Rounding up the week with good news: AliveCor’s Series F round, Scotland’s Smplicare gains £750K for fall research

AliveCor has moved to a Series F round led by GE Healthcare. In this funding-parched environment, this is impressive though the funding amount is (sigh) not disclosed. The round was joined by NGK-NTK (through a CVC partnership with Pegasus Tech Ventures) and existing investors including Khosla Ventures, Bold Capital Partners, Qualcomm Ventures, and WP Global Partners. The fresh funding will be used to advance new innovations, their AI roadmapping, and existing ones such as introducing subscription services, KardiaCare and KardiaComplete for patients, payers and employers, and KardiaPro for physicians. KardiaCare has 165,000 members, claiming 2 million users and 160 million ECGs to date. GEHC and AliveCor currently partner on integrating KardiaMobile 6L’s ECG data directly into GE Healthcare’s MUSE Cardiac Management System.  Release. Hat tip to Dr. Dave Albert, founder and Reader.

The UK funding environment is also perking a bit in the public/private area. Edinburgh-based startup Smplicare now has £750,000  to explore how commercially available wearable technologies can predict the risk of falls and other age-related health issues. Funding came from private investors and UK Research & Innovation (UKRI)’s Healthy Ageing Challenge, with the goal of adding five years of healthy, independent living for everyone by 2035. Overall, the challenge has seven themes and an extensive list of partnerships worth referencing if your technology, platform, or social enterprise is in this area of keeping older people active, productive, and in their communities. Smplicare’s tech uses a questionnaire to easily determine levels of clinical fraility, then a dashboard to project trends. Their project is to monitor 300 individuals 55+ and with a history of falls agreeing to wear a mainstream wearable for six months. What this will enable Smplicare to do is to have enough data to create an AI-powered algorithm that will predict the likelihood of a fall, possibly saving the NHS more than £4.4 billion annually. The research is led by Smplicare’s chief innovation officer, Dr. Adrian Smales, an award-winning PhD in health informatics. Support comes from the analytics team at Data Lab, Scotland’s innovation center for data and AI, and on the clinical side, Dr. Atul Anand, an NHS and University of Edinburgh geriatrician with experience in big data clinical studies. Insider.co.UK, The Scotsman

US International Trade Commission initial determination: Apple infringed AliveCor’s patents (updated)

If affirmed, a David versus Goliath win. AliveCor, the developer of the KardiaMobile ECG devices, announced late today that Administrative Law Judge (ALJ) Cameron Elliot of the US International Trade Commission (ITC) issued an Initial Determination that Apple infringed certain AliveCor technology patents. If affirmed by the full ITC in a Final Determination by 26 October (!), it could lead to an exclusion order barring the importation of certain Apple devices infringing on AliveCor patents from the US.

The initial complaint was filed in May 2021 [TTA 29 April] concerning Apple’s infringement in the Apple Watch 4, 5, and 6 of three AliveCor ECG technology US patents: No. 10,595,731 (“the ’731 patent”); No. 10,638,941 (“the ’941 patent”); and No. 9,572,499 (“the ’499 patent”). Last February, AliveCor successfully moved with the ITC to have the investigation terminated on certain claims on the three patents, but a considerable number remained. This is what ITC terms an “unfair import” or Section 337 investigation. These regard intellectual property rights, including “allegations of patent infringement and trademark infringement by imported goods.”

Updated for links: AliveCor press release, ITC Public Notice which details what parts of what patents have been infringed. Both the 731 and the 941 patents have been found to be infringed under Section 337. The 499 patent has not been violated. This Editor will assume we have to wait till October for any exclusion orders.

ATA conference roundup: a new board chair, a digital app review pilot, and company announcements

The American Telemedicine Association (ATA) 2022 conference and expo is a wrap, after starting on Sunday through to Tuesday. While your Editor could not attend due to other commitments that precluded a trip to Boston, one industry insider who visited the expo–his first in-person event in two years–reported that after a slow start on Sunday, the floor busied up on Monday. Business was being done, finally and not virtually. What were the busy booths and what was ‘hot’? Companies in the areas of telemental health and remote patient monitoring (RPM). (Did you attend? What was your impression? Leave comments below.)

ATA had two major announcements of its own during the conference:

  • Kristi Henderson, DNP, NP-C, FAAN, FAEN, has been named as Chair of the ATA Board for a two-year term. Henderson is the CEO of Optum Everycare, where she leads a team building digital and virtual health solutions to improve quality outcomes and experiences for patients and providers. She has served on the board since December 2020. As Chair, she is succeeding Joseph Kvedar, MD and Professor at Harvard Medical School among other positions. Dr. Kvedar will become Immediate Past Chair and Senior Advisor to the ATA. Announcement
  • ATA, the American College of Physicians (ACP), and ORCHA, the Organization for the Review of Care and Health Applications,  announced a framework for the assessment of professional and consumer digital health technologies, including mobile apps and web-based tools. ACP and ORCHA, which has experience assessing compiling libraries of apps, will be piloting a test of the framework against a database of digital health tools. The goal of the pilot is to “determine how the library can be useful to physicians in recommending high-value digital health tools to their patients, and what other barriers to wider adoption of digital health tools may exist.” Announcement

Quite a few company announcements were made during ATA–a selection:

  • Johns Hopkins Bloomberg School of Public Health highlighted the publication of a major scientific study (full text) documenting telehealth outcomes in JAMA Network Open. This Johns Hopkins-based research was partially supported by the ATA. The study followed a national cohort of 40.7 million commercially insured persons from July to December 2021 and included 21 chronic and non-chronic conditions. Fourteen-day follow-ups for persons with an initial telehealth visit were compared to persons receiving in-person care. On average, patients participating in an initial telehealth consult for a new health condition did not require more unplanned hospitalizations or follow-up ED visits within 14 days of their initial consult compared with patients making an initial in-person visit. The exception was respiratory conditions. Release
  • BioIntelliSense, which last year scored $45 million in funding for its on-body sensors, announced two major collaborations for remote patient monitoring (RPM) with UC Davis Health and Houston Methodist.
  • CDW Healthcare and Caregility announced a strategic partnership to expand their virtual care capabilities, including Caregility’s new Inpatient Virtual Engagement solution (IVE), also launched during ATA. 
  • Connect America, which snapped up Lifeline last year, launched Connect America Home, a single health and safety platform connecting (PERS) and remote patient monitoring (RPM) with supporting services, including AI-enabled virtual health assistance and Social Determinants of Health (SDoH) support, along with analytics. Release.
  • AliveCor announced the launch of KardiaComplete, a comprehensive heart health enterprise solution designed to drive improved health outcomes and reduce the cost of cardiac care. The service will be available through self-insured employers, health insurance plans, and health systems to those diagnosed with hypertension and arrhythmias, like atrial fibrillation.
  • Withings launched Withings RPM, the company’s most advanced remote patient monitoring solution designed to enhance the patient experience. It is a single platform that enables clinicians to order and send Withings RPM devices, manage data from multiple patients with automated alerts and reminders, communicate via SMS, phone, and in-app video calls, billing, sleep tracking, and more. 

TTA was a media partner of ATA 2022.

Thursday news roundup: Walmart hiring 50K workers including health, Anthem name-changing, GE Healthcare-AliveCor partner, IPO for Komodo Health amid slowdown?

In the midst of war, inflation, and the contradiction of a tight labor market, it’s somehow reassuring that Walmart needs to hire 50,000 new workers–and fast, by end of April. According to reports, some of those new hires will be bolstering the health and wellness areas. In the past, Walmart has hired heavily in their in-store pharmacies. Many of these jobs are lower-end–delivery drivers for direct-to-fridge InHome groceries, in-store workers, and supply chain staff. One higher-level worker area that points to health is global tech, creating offices in Toronto and Atlanta, with Walmart planning jobs for 5,000 engineers, data scientists, analysts, and tech experts. Additional hires will go to increasing its advertising business which is based in the New York metro area. Especially for those high-skill positions, six weeks is not quite plausible in this market. But you have to admire them for trying. CNBC, Becker’s

Anthem changing its name–again. Health insurer giant Anthem, Inc. has announced a renaming to Elevance Health. According to the release, the name is a combination of elevate and advance, presumably for health but as they say in their release, vaulting beyond healthcare into the rarefied air of ‘whole health’. It also reflects vaulting beyond the health plan business, as they fully savor the rarified air of healthcare diversification like fellow giants UnitedHealth Group, Centene, and CVS Aetna.

The parent company of Anthem Blue Cross Blue Shield plans, Anthem owns non-Blues Amerigroup, Integra Managed Care in NY,  pharmacy benefits manager IngenioRx, plus a $25 million investment in digital health hub Sharecare. Plan and product names, along with organizations will not change at this time–these are major changes that usually require state department of insurance approvals.

To this Editor’s Gimlet Eye, the coined name Elevance feels pharmaceutical and not in a good way–it’s very close to an old anti-depressant, Elavil. A return to WellPoint, a name the company had up to 2014, would have accomplished the same ends. But there’s always the shock of the new, the opportunity to change the tired signage, and behind this, someone making a point for themselves. Undoubtedly the shareholders will agree at the 18 May annual meeting, since they always do, and it will start to be used–presumably with a logo and new graphics they don’t have now–at end of Q2. Another gimlety view–it takes a certain myopia to announce a name change given what’s happening in the world. Healthcare Dive

In time for HIMSS, GE Healthcare and AliveCor, developer of the KardiaMobile ECG, announced their partnership to transmit KardiaMobile 6L data directly into GE Healthcare’s MUSE Cardiac Management System for clinical evaluation. MUSE is used by 87 percent of the top cardiac hospitals in the US. The direct integration of KardiaMobile 6L data that is taken anywhere into the MUSE workflow and then into an EMR, targeting atrial fibrillation but also other cardiac monitoring, is a big validation and win for AliveCor. Release

Analytics software company Komodo Health is preparing an IPO as early as this summer. Goldman Sachs and SVB Securities are rumored to be the lead bookrunners. Timing will depend on markets and financing. Komodo completed last March a $220 million Series E for funding to date of $314 million [TTA 25 Mar 2021]. With a valuation now topping $3 billion, Komodo may be the ‘IT’ company of healthcare IPOs in a market much tamer than last year’s Wild West Rodeo. What they do isn’t easy to explain, but they feed their 325 million patient encounter database drawn from EHR, pharma, lab, and government data into proprietary software to map patient journeys, providing analytics on more than 325 de-identified, real-world patient insights. These are used to drive better health outcomes across therapeutic areas. The primary markets for their data are life sciences and pharma for R&D, clinical trials, and medical affairs, but are seeking to expand to providers and payers.

Other IPOs rumored to be on tap are Included Health (the former Grand Rounds/Doctor on Demand) [TTA 20 Oct 2021] and Tempus Labs in precision medicine.

AliveCor releases KardiaMobile ECG in the convenient credit card size

AliveCor, the parent company of KardiaMobile mobile ECG devices, is releasing for sale the KardiaMobile Card, a credit card-sized single-lead ECG. It was FDA cleared in November. It’s mighty for its size, detecting six of the most common arrhythmias: atrial fibrillation, bradycardia, tachycardia, PVCs, sinus rhythm with SVE, and sinus rhythm with wide QRS. The pricing is $149 and includes the $99 annual KardiaCare subscription, which renews after the first year. 

In a price and product comparison, the standard KardiaMobile single lead, which is a strip with two press sensors, remains on sale for $169 and the 6L, which has a slightly bulkier sensor but is clinically equivalent to a six-lead ECG, is $239. KardiaCare includes advanced determinations, cardiologist reviews, heart health reports, and more. Owners of older smartphones should review compatibility before buying, however. Release, Mobihealthnews

As of 1 February, there is no update on AliveCor’s legal actions against Apple on patent infringement in the Apple Watch: April’s patent infringement complaint filed with the US International Trade Commission (ITC) [TTA 29 Apr 21] and their late May Federal antitrust suit in the Northern District of California [TTA 9 July 21].

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%

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

David sues Goliath: AliveCor claims patent infringement by Apple–ITC filing requests bar on Apple Watch US importation

Slingshot battle! AliveCor, developer of the Kardia Mobile electrocardiogram (ECG) and connected heart rhythm devices, filed a complaint with the US International Trade Commission (ITC) alleging Apple’s infringement of three AliveCor ECG technology patents for the Apple Watch 4, 5, and 6. The filing seeks to bar the importation of Apple Watches into the US and their sale.

According to AliveCor’s carefully worded release, their filing in the ITC “is one step, among others, AliveCor is taking to obtain relief for Apple’s intentional copying of AliveCor’s patented technology—including the ability to take an ECG reading on the Apple Watch, and to perform heartrate analysis—as well as Apple’s efforts to eliminate AliveCor as competition in the heartrate analysis market for the Apple Watch.”

This follows on the first shoe–AliveCor’s December lawsuit, filed in the US District Court for the Western District of Texas, alleging that the Apple Watch 4, 5, and 6 infringed on the same patents. The timing was interesting, as FDA cleared the latest update of the Apple Watch’s ECG monitoring at about the same time [TTA 10 Dec 2020]. In November, AliveCor cleared a Series E of $65 million.

The irony is that in 2017, the KardiaBand was the first FDA-cleared medical device accessory for Apple Watch. It was an ECG-reader that clipped onto the watch. AliveCor pulled it from the market after Apple introduced its own ECG feature in the Apple Watch 4.

AliveCor has their entire business riding on this. The mass-market Kardia Mobile, their six-lead medical-grade KardiaMobile 6L, and their KardiaCare platform with monitoring and evaluations are their business, unlike Apple for which ECG is only a feature.  Mobihealthnews, FierceHealthcare, MDDIOnline

Deal and news roundup, 17-18 Feb: Sharecare goes SPAC for hefty $3.9 bn valuation; Humana Care Support pilots; AliveCor, AstraZeneca partner on renal, cardiac; Current Health RPM in clinical trials

Sharecare, a free/paid app platform that enables users to consolidate all their health and wellness data in one location and use proprietary health management tools, is going the SPAC route with Falcon Capital Acquisition Corp. It will trade on NASDAQ under SHCR. Initial enterprise value is expected to be $3.9 bn with approximately $400 million in growth capital. Closing is expected to be in Q2 of this year.

Founded in 2010 by celebrity doctor Mehmet Oz, MD (now on the board and not in active management) and WebMD founder Jeff Arnold, the current CEO, Sharecare will also have an undisclosed investment by strategic partners Anthem and Digital Alpha. Anthem is looking at the AI value plus consumer engagement and personalized care. Helping to fund both the public equity and cash position is a fully committed private investment in public equity (PIPE) of $425 million at $10.00 per share which is below market value. Falcon Capital will retain about 20 percent of the company. Mr. Arnold will join the board and be retained as CEO. After the closing, Sharecare and Falcon will donate about $4 million in stock to Sharecare’s charitable foundation.

Sharecare sells the platform to enterprises such as providers, employers, health plans, government organizations, and communities, as well as individuals on their free apps. Release, FierceHealthcare, Becker’s

Rival health plan Humana is also adding to its care management tools with a pilot of the Humana Care Support program. The platform creates an integrated, personalized experience for members, including a multi-disciplinary care team and SDOH integration. The pilot targets select groups of Medicare Advantage members in Kentucky, Pennsylvania, and West Virginia with multiple chronic conditions, complex congestive heart failure, and diabetes, with multi-disciplinary care teams. Humana Care Pilot is built on Salesforce’s Health Cloud platform for viewing the patient’s medical history and integrating clinician workflows. Its analytics are powered by Microsoft’s Azure and Power BI. The goal is lowering costs and improving outcomes for this high-cost group of patients. If successful, the program will roll out to other markets this year. Humana release, FierceHealthcare

AliveCor, the developer of the KardiaMobile mobile ECG/EKG, and AstraZeneca are partnering on research for new disease management solutions in cardiovascular, renal, and metabolism (CVRM) therapeutic areas. This will use AliveCor’s monitoring system for blood potassium. The Kardia-K AI platform uses ECG/EKG neural network analysis to measure a patient’s potassium levels without a patient blood draw. Hyperkalemia (elevated blood potassium) is linked to renal issues and kidney disease as well as cardiac issues. Kardia-K received Breakthrough Device Designation status from the FDA to screen for elevated levels of blood potassium in September 2018, and was validated in a study with Mayo Clinic published in 2019. Release, Mobihealthnews

Current Health, a monitoring and care management RPM system for enterprise-level health organizations, announced its “Community” initiative to build diverse longitudinal datasets for decentralized clinical trials. Their platform is FDA-cleared and used at scale in phase III and phase IV drug trials by major pharmaceutical organizations for remote endpoint collection and for virtual trial delivery. Monitoring is performed through wearables and sent to the electronic data capture (EDC) vendor for the clinical research organization (CRO). Current Health is using Community for its own COVID-19 study to predict hospitalizations and inform clinical treatment. The study is recruiting US participants diagnosed with the virus in the last 48 hours. Current has locations in Edinburgh, London, Boston, and San Francisco according to their website. Mobihealthnews

News roundup: Cera hits £89.5M revenues, Alcove Carephone in new elder housing, Everlywell home test kits raise $179M; FDA clears Lucira’s all-in-one COVID test kit, Apple Watch new ECG feature

Farringdon, London-based Cera announced a high point in its revenues of £89.5 million ($120 million) since their 2016 launch. While it is primarily a home care company d/b/a-ing under Cera Care (and seeks to hire an additional 5,000 staff, mostly professional carers), we noted back in March their £52 million ($70 million) raise and the launch of SmartCare, a sensor-based analytics platform that uses machine learning and data analytics in real-time on behaviors to personalize care and detect health risks with a reported 93 percent accuracy. Cera also has a proprietary app to connect families with Cera on visits and progress. Unfortunately the Cera website is singularly uninformative on company news and SmartCare. Mobihealthnews

Alcove is partnering with Cornell Court in Saffron Waldon, Essex, an extra-care community developed and run by L&Q Living, to fit out apartments with their in-residence Carephone tablet. Having the access to the tablet, residents can easily initiate a group video call with family members, as well as attend virtual care and therapy sessions and activities including bingo and exercise classes. There is also access to a ‘virtual concierge’. The combination of onsite services and the Carephone access helps with resident independence. All helpful as the UK remains on a non-virtual lockdown in most places and Christmas looks distinctly un-festive this year, especially for older adults. Local Authority Building & Maintenance (LABM) Online.

COVID-19 has certainly been a boom of a boon for at-home testing companies.

  • Everlywell just raised a hefty Series D of $179 million. They market and process over 30 FDA-cleared kits, including (of course) symptomatic COVID-19 (SARS-CoV-2, lower nasal swab) with a follow up from the lab in 24-48 hours via their app coupled with a telehealth consult. Other kits include thyroid, indoor/outdoor and food allergies, and hepatitis C, at prices ranging from $49 to a comprehensive food sensitivity test at $259. Prediction: Everlywell and similar companies will be 2021’s 23andMe/Ancestry.com.  Fierce Biotech
  • An equally intriguing ‘home run’? FDA cleared the first ‘all-in-one’ home test for COVID-19 under an EUA (Emergency Use Authorization). The Lucira Health molecular test from a nasal swab sample is completed by a battery-powered handheld unit that includes all the reagents needed to process the test. The unit then shows the result with a green light for positive or negative. Average time: 2 minutes. Molecular tests are more sensitive and accurate than the current quick tests of antigens. Go-to-market of the single-use test kit is expected early spring 2021, at a cost of $50. The by-prescription test can also be performed in point of care settings. The company will be filing early next year to have as an option prescription via telehealth. Sutter Health in Northern California and Cleveland Clinic Florida in Miami-Ft. Lauderdale participated in the trials and will be first on distribution. Fierce Biotech, Lucira press release, FDA release

Remember when any burp from Apple was Major News, breathlessly awaited? Now ho-hum. FDA cleared the latest update of the Apple Watch’s ECG monitoring. Now the feature enables heart rate detection up to 150 beats per minute and adds a classification category called A-Fib with high heart rate. The Apple Watch has been used in some studies to monitor for atrial fibrillation. No release date is set for the watch. However, AliveCor is suing Apple on patent infringement of three patents, from the Apple Watch Series 4 and later devices, so stand by. Mobilhealthnews

AliveCor, OMRON announce cardiac monitoring strategic alliance, equity investment

You know it’s a step towards a more normal state of affairs when this Editor can cheerfully announce something which has really nothing to do with a virus, pandemic, or something ending in 19, although there’s the expected COVID spin. Almost getting lost in All That was the announcement last week of a global strategic alliance between AliveCor, the developer of KardiaMobile, and OMRON Healthcare, the Kyoto-based cardiac health and wellness company. Cardiac monitoring was around well before this virus and with a focus on mobile monitoring, is a major up-vote for an innovative company like AliveCor.  What’s in the release is the announcement of a global alliance, technology integration, and at the very end of the release, closing of an undisclosed equity investment by OMRON Corporation (OMRON Healthcare’s parent). This is actually the second equity investment which OMRON has made in AliveCor, with the first being in March 2017 with the Mayo Clinic. Hat tip to co-founder and ever-dapper Dave Albert, MD via Twitter

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

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 

News roundup: Proteus may be no-teous, DOJ leads on Google-Fitbit, HHS’ mud fight, Leeds leading in health tech, malware miseries, comings and goings

Proteus stumbles hard, cuts back. The original ‘tattle-tale pill’ company, Proteus Digital Health, plans to lay off 292 people in the San Francisco Bay Area and to permanently close its three Redwood City and Hayward locations, starting 18 January, according to notices sent to California state and local offices, including the state employment development department. It is unclear where Proteus will be located after the closures.

This followed after Proteus failed to launch a twelfth funding round of $100 million. According to reports, they furloughed most of their employees for two weeks in November and are reorganizing. This is after a substantial number of investors have put in about $487M in funding through a Series H (Crunchbase), including a game-changing investment by Novartis dating back to 2010.  Proteus achieved unicorn status about three years ago, but its high-priced pill tracking technology with a pill sensor tracked by a skin-worn monitor reporting into a smartphone has a built-in limited market to expensive medication. Otsuka Pharmaceutical in 2017 partnered with Proteus for an FDA-cleared digital medicine system called Abilify MyCite that basically put an off-patent behavioral drug back into a more expensive tracking methodology. But Proteus remains a great idea on tracking compliance in search of a real market, and may not have much of a future. San Jose Mercury News, CNBC

But ingestible detectable pills are still being tested. On Monday, as Proteus’ bad news broke, eTectRx announced its FDA clearance of the ID-Cap System and its testing at Brigham and Women’s Hospital and Fenway Health, focusing on HIV medication when used for treatment and prevention. Release, HISTalk

Department of Justice taking the lead on scrutinizing Google’s Fitbit acquisition. The Federal Trade Commission also sought jurisdiction over the transaction. According to the New York Post, “both agencies are concerned that a Google-owned Fitbit would give the search giant an even bigger window into people’s private data, including sensitive health information, sources said. Under the Hart-Scott-Rodino Act, all large mergers must file proposals with both the DOJ and the FTC, but only one antitrust agency reviews the merger.”

Coal from stockings being thrown about at HHS. According to POLITICO and the New York Times, the disagreements between Seema Verma, the head of the Centers for Medicare and Medicaid Services (CMS), and the Cabinet-level Secretary of Health and Human Services (HHS), Alex Azar, have boiled over, enough to have to be settled by the President’s acting chief of staff, Mick Mulvaney. According to the Times, both President Trump and VP Mike Pence have told them to find a way to work together. Both are administration appointees, but President Trump has not been reluctant to cut a mis-performing or overly contrary appointee loose. The latest salvo from those obviously not on Ms. Verma’s side was the revelation that she requested compensation for jewelry stolen on a business trip, contrary to government policy of course. She was compensated for other items which is standard. (Isn’t that what homeowners’ insurance is for? And what sensible person actually travels with valuable jewelry?) Under Ms. Verma, CMS has been quite progressive in developing new business models in Medicare fee-for-service, moving providers to two-sided risk, and innovating in both Medicare and Medicaid. It will either be settled, or one or both will be gone. Pass the popcorn.

Leeds picks up another health tech company. Mindwave Ventures is opening an office there, as well as appointing Dr Victoria Betton and Dr Janak Gunatilleke to the roles of chief innovation officer and chief operating officer. Mindwave develops technologies around digital products and services in healthcare and health research. Leeds reportedly is home to over 250 health tech companies and holds an annual Leeds Digital Festival in the spring [TTA 11 April].

Ransomware attack hits Hackensack Meridian. Systems were down for about a week. While this large New Jersey health system hasn’t admitted it, sources told the Asbury Park Press that it was ransomware. And if it’s not ransomware, its Emotet and Trickbot. Read ZDNet and be very apprehensive for 2020, indeed, as apparently healthcare is just one big target.

Comings and Goings: There may be some end of year bombshells, but after last week’s big news about John Halamka, it’s been fairly quiet. Paul Walker, whom this Editor knew at New York eHealth Collaborative, has joined CommonWell Health Alliance as executive director. Mr. Walker was most recently Philips Interoperability Solutions’ vice president of strategy and business development. CommonWell’s goal is improving healthcare interoperability and its services are used by more than 15,000 care provider sites nationwide. Blog release, Healthcare Innovation ….Dr. Jacqueline Shreibati, the chief medical officer for AliveCor, is joining Google Health in the health research area. Mum’s the word when it comes to Fitbit (see above). CNBC ….Peter Knight has pleaded guilty to falsifying educational credentials to gain his position as chief information and digital office at Oxford University Hospitals NHS Foundation Trust. He held that position from August 2016 until September 2018. BBC News

News, events roundup: FDA clears AliveCor’s first 6 lead ECG, Jawbone Health rises from ashes, Let’s Get Checked’s $30M check, Health Wildcatters’ $35M ‘how to’ breakfast

AliveCor receives FDA clearance for KardiaMobile 6L, the first FDA-cleared personal 6-lead device. From the AliveCor release, the description: “In addition to the two electrodes on the top of the device, there is one additional electrode on the bottom. The user places her thumbs on each of the two top electrodes, and places the bottom electrode on her left knee or ankle. This formation, known in cardiology as the Einthoven Triangle, allows cardiologists to view electrical activity in the heart from six perspectives or “leads.”” The information is sent to the mobile device’s software including KardiaAI bradycardia and tachycardia detection features cleared recently for the single-lead KardiaBand, as well as deeper information into arrhythmias. The single-lead ECG space that AliveCor pioneered with first their snap-on then the KardiaBand is now crowded with the Apple Watch, Withings, and numerous others. It’s a big step forward for the company. AliveCor has opened pre-orders now at $149, to be delivered starting in June. Hat tip to co-founder Dr. Dave Albert. 9to5Mac, Biospace (release), Mobihealthnews

Save Your Jawbones, the Founder Rises Again. Yes, Jawbone founder Hosain Rahman just raised $64.5 million for a new company. The new outfit, dubbed Jawbone Health, will offer a “personalized subscription service where we take all of this continuous health data about you and we combine that with a lot of machine intelligence . . .” to prevent avoidable diseases. After having burnt to a crisp $1 billion over 10 years on wireless speakers and fitness bands, again Mr. Rahman goes into territory which isn’t exactly unique with the footprints of the aforementioned Apple Watches, Withings, Spry Health’s Loop, EarlySense, etc. But hey,  SignalFire and Refactor Capital in the Bay Area, Polymath Ventures and Meraas in Dubai like his style. Even TechCrunch is arching an eyebrow.

Let’s Get Checked checks in with $30 million raise. This NYC-based direct-to-home supplier and manufacturer of in-home test kits raised a $30 million Series B from Leerink Transformation Partners, Qiming Venture Partners USA, and Optum Ventures after last year’s $10 million Series A. Customers can order in-state physician-approved laboratory tests via LetsGetChecked.com or through partner retailers, including CVS, Walmart, Pharmaca, and McKesson online stores, with delivery in 1-2 days. Tests covering wellness, men’s and women’s health are processed by CLIA-certified reference labs with results sent to a secure online account in 2-5 days, with the customer referred to in-state physicians for interpretation of results and further action if needed. PrivaPath Diagnostics markets in the US, Canada, Ireland, and Europe. Release

Speaking of raising money, how about $35 million for your med device startup? Health Wildcatters is hosting one of their Pulse Health Startup Education Series breakfasts (7.30-9am) in Dallas on Tuesday 21 May with main speaker Ken Nelson from Bardy Diagnostics, which just had a $35.5 million Series B, presumably letting everyone in on the secret. Registration and more information here.

Rounding up September’s start: AliveCor’s hyperkalemia detector, Apple’s ECG Watch, Tunstall Nordic’s EWII, steps towards a bionic eye, Philips licenses BATDOK, VistA’s international future

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/12/Lasso.jpg” thumb_width=”120″ /]AliveCor gets a fast track for its bloodless hyperkalemia (high blood potassium) detector through the FDA Breakthrough Device program. Working with doctors at the Mayo Clinic, they developed a way to read patterns in electrocardiograms (ECG/EKG) that track increasing potassium levels without drawing blood. While attributed in the CNBC article to AI, it seems closer to machine learning. Hyperkalemia is a condition that is seen in type 1 diabetes, chronic kidney disease, and other kidney related conditions. The device and software is at least one year away from approval including a clinical trial, even on this program which further speeds up the Expedited Access Pathways (EAP) program under the 21st Century Cures legislation. AliveCor currently markets the Kardia Band that reads ECGs.

Meanwhile, the Series 4 iteration of the Apple Watch moves further into the medical device area–and AliveCor’s ECG niche–with a built-in atrial fibrillation-detecting algorithm and an ECG, along with fall detection via the new accelerometer and gyroscope. The Apple Watch will start shipping September 21. Mobihealthnews.

Danish energy and broadband provider EWII has sold its subsidiary EWII Telecare A/S to Tunstall Nordic. EWII Telecare provides telemedicine and telehealth services on a tablet platform dubbed Netcare (video here). The EWII Telecare website is already down. Telecompaper, Tunstall Nordic release

Foundational technology for a bionic eye? The University of Minnesota has developed a method using 3D printing to create light receptors on a hemispherical surface. Printing a base of silver ink, the next layer was photodiodes of a semiconducting polymer which convert light into electricity. ZDNet

Philips Healthcare is licensing the Battlefield Airmen Trauma Distributed Observation Kit (BATDOK) technology for remote monitoring of vital signs by combat paramedics. Terms were not disclosed. BATDOK was developed by the US Air Force Research Laboratory, which sought commercialization. [TTA 6 Sept 17]  Mobihealthnews

What is generally not known about the VA’s eventually departing EHR is that it has for some years an open source version called OSEHRA VistA. Plan VI will expand VistA capability by making it compatible with different languages using Unicode and creating a reference implementation for global use. Working with non-profit OSEHRA are research groups in South Korea, China, and the Kingdom of Jordan. Release

Health tech for stroke prevention and rehab from Kardia Mobile, Watch BP, Northwestern U (UK/US)

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2018/02/Northwestern-stroke-patch.jpg” thumb_width=”150″ /]Is stroke avoidable? We know it is an expensive medical event at $20-23,000 for hospitalization alone (NIH), which does not count rehabilitation or the devastation to individuals and their families, including loss of ability and work. NHS England is testing two devices, the Kardia Mobile and Watch BP, with an eye to preventing stroke in those vulnerable to it. 6,000 devices are being distributed to GP practices in England in a program through 15 NHS and care innovation bodies known as Academic Health Science Networks (AHSNs). The Alivecor‘s Kardia Mobile is a smartphone add-on clip that captures a medical-grade ECG in 30 seconds, stores, and sends readings to physicians. The application to stroke is primarily in atrial fibrillation (AF) and irregular heart rhythms, which according to statistics, more than 420,000 people across England have. Watch BP is a blood pressure cuff device which is also equipped with an AF detection system. The goal of the project is to identify 130,000 new cases of AF over two years, to prevent at least 3,650 strokes and potentially save 900 lives. Savings to NHS are being estimated at £81 million annually. Digital Health News

Post-stroke rehabilitation treatment is also being boosted by a new device developed at Northwestern University and being tested at the Shirley Ryan AbilityLab, a Chicago research hospital. It is a Band-Aid® like device which can be applied to key areas such as the throat (left above, credit AbilityLab), chest, or limbs to send back information to doctors on how a patient in treatment post-discharge, especially at home, progresses. The sensors and platform measure heart activity, muscle movement, sleep quality, swallowing ability, and patterns of speech. Especially revolutionary is the monitoring of speech communication and swallowing, which are often impaired in stroke patients but hard to track once the patient is out of a facility. The team’s research was presented last week at the American Association for the Advancement of Science (AAAS) annual meeting. New Atlas. Hat tip to Toni Bunting.

5 vital signs, one ‘heavyweight’ device on the back of your Moto X smartphone

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2018/01/Vitals-product.jpg” thumb_width=”150″ /]Are we getting to the ‘tricorder’ through the smartphone mod back door? Smartphone clip-ons to measure a vital sign are nothing new–the early 2010s AliveCor device was a snap-on case for the iPhone containing EKG electrodes, now replaced with the Kardia Mobile and KardiaBand for the Apple Watch. But the Vital USA Moto Mod has to be the heavyweight champ of clip-on ‘mods’. It is for the Motorola Moto Z only, and the reveal at CES was by Lenovo, the official global distributor. Release (PDF).

The Vital Moto Mod measures five vital signs–heart rate, respiratory rate, blood oxygen saturation (SpO2), non-contact core body temperature, and systolic/diastolic blood pressure–through primarily a finger cuff and sensors. For BP, the cuff uses sensors and a novel inflatable bladder. Vital USA claims that running through all five readings takes between two to three minutes. The results download to the HIPAA-compliant Vital app which will be available through the Google App Store. The app also guides the user through how to take one or more of the vital signs. The Vital Moto Mod is not yet FDA cleared or CE Marked. 

As CNet remarked, the mod is huge and not exactly something you slip into your back pocket. They didn’t have the opportunity to check it for accuracy against other standard medical devices. It will be available after April 8 for $395 (£290).

One questionable aspect of the website is the consistent usage and demonstration of ‘vital signs monitoring’ and confirmation of its accuracy when in the FAQs, under “Is the product FDA approved”, it states that “this is a health and general wellness product. The Vital Moto Mod is not a medical device and therefore not currently regulated by the FDA.” 

However, announced on the 24th was their partnership with Partners Connected Health of Boston to validate the readings in a clinical trial that will compare the Vital Moto Mod to predicate medical devices, which is preliminary to FDA approval. Release

It appears that the US company, HQ’d in Boca Raton, FL, has an Irish parent, ARC Connected Health.

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2018/01/sensoscan.jpg” thumb_width=”150″ /]An earlier, less clunky entrant, which this Editor first saw at Connected Health 2015 is the Sensogram SensoSCAN finger cover monitor which is a 4-in-1, measuring blood pressure, heart rate, blood oxygen saturation (SPO2), and respiration rate (but not temperature). Measurements are viewable on a screen readout. It is currently available for $499 through their website and is in the process of FDA clearance. In development is the VitalBand, which adds fall detection, medication reminders, goal notifications, and pre-programmed contacts to the SensoSCAN’s four vital signs. Data is stored on both devices and uploaded to their app via Bluetooth.

This Editor is impressed with the idea of consumers not having to work with multiple devices but sees two definite drawbacks: size of the Vital Moto Mod and the cost of both up to $499. They are most useful to those who have to monitor multiple vitals for chronic conditions, yet they are both, at this time, stand-alone, not reimbursable, and not integrated with any major telehealth system. It’s yet to be seen if they will be accepted by telehealth companies (which kit their tablets or hubs with multiple devices), payers, and patients.