MediBioSense and Blue Cedar take a new approach to secure medical wearable data (UK/US)

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2018/01/VitalPatch_Header_Photo_Tablet.jpg” thumb_width=”150″ /]Doncaster UK-based MediBioSense Ltd. has partnered with San Francisco-based Blue Cedar to protect their VitalPatch app on smartphones and tablets. MediBioSense uses VitalPatch in their MBS HealthStream system marketed in the UK in acute care and long-term care setting. Blue Cedar is securing the app through their patented code-injected technology which protects the VitalPatch-collected data from the app to the provider database. The system with Blue Cedar’s security is available directly from MediBioSense.

VitalPatch is a single-use adhesive biosensor patch applied to the patient’s chest (see left above). It monitors eight vital signs and activity signs: heart rate, respiration, ECG, heart rate variability, temperature, body posture including fall detection/severity, and steps as an indicator of activity. MediBioSense contracted with the US-based developer, VitalConnect, to sell the system in the UK. VitalPatch is US FDA-cleared (Class II) and CE Marked for the EU.

One impetus, according to the release (PDF), is the GDPR (General Data Protection Regulation), the pan-European/UK data-protection law slated to take effect in May. This not only applies to European Union citizens’ personal data but also requires reports on how organizations safeguard that data. 

Blue Cedar, which this Editor has previously profiled [TTA 3 May 17], has developed code-injection technology that secures data from the app to the provider location on their servers or in the cloud. It secures the app without the device being managed. Devices have their own vulnerabilities when it comes to apps even when secured, as 84 percent of cyberattacks happen at the application layer (SAP). Blue Cedar’s security also enables tap-and-go from an icon versus multiple security entries, thus quick downloading from app stores or websites. For companies, the secured app provides granular analytic reports about users, app usage, devices, and operating systems which are useful for GDPR requirements.

Blue Cedar’s latest release of app security is Enforce, to secure existing mobile apps using in-app embedded controls to enforce a broad range of security policies. It is sold on the Microsoft Azure cloud platform and is primarily targeted to the value-added reseller (VAR) market. 

All the more reason to use all means to secure devices and apps. When as of last week Allscripts‘ EHR for e-prescribing was hit with a ransomware attack (FierceHealthcare), yet another hospital (Hancock Regional in Indianapolis) paid $5,000 to hackers to get back online (Digital Health), and Protenus/DataBreaches.net tracks a breach a day [TTA 29 Dec 17], cybersecurity has become Job #1 for anyone in the healthcare field. (And Big Healthcare now votes for security. Protenus today announced their $11 million Series B led by Kaiser Permanente Ventures and F-Prime Capital Partners. Release.)

EHR action: Allscripts acquires Practice Fusion, expands footprint in small/ambulatory practices

A significant EHR acquisition kicks off an action-packed week. Announced today by leading EHR Allscripts is their acquisition for $100 million of independent practice EHR Practice Fusion. Allscripts, which has been usually in the top five US EHRs (Kalorama April 2017 survey), vastly expanded its hospital market share with August’s acquisition of #2 McKesson‘s health IT business and with this would be ranked just behind EHR leader Cerner. In acute care settings, Epic and Cerner dominate with 25 percent of the market each with Allscripts/McKesson far behind #3 Meditech (KLAS April 2017). 

Practice Fusion, one of the pioneers in the small practice/ambulatory EHR starting with a basic free, ad-paid model in 2005, has 30,000 ambulatory sites serving about 5 million patients each month. In the Allscripts view, they will now be able to offer “last mile” reach to the under-served clinicians in small and individual practices” and close gaps in care. Allscripts President Rick Poulton noted in the statement that “We believe this transaction will directly benefit Practice Fusion clients, who will now have access to Allscripts solutions and services. We look forward to welcoming Practice Fusion team members to our family.” which leads one to believe that the Practice Fusion name will be sunsetted. Allscripts release and Healthcare IT News

From being the leader in small practice EHRs, Practice Fusion found the last few years difficult as competition expanded into their segment, from eClinical Works, drchrono, athenahealth, and NextGen to small practice packages from Epic and Cerner.

It should be noted that Practice Fusion in 12 years went through 13 funding rounds, raising almost $158 million from a long list of VC luminaries such as Kleiner Perkins, Artis Ventures, Founders Fund, and Qualcomm Ventures (Crunchbase). However, it disappointed its investors and Wall Street, which expected two years ago a $1.5 billion IPO. The $100 million from Allscripts is all cash and the price is “subject to adjustment for working capital and net debt”–an exit which was surely not the sugarplum in the eyes of its 2014 and prior  investors. CNBC

Walgreens partners with Chicago health tech incubator MATTER (US)

Walgreens, the US retail pharmacy part of Walgreens Boots Alliance, on 20 December announced its own alliance with Chicago healthcare incubator and innovation community, MATTER. This Editor believes it is the first retail partnership with a health tech-focused incubator or accelerator in the US; most of these partnerships are with angel networks, VCs, health system venture arms or large commercial healthcare partners such as Qualcomm, Allscripts or GE Healthcare. Walgreens’ contribution will be to mentor and collaborate with MATTER entrepreneurs. Reportedly they have or have had more than 150 startups in their program. They are also part of Chicago’s push to slice itself some health tech cake versus cities like San Diego, Palo Alto, Dallas, Boston and New York via the recently launched Health Care Council of Chicago (HC3), which was co-created by MATTER and Leavitt Partners. Hopefully, Walgreens will get some of their $140 million back via their Theranos lawsuit ending their blood testing misadventure [TTA 17 Nov, Ch. 24] and spread their bets with legitimately promising startups. Press release, ChicagoInno

Friday’s cyberattack is a shot-over-bow for healthcare (updated)

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/26ED4A2300000578-3011302-_Computers_are_going_to_take_over_from_humans_no_question_he_add-a-28_1427302222202.jpg” thumb_width=”150″ /]Friday’s multiple distributed denial-of-service (DDoS) attacks on Dyn, the domain name system provider for hundreds of major websites, also hit close to home. Both Athenahealth and Allscripts went down briefly during the attack period. Athenahealth reported that only their patient-facing website was affected, not their EHRs, according to Modern Healthcare. However, a security expert from CynergisTek, CEO Mac McMillan, said that Athenahealth EHRs were affected, albeit only a few–all small hospitals.

A researcher/spokesman from Dyn had hours before the attack presented a talk on DDoS attacks at a meeting of the North American Network Operators Group (NANOG)

The culprit is a bit of malware called Mirai that targets IoT–Internet of Things–devices. It also took down the (Brian)KrebsOnSecurity.com blog which had been working with Dyn on information around DDoS attacks and some of those promoting ‘cures’. According to Krebs, the malware first looks through millions of poorly secured internet-connected devices (those innocent looking DVRs, smart home devices and even security devices that look out on your front door) and servers, then pounces via using botnets to convert a huge number of them to send tsunamis of traffic to the target to crash it. According to the Krebs website, it’s also entwined with extortion–read, ransomware demands. (Click ‘read more’ for additional analysis on the attack)

Here we have another warning for healthcare, if ransomware wasn’t enough. According to MH, “even for those hospitals with so-called “legacy” EHRs that run on the hospital’s own computers, an average of about 30 percent of their information technology infrastructure is hosted (more…)

The mixed picture of health tech investment: a potpourri

One picture is generally positive–plenty of opportunity in the aging and ill population, particularly in data integration from various sources, and value-based care. Everyone loves the excitement that a startup with a novel technology or way it can make knowledge more useful brings to the field.  Another picture is one of pitfalls aplenty, from overhyping technology (poster child, Theranos) to overestimating growth, overspending and especially picking the wrong (nervous, impatient) investors at the wrong time, which have left a general patina of mistrust around digital health. There’s also the fact that healthcare is a highly, confusingly regulated, long-cycle business that’s challenged money-wise, whether in the US, UK, Europe or Asia. Some advice to startups contained in these two articles, including from the principals of StartUp Health accelerator (who’ve seen it all), has to do with building trust, finding the right investors, the right advice/advisors, collaboration (though that is difficult with IP), finding proven (affordable) management and a sustainable (and resilient) culture. Underpromise, overdeliver.  TechCrunch, Healthcare Dive

No wonder that investment was flat in 2015, and that much of the news is around acquisitions that rearrange companies and/or offerings. The latest today is Allscripts‘ and GI Partners’ acquisition of behavioral EHR/care coordination company Netsmart for $950 million; Allscripts is moving its homecare business into Netsmart’s CareFabric suite. Kansas City Business Journal, Healthcare Dive  In addition we’ll cite our earlier Mo’ Money article on the $600 million in various digital health investments. UPMC, which had invested in Vivify Health’s telehealth/RPM platform, is spreading $3 million around partly in-house to six health tech projects developed under the Pittsburgh Health Data Alliance. And in an example of Wearables Confusion, investors put $16 million into LifeBeam to develop another DTC ‘holistic’ health wearable (LifeBeam’s origins are sensors for aerospace and defense) while early wrist fitness entrant Pebble has laid off 40 staff in an attempt to refocus on…fitness.

Early-stage companies are also alliancing and merging. Fresh out of Newark and the New Jersey Institute of Technology’s NJ Innovation Institute, the merger of Practice Unite (which knits together secure mobile clinician/patient communications into a customized platform) and Uniphy Health (physician engagement), is an example of complimentary enlargement. This expands care collaboration offerings and shades over into patient engagement if you look at the PHM quadrant here. According to Director/Chief Medical Officer Stuart Hochron, MD (who was a Practice Unite founder), “We’re really pleased with the outcome of this merger. It’s given us the capital and resources that we need to scale.” It’s also good to see that both the founders and the CTO are moving into the new Uniphy Health–and staying in Newark.  Release

Care Innovations’ Slovenski, 23andMe’s Schwartz move to Healthways

Breaking News: Healthways, an online wellness program company based in Nashville, this morning announced that two executives well known to many of us in digital health have joined them. Sean Slovenski, CEO of Intel-GE Care Innovations, is now their President, Population Health Services. Steve Schwartz, their new SVP Strategy and Corporate Development, joins the company from VP Business Development and Strategy, 23andMe.

Mr Slovenski’s track record in 2.5 years at CI certainly impressed this Editor (formerly with the developer of their behavioral telemonitoring system bequeathed from GE Healthcare, QuietCare) with turning around the company from an outpost of Intel and GEHC having difficulty transitioning from ancient technology (remember the Intel Health Guide?) to a telehealth platform dubbed Health Harmony. He also put together a team that engineered multiple academic and health system alliances, along with an interesting turn into home digital health certification. While he came to CI from health insurance giant Humana in Louisville Kentucky running their behavioral health and wellness businesses, his prior experience includes both entrepreneurial turns at his own company and with smaller companies. He most recently engineered a Louisville outpost of CI [TTA 14 Oct 15]. Since Mr Slovenski is still listed on the CI website as CEO, this may have been a quickly executed move.

Mr Schwartz’s business development background includes long stints at two large healthcare companies, Allscripts (EHRs and practice management software) and LabCorp (lab testing). He weathered 23andMe’s FDA troubles and headed up their B2B sales area. Healthways release

Unusually, Healthways is a NASDAQ traded company that closed at $12.11 today in a down market. It’s old (in our terms) having been founded in 1981, becoming publicly traded ten years later. Its last round of venture financing was $20 million from CareFirst BlueCross Blue Shield in October 2013 (CrunchBase). Healthways has a fairly new CEO as well, who joined last August and obviously feels comfortable adding to his team.

US Department of Defense picks Cerner/Leidos/Accenture for $4.3 bn EHR

Breaking News Updated  The winner of the massive, potentially ten year contract for the Defense Healthcare Management System Modernization program is defense computer contractor Leidos, which brought in Cerner and Accenture Federal Systems.The DOD announcement mentions only lead contractor Leidos, interestingly under the US Navy Space and Naval Warfare Systems Command, San Diego, California. The announcement was released just after 5pm EDT today.

This combination beat the Epic/IBM and the Allscripts/Computer Sciences/HP bids. According to the DOD announcement, “This contract has a two-year initial ordering period, with two 3-year option periods, and a potential two-year award term, which, if awarded, would bring the total ordering period to 10 years. Work will be performed at locations throughout the United States and overseas. If all options are exercised, work is expected to be completed by September 2025. Fiscal 2015 Defense Health Program Research, Development, Test and Evaluation funds in the amount of $35,000,000 will be obligated at the time of award.” Modern Healthcare attended the embargoed press conference this morning and adds in its article that only one-third is fixed cost, with the remainder as ‘cost plus’, which could conceivably run the contract to the $4.33 bn ceiling over the 10 years. The system will be used in 55 military hospitals and 600 clinics, with an initial operational test as early as 2016 (Washington Post) and full rollout by 2023.  Interoperability with private EHR systems was a key requirement (Healthcare IT News).Over the 18 year life cycle, the contract value could be up to $9 bn, according to the WaPo.

The race to replace DOD’s AHLTA accelerated with the final failure to launch a plan to create a joint DOD-VA EHR in March 2013 [TTA 27 July 13], though hopes revived in Congress occasionally during the past two years [TTA 31 Mar].

It is also widely interpreted as a blow to Epic, which has been defensive of late about its willingness to play in the HIT Interoperability sandbox with other EHRs; certainly it cannot make Big Blue, which would undoubtedly have found some way to sell Watson into this, happy.

POLITICO’s Morning eHealth had many tart observations today, mostly pertaining to the belief of some observers that Cerner will be strapped in meeting this Federal commitment and would find it increasingly difficult to innovate in the private sector.

Example–From Micky Tripathi, CEO of the Massachusetts eHealth Collaborative: “My biggest worry isn’t that Cerner won’t deliver, it’s that DOD will suck the lifeblood out of the company by running its management ragged with endless overhead and dulling the innovative edge of its development teams. There is a tremendous amount of innovation going on in health IT right now. We need a well-performing Cerner in the private sector to keep pushing the innovation frontier. It’s not a coincidence that defense contractors don’t compete well in the private sector, and companies who do both shield their commercial business from their defense business to protect the former from the latter.”

Unnerving mergers (US-UK); DoD’s EHR picked; EHRs & AMA

Blues feeling Blue about…The Anthem-Cigna merger, finalized last week (but yet to be approved by the US and likely the UK Governments as Cigna issues policies there), gives them bragging rights over the Aetna-Humana merger and Optum/United Healthcare in their covering of 53 million US lives as the largest US health insurer. Unnerved is the Blue Cross and Blue Shield Association, of which Anthem is a part of with the Anthem and Empire Blue Cross plans plus others in a total of 14 states. But Anthem also competes with ‘the Blues’ in 19 additional states where it markets under a non-Blue brand, Amerigroup, primarily for Medicare and Medicaid (state low-income coverage). Many of the Blues are non-profit or mutual insurers; many are partial or single-state, like Independence, Capital and Highmark (PA/DE/WV) in Pennsylvania and Horizon Blue Cross of New Jersey. Their stand-alone future, not bright since the ACA, now seem ever dimmer in this Editor’s long-time consideration and that of Bruce Japsen writing in Forbes. Also Morningstar considers Anthem’s overpaying and the LA Times overviews.

Walgreens Boots Alliance, another recent merger of quintessentially American and British drug store institutions, named as its interim CEO Stefano Pessina. He previously ran Alliance Boots prior to the merger and is the largest individual shareholder of WBA stock with approximately 140 million shares, so one cannot call it a surprise. At a youthful 73 (see video), one assumes he also takes plenty of Walgreens vitamins and uses Boots No 7 skin care. Forbes.

Updated: The big EHR news is the US Department of Defense announcing the award of its Defense Healthcare Management System Modernization contract this week. At 10 years and $11 billion, even giant EHRs went phalanxed with other giant government contractors to face DOD: Epic with IBM; Cerner with Leidos, Accenture and Intermountain Healthcare; Allscripts with Computer Sciences Corp. and Hewlett Packard. Certainly there will be ‘gravitational pull’ that affects healthcare organizations, but the open and unanswered question is if that pull will include the far nearer and immediately critical lack of interoperability with the Veterans Health Administration’s (VA) VistA EHR. The Magic 8 Ball reads: Hazy, try again later.  Leidos/Cerner announced as winners close of business Wednesday 29 July. 

In other EHR news, US doctors vented last week on how much they hate the @#$%^&* things to the American Medical Association‘s ‘town hall’ in Atlanta. Bloat, diminished effectiveness, error, getting in the way of care due to design by those without medical background presently prevail. The AMA’s Break the Red Tape campaign asks CMS to “postpone” finalizing Stage 3 Meaningful Use (MU) rules so that it can align with new payment/delivery models. Better yet, they should buy thousands of copies of Dr Robert Wachter’s book [TTA 16 Apr] and drop them on every policymaker’s desk there, with a thud. Health Data Management 

Onward the 76 Hundred! Healthcare M&A, funding jam the news

Healthcare mergers, acquistions, investments and joint ventures are doing their own Charge of the Light Brigade as we cross the mid-year bar.

* Onward the 76 Hundred! 7,600 startups around the world are developing solutions in digital health, according to accelerator/investor StartUp Health’s 2015 mid-year report. It also notes that ‘personalized solutions’ are the It Girl of digital health, and that data analytics/big data has fallen to third in investor interest after wellness/benefits (largely skewed by Zenefits) and patient/consumer 
experience received large funding rounds. Cheering news is that StartUp Health notes that investment in 50+ health companies is remaining steady. But the rest might be a bit frothy. The Gimlet Eye’s tut-tut: “whatever Zenefits is, it can’t produce enough Employee Wellness and manage enough HR to be worth an investment of $500 million”. For our Readers, we give you a direct link to their 2015 Midyear Funding Insights Report. (We await RockHealth’s take on the the Year to Date.)

* Onward with an IPO! Telemedicine darling Teladoc (TDOC, NYSE) is even more so with a smashing initial public offering, targeted to open at $19 which closed on Wednesday at $28 and today (Thursday) at same. Rosy forecasts abound despite those annoying losses ($12.7 million in 1st quarter ’14) and court action (Dallas News, TTA 9 June) . We at TTA are sticklers on terminology; still, we were happily surprised to see USA Today in our corner chiding Mr Gorevic on his misapplication of telehealth for telemedicine.

* Onward to Invest in Each Other! The new Allscripts-NantHealth deal gives new meaning to swap. EHR Allscripts bought a $200m, 10 percent equity stake in NantHealth, the health informatics chunk of Dr. Patrick Soon-Shiong’s NantWorks mini-conglomerate. Meanwhile another Soon-Shiong company bought stock valued at $100m in Allscripts. Neil Versel in MedCity News

* Onward from Amsterdam to Tel Aviv! MedCity News and Reuters also report that Teva Pharmaceuticals and Philips Healthcare have inked a joint investment (more…)

GE moving out of the hospital EHR business–and healthcare lending?

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/04/2000px-General_Electric_logo.svg_.png” thumb_width=”100″ /]Updated. Spring cleaning at GE continues that may affect healthcare more than EHRs. Neil Versel catches at HIMSS, if not an exclusive, close to it, by finally getting a GE exec to admit the awful truth–that they are phasing out their Centricity Enterprise (hospital) EHR. Versel: “It’s now helping customers with a “graceful transition over a number of years,” said Jon Zimmerman, general manager of clinical business solutions at GE Healthcare.” Even more remarkable, that decision was made three years ago. MedCityNews also updated their article to highlight some of their recent problems with Intermountain Health; we’ve also noted that UCSF converted to Epic after 12 years (see our Weekend Must Read).

The GE Capital exit may affect healthcare too. The other and more major part of the spring cleaning–their exit from GE Capital with the sale/spinoff of assets over the next two years–was announced over the weekend (Bloomberg). Their Healthcare Financial Services lends to healthcare entities including hospitals, life science and in senior housing/health facilities. It also houses the Healthymagination Fund, the capital source for GE Ventures, its early stage developmental arm for healthcare, software and energy. According to The Wall Street Journal, GE will retain healthcare financing to support what it makes in its GE Healthcare unit: ultrasound, imaging, patient monitoring and diagnostics industrial equipment, down to the Vscan (yes! it’s still there). We would bet that GE Ventures is safe. But does this mean that its healthcare real estate unit within Healthcare Financial Services, which lends to senior housing, skilled nursing and other medical properties, is on the block, especially as GE this weekend completed the sale of its real estate holdings? What else, we wonder, will GE sell at the right price to pull up share price–and in the longer term, the future of its manufacturing in areas like major healthcare equipment which have been facing a declining and heavily competitive US market?

Exiting the hospital EHR business makes sense for GE, but what else will it entail? While it retained a solid footprint of vendor loyalty and satisfaction (more…)

Patients should be less engaged, not more

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/04/Thomas.jpg” thumb_width=”150″ /]What, the very premise of ‘increasing consumer engagement’ doesn’t work? Whatever will all the (startups, websites, gamification, personalized health, behavior modification, Quantified Selfing) do?

What the chronically ill really want is less engagement with, less time spent on their particular condition or disease–certainly not to be forced into Sisyphean tasks. What this Editor has termed the ‘perpetual Battle of Stalingrad’ of self-monitoring (especially apparent in diabetes) means extra effort with minimal/no reward, never achieving ‘normal’ and never catching a break. Glen Tullman, former CEO of Allscripts and currently a healthcare investor with 7WireVentures, points out that the endless promotion of ‘consumer engagement’ is not only patronizing, but also wrong-headed in blaming the patient for not managing their illness their way. People want simply to live their lives, not their problems.

  • “What if we ask patients—or “health consumers” as I call them—to do less rather than more?” (more…)

Cerner acquires Siemens HIT business

The big news in HIT circles today was Cerner’s purchase of Siemens’ health IT business for $1.3 billion. Forbes has the most detailed analysis by far, which appears prepared in advance based on the 22 July rumor published by HISTalk at that time. HISTalk’s and their readers’ comments on the announcement conference call today are moderately scathing and worth reading if of interest to you. The takeaway for this Editor is that it was a defensive move for Cerner versus Epic Systems, Athenahealth and Allscripts; they bought out a competitor, bought market share with the acquisition (although how much of it would have fallen to them anyway is a question), gained more of an international foothold plus an inside track to customers eager to move to newer technology. For Siemens, it appears  (more…)