ever more to come forward, what ones will even make it to market, far more be winners? Aside from the Samsungs and P&Gs, which of these young companies planting their stake at CES will be there next year?  As in past CES, the wheel goes round and round, and where it stops, nobody knows–not even the JPM investors. 

News roundup for Tuesday: room at the top at VA? (updated), Philips integrates teleradiology. 3rings Care premieres Amazon Echo service

March 27, 2018 | by

Updated. Who’s the Leader? At the Veterans Administration, the soap opera plot accelerated on the continued tenure of Secretary David Shulkin who, after a strong start (and coming from within VA’s tech area), has stumbled over charges of inappropriate spending and staff turmoil since the beginning of the year. Journalist Christopher Ruddy, CEO of Newsmax, who speaks regularly with President Trump, indicated in an interview on ABC’s This Week on Sunday that Dr. Shulkin will likely be the next Cabinet departure. The fact that VA Choice 2.0 did not make it into the huge ‘omnibus’ budget bill indicated a disillusion with him on Capitol Hill. The lack of closure on replacing VistA with Cerner is also not in favor of a longer stay. The replacement may come from the VA House committee, the defense contractor community, or DoD. Why it’s important? VA is the largest purchaser of telemedicine and telehealth in the US, and has set the pace for everything from EHRs to info security. And there are those 9 million veterans they serve. Stay tuned. POLITICO Morning eHealth…..

By the next morning, a press secretary was saying “At this point in time though, he [President Trump] does have confidence in Dr. Shulkin. He is a secretary and he has done some great things at the VA. As you know, the president wants to put the right people in the right place at the right time and that could change.” But one of Dr. Shulkin’s biggest thorns-in-side at the VA, Darin Selnick, shuffled off last year to the Domestic Policy Council, will return to a post at the VA.

HIMSS continued to support VA’s and Dr. Shulkin’s efforts to increase veteran patient record sharing through changing the consent requirements authorizing the VA to release a patient’s confidential VA medical record to a Health Information Exchange (HIE) community partner. Letter.

Philips has entered the integrated teleradiology field by combining Philips’ Lumify portable ultrasound system and Innovative Imaging Technologies‘ (IIT) Reacts collaborative platform. It combines a compatible smart device that enables a two-way video consult with live ultrasound streaming. How it works: “clinicians can begin their Reacts session with a face-to-face conversation on their Lumify ultrasound system. Users can switch to the front-facing camera on their smart device to show the position of the probe. They can then share the Lumify ultrasound stream, so both parties are simultaneously viewing the live ultrasound image and probe positioning, while discussing and interacting at the same time.” Release

Following up on 3rings and their integration into the Amazon Echo virtual assistant system [TTA 18 Oct], Mark Smith from their business development area has told us that they have formally launched this platform earlier this month. The person cared for at home can simply ask Alexa to alert family and caregivers that they need help via voice message, text or email. Care staff or family can also use Echo to check through the 3rings platform by simply asking Alexa if that person is safe and OK. 3rings is now actively seeking to partner with innovative health, housing, and social care organizations. Overview/release.

What if you crossed Alexa with a robotic healthcare manager?

March 7, 2018 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2018/03/pillo_01-625×350.jpg” thumb_width=”150″ /]You might have a tabletop ‘companion robot’ that’s called, interestingly, Pillo. It doesn’t look like something on a bed, nor does it ambulate, but more like a souped-up pastel colored Alexa with Eyes. Debuting at HIMSS 2018 this week, what is non-Alexa-like about it is that is a voice-responsive Wi-Fi/Bluetooth-connected healthcare manager, interacting with the user on Alexa-type requests but in the main managing (nudging?) their care plan, reminding them of medical appointments, delivering patient education, and dispensing their pre-loaded medications in a cup . Pillo claims to use AI algorithms to manage care, proactively engage with patients, and recognize users via voice and facial recognition. Orbita is supplying the platform for the voice assistant technology.

Pillo appears to be targeted to users with chronic conditions who need assistance in care management and with a connecting mobile app to family caregivers and clinicians. There’s no mention of a tracking platform nor connectivity with medical devices such as glucose meters or blood pressure cuffs. According to Forbes, it will ship in 4th Quarter, no pricing mentioned. Pillo raised $1.5 million in a venture round last August from BioAdvance (Crunchbase) with additional funding from Stanley Ventures, Hikma Ventures (the venture arm of Hikma Pharmaceuticals) and Thompson Family Foundation for a total of $4m (Forbes). It’s hard to tell if this will appeal to or be subsidized by pharma, payers, or Medicare primary care providers such as ACOs because the release is rather opaque on specifics.

What’s up with Amazon in healthcare? Follow the money. (updated)

January 23, 2018 | by

Updated–click to see full page. Amazon is the Scary Monster of the healthcare space, a veritable Godzilla unleashed in Tokyo, if one listens to the many rumors, placed and otherwise, picked up in mainstream media which then are seized on by our healthcare compatriots.

According to CNBC’s breathless reporting, they have set up a skunk works HQ’d in Seattle. When they posted job listings, they were under keyword “a1.492” or as “The Amazon Grand Challenge a.k.a. ‘Special Projects’ team.” In late July, these ads for people like a UX Design Manager and a machine learning director with experience in healthcare IT and analytics plus a knowledge of electronic medical records were deleted. Amazon has separate initiatives on selling pharmaceuticals and building health applications to be compatible with Echo/Alexa and other smart home tech. Both have come up in the context of the CVS-Aetna merger, where buying up state pharmacy licenses cannot be kept secret (see end of our 8 Dec article) and that efforts to extend Alexa and Echo’s capabilities aren’t particularly secret.

A quick look at Bezos Expeditions, Amazon supremo’s Jeff Bezos’ personal fund, on Crunchbase reveals several healthcare investments, such as GRAIL (cancer), Unity Biotechnology (aging), Rethink Robotics, and Juno Therapeutics (cancer). Not really things easy to sell on Amazon.

Last week, Amazon reportedly hired Dr. Martin Levine, who ran integrated primary health Iora Health’s Seattle-based clinics, according to CNBC and Becker’s. They met with Iora, Kaiser, and the now-defunct Qliance about a year ago on innovative healthcare models. More breathless reporting: they are hiring a “HIPAA compliance lead.” 

What does this all mean? It may be more–or less–than what the speculation is. Here’s what this Editor believes as some options:

  • Alexa and Echo are data collectors as well as assistants–information that has monetary value to healthcare providers and pharma. To this Editor, this is the most likely and soonest option–the monetization of this data and the delivery of third-party services as well as monitoring.
  • Amazon now employs a lot of people. It is large enough to create its own self-funded health system. It’s already had major problems in the UK, Italy, and even in the US with healthcare and working conditions in its warehouses. Whole Foods’ non-union workers are prime for unionization since the acquisition (and also if, as rumored, robots and automation start replacing people).
  • A self-funded health system may also be plausible to sell  (more…)

3rings smart plug moves to IoT through Amazon Echo (UK) (updated)

June 27, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/02/3rings-logo-only.jpg” thumb_width=”150″ /]Updated. Good morning, Alexa! 3rings, the ‘smart plug’ that has been monitoring since 2015 a loved one’s or neighbor’s wellness through their daily use of a key home appliance like a kettle or TV, then reporting that activity via a mobile phone/smartphone app, has expanded to the Internet of Things (IoT) with the integration of the 3rings plug with Amazon Echo. 

The 3rings plug works with Echo and the Alexa avatar in two ways. The first is for family members, friends or neighbors to ‘ask Alexa’ (the Echo unit) if their loved one is safe, similar to the mobile phone reports and alerts. The second is to place an Echo unit in that person’s home so that the person can directly ask Alexa to tell 3rings they need help. This also sends an immediate alert to their friends/family network.

To this Editor, 3rings founder Steve Purdham noted that with Amazon Echo, the 3rings system is now expandable and agnostic, through the addition of proprietary sensors dubbed “Things that Care” and other makers’ devices to the 3rings smart plug so that families have a fuller picture of the monitored person’s pattern of activity. 3rings Things monitor temperature, activity, motion, open/close of doors and windows, and button, and are priced a la carte or in a package with the Echo. The system also integrates with Samsung SmartThings, purchased separately, for additional types of monitoring. “Through this platform we want to stay ahead of the Internet of Things curve and demonstrate how technology can care.” Steve confirmed that the system is available now via a new website from the original (and still available) 3rings, with a group of users already on board. Full rollout is expected in August. Another advantage of integrating with Echo, according to Steve, is that the system can be offered in any location where Echo is. Also release

Dream team or dance of the dinosaurs? Another view of Legrand’s recent acquisition

May 9, 2016 | by

The recent news of  Legrand’s acquisition of Jontek Ltd to join Tynetec in their Assisted Living & Healthcare Business Unit stirs many nice memories, as this editor has much to thank both Tynetec, and Jontek for.

Once Tynetec quality was a match for the other major player in the telecare market, their competition was truly appreciated in restraining the cost of delivering telecare. They were enormously helpful, particularly when this editor was working in Surrey. However at the end of the day, their systems, like the other major competitors in the market, were proprietary. Thus once a Tynetec dispersed alarm unit was installed, only Tynetec peripherals could be added.

Jontek on the other hand were able to receive alerts from all the major telecare players, so enabled mixed economies (as we had in Surrey) to be managed by the same call centre. Although “for legal reasons” there were problems with getting (more…)