TTA’s Christmas Runup #1: Boss Lady Holmes takes the Theranos trial stand, Athenahealth sold, CVS-Microsoft partner again, VA restarts Cerner, Owlet’s Owww! with FDA

 

 

Weekly Update

 

Editor’s Note: We’re looking for contributors–if interested, email Editor Donna

Holmes testifies about Her Boss Lady Life At Theranos, staying on strategy with deflection, blaming others, and a soupçon of diminished capacity. Athenahealth sold to new investors, VA reorganizes to restart their Cerner implementation, CVS and Microsoft do another deal. A POV on patient engagement. And disappointingly, Owlet’s baby monitor sock runs afoul of the FDA.

Owlet sock pulled from US distribution after FDA warning letter (Owww! A setback for a high flyer)
News and deal roundup: Best Buy’s $400M for Current, VA’s Cerner restart 2022, CVS-Microsoft product deal, and Athenahealth (finally) sold for $17B (Deals may be winding down, but they’re still rich)
Theranos, The Trial of Elizabeth Holmes, ch. 12: all bucks stop with the CEO (updated) (It’s beginning to feel like Twinkie Defense Variations)
Perspectives: How enhanced digital communications can improve patient engagement (Avaya’s insight on designing your communications)
Theranos, The Trial of Elizabeth Holmes, ch. 11: Holmes’ widening gyre of diffusion of blame–and abuse (A lurid Svengali story that woke up the jury)
Theranos, The Trial of Elizabeth Holmes, ch. 10: Holmes testifies about the salad days of Theranos, setting up cognitive dissonance (When in doubt, deflect from the forgery with idealism)

The denouement of Elizabeth Holmes’ trial draws near, with the prosecution resting (not before drawing all the fraud threads together) and Holmes surprisingly taking the stand as the week ends. The year’s end and holidays mean the smaller fundings wind up now, with a few larger (Athenahealth?) to come. Amazon Care’s fan dance reveals an H for Hilton. Telehealth and retail strategies ambitiously puzzle. And Loughborough neighbors Access Group and Alcuris walk off with each other.

Short takes: Athenahealth close to sold, Teladoc wants More of the Patient, CVS fewer store customers (Questionable strategies at various stages?)
Alcuris acquired by the Access Group (UK) (Loughborough neighbors getting together)
News and deal roundup: Amazon Care lands Hilton, Lightbeam buys CareSignal RPM; aptihealth’s $50M, MedArrive’s $25M, Ribbon Health’s $43.5M (Amazon reveals a bit more, while funding numbers shrink at year’s end)
Theranos, The Trial of Elizabeth Holmes, ch. 9: the cold $96 million (updated 19 Nov) (The prosecution ends with a hammer blow, the defense opens with…Holmes)
Theranos, The Trial of Elizabeth Holmes, ch. 8: choosing investors with more money than sense a winning strategy (And make sure they’re not too tightly wrapped!)

Big News this week was Giant Company Spinoffs–GE Healthcare and J&J’s split. Finance deals are taking a rest–only one this week of note. A major health system is in court for telehealth IP theft. Theranos’ mountain of deception grows higher. And what is the NHS going to do with their Unconnected Patients? No appointments, just queue?

Short takes: Now J&J splits up, a Color(ful) $100M, Cue Health goes DTC, Amwell’s busy Q3, Teladoc’s Investor Day 19 Nov (Telehealth Wars continue)
News roundup: GE Healthcare spins off, Mercy Health accused of telehealth tech theft, NHS’ proposed $8.1bn bump for backlogs–with a 83 y/o in a 7am queue (Not right to discriminate against the Unconnected)
Theranos, The Trial of Elizabeth Holmes, ch. 7: Edison labs consistent–in deficiency and strange results (PSA findings for women, and sign right here, Lab Director)

As the deal pace settles down to a nine-figure progression, and it’s hard to find a space in the Unicorn Parking Lot, telehealth is also settling down to entering primary care (though Teladoc continues in the red) and a 4% claim level in the US. It’s now the downslope for the Theranos trial with the deception piling wide and high. And our supporter Legrand for connected care is now Legrand Care.

Short takes: Papa Health’s $150M Series D, Hinge Health’s $600M Series E, Teladoc’s revenue up 81% but continues in the red
Legrand’s new global brand: Legrand Care (Another rebranding!)
Theranos, The Trial of Elizabeth Holmes, ch. 6: the decision maker was Holmes–and she was ‘cagey’ (Not looking good for Liz)
US telehealth usage increases slightly in August, reversing months of decline (But only a small bump up)
Wirral Council investing £1.5 million in next-generation digital and ‘preventative’ telecare (UK) (Alcuris and Medequip)

The pace of deals is slowing as we lurch to year’s end, but nine figures have become the New Average with Oak Street-RubiconMD, 23andMe-Lemonaid, and ModivCare-VRI. Name changes are too, with Doro Care morphing into Careium (and Facebook becoming Meta-something). Google bets on mental health. The Theranos opera moves into Act 2 with the Gulling of the Rich Families.

News & deal roundup: Oak Street adds telespecialty RubiconMD, ATA plumps for wider telehealth access, yet claims fall to 4%, West Suffolk NHS adds Zivver mail/file security, Northwell’s $100M for AI–and miss industry shows yet? (Your Editor does!)
Theranos, The Trial of Elizabeth Holmes, ch. 5: how to easily fool rich people and their investment offices (‘The Grifters’, the Palo Alto remake)
Google joins the behavioral health wars, adds new senior executive from Headspace (Accompanied by self-important flapping about)
Doro AB splitting in two, Doro Care changing name to Careium (Must be a trend…Facebook just became Meta-whatever)

Serious swerving indeed: 23andMe buys Lemonaid Health for $400 million (Lemony23?)
PERS/RPM catchup: VRI bought by ModivCare for $315M; Connect America buys AI-powered RPM 100Plus, opens new SC center (There’s lots of life and money in PERS)

The pace of financings and M&A slows down a bit, though the realignments are important–and the renaming starts. Google creates an app around their Care Studio EHR search tool. Another look at Amazon Care and their possible strategy as they spend beaucoup lobbying bucks. Theranos proves to be a bottomless well of deception, darkly tinted with silty water.

Short takes: Google’s Care Studio app debuts, Modern Age’s healthy (aging) $27M Series A, OnSky Health launches pad-based RPM
Amazon Care confirms five more cities, beefs up DC lobbying–but what’s the real game? (It may be your data, not your health, as competition ramps up)
Theranos, The Trial of Elizabeth Holmes, ch. 4: we deceive those who want to believe (A skillful shell game that worked very well until The End)
News roundup: Grand Rounds rebrands as Included Health, HealthEdge buys Wellframe, TytoCare rings Google Chime

The Trial reveals Walgreens’ and Safeway’s frustrations and deceptions with Theranos that ultimately cost them a collective $520 million. Walgreens learned its lesson, bringing home the primary and post-acute care of VillageMD and CareCentrix. Babylon raises even more $, Best Buy moves into home care management with Edinburgh’s Current Health. And stepping back, is telehealth now due for a correction?

Short takes: Walgreens now majority share of VillageMD, CareCentrix; Lark Health lifts $100M, UnitedHealth Group’s profitable Q3 and Change delay
What’s next for telehealth? Is it time for a correction? (Maybe not as much as we cracked it up to be)
News and deal roundup: Babylon’s $200M raise, Best Buy buys Current Health, Virgin Pulse-Welltok, Devoted Health’s $1bn raise, Withings watch gains FDA ECG clearance
Theranos, The Trial of Elizabeth Holmes, ch. 3: Safeway, Walgreens execs testify to deception, frustration with Holmes, failed pilots and labs (updated) (Expensive lessons!)

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Telehealth & Telecare Aware: covering the news on latest developments in telecare, telehealth, telemedicine, and health tech, worldwide–thoughtfully and from the view of fellow professionals

Thanks for asking for update emails. Please tell your colleagues about this news service and, if you have relevant information to share with the rest of the world, please let me know.

Donna Cusano, Editor In Chief
donna.cusano@telecareaware.com

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Perspectives: How enhanced digital communications can improve patient engagement

TTA has an open invitation to industry leaders to contribute to our Perspectives non-promotional opinion area. Today, we have a contribution from Dave O’Shaughnessy, Avaya’s Healthcare Practice Leader for EMEA and APAC. The subject is the hot button of patient engagement–how telehealth and virtual care systems can be used to connect patients to providers, improve patient understanding, and increase both patient and provider satisfaction.

Interested contributors should contact Editor Donna. (We like pictures and graphs too)

For most of us, the term “patient engagement” seems straightforward. Patients who come in for their annual exams or patients with a chronic disease who regularly take their prescribed medications are considered engaged patients. But what about the rest of us who feel reluctant to contact our GP when we have health concerns or don’t take our prescribed medicine when we should. If these people were better engaged, their patient experience and outcomes would be improved.

Communications technology that was once considered cutting-edge is now holding healthcare back and one of the most significant obstacles to building an engaged patient experience is the traditional calling-centric communication model. Today, implementation of virtual care systems (telehealth), especially via cloud-based software-as-a-service (SaaS) applications that can be accessed from smartphones or tablets, improves patient engagement levels, and directly contributes to their overall health and outcomes.

So, what should a healthcare provider look for in a modern cloud communication and customer engagement solution? Here are four vital components for starters:

A unified communications platform

A unified communications and patient engagement platform in the cloud provides seamless connections across modes of communication (voice, messaging, chatbots, online meetings, and video), as well as devices (desktop, mobile, and tablet devices). Because it’s all integrated, patients get to use their communication channel of choice over their device of choice, and providers get the features they need to ensure that patients can engage a suitable person when they get in touch. In addition, self-service capabilities such as automated messages for appointment reminders and confirmations help to dramatically reduce time-wasting no-shows for healthcare organisations.

Real-time communications and collaboration

Provision of care requires constant and intuitive access to clinical information and the ability to effectively and efficiently communicate across dispersed teams to exchange critical information throughout care-coordination workflows. Effective and secure real-time collaboration across all communications channels helps staff reach the right people across the organisation at the right time using the most appropriate mode of communication. Most critically of all, these communication services for clinical staff must be easy-to-use, leveraging features like Single Sign-on authentication across multiple apps on a mobile device and offering intuitive click-to-call or team-calling abilities helping teams collaborate easily and rapidly.

Follow-up Patient Engagement

When patients aren’t engaged, they are less likely to follow instructions, resulting in more frequent readmissions. Cloud-based communications solutions with features such as click-to-chat and click-to-video allow patients to keep informed of what, and when, they need to take action for positive health outcomes. Providers can also add automated outbound patient notifications using SMS or Chatbots to follow up on patient satisfaction surveys, freeing critical staff to focus on in-office patients and higher priority, higher quality services.

A Secure and Flexible Platform

To avoid the security pitfalls of Bring Your Own Device (BYOD), healthcare provider staff need a “one-device, two numbers” experience that enables them to securely use one device for both personal and business. And lastly, a communications solution should be able to seamlessly integrate with the most common digital systems used by healthcare professionals.

With the cloud, communication and collaboration can become integrated into one solution that works the way patients and providers work—across any device, anytime, anywhere. Most importantly, the flexibility of cloud communication—particularly when it comes to solutions with open platforms—means providers can add new capabilities in minutes, with almost immediate access to the latest innovations. Look to partner with a solutions provider that has proven experience in patient engagement and experience solutions.

Iron Bow partners with Vivify Health for $258 million VA telehealth contract

One mystery solved! Iron Bow Technologies announced that its telehealth delivery partner for their award of $258 million in the Veterans Affairs Home Telehealth program is Plano, Texas-based Vivify Health. As noted in our original article [TTA 6 Feb] on the much-delayed VA remote patient monitoring award, Iron Bow was an existing contractor in other VA Telehealth services, Clinical Video Telehealth (video conferencing) and Store-and-Forward (clinical imaging review), but did not have vital signs RPM capability. The addition of Vivify with its mobile and tablet-based solutions and integrated peripherals adds that capability.

Vivify structures its main telehealth solutions based on escalating patient ‘risk’: 1) healthy and ‘at risk’ (may have early stage disease), 2) rising risk (has complex chronic disease) and 3) high risk (for hospitalization). The approaches are scaled up from engagement on BYOD mobile and web for (1), to vital signs monitoring and telemedicine clinician visits via mobile and tablet (2), to the highest level of an integrated kit with tablet and integrated peripherals (3). These further divide into five ‘pathways’ which are more product-oriented.

Cost is, of course, a factor, with VA a very demanding client in this regard as individual VISN (region) budgets are tight. Medtronic, the incumbent, has not only been using the venerable Cardiocom Commander Flex hub, but also provides VA with Interactive Voice Monitoring (IVR) which is an inexpensive patient management solution. (Ed. note: having worked with IVR in the past, it can work well if used with primarily lower-risk patients, is structured/implemented properly and integrated with live clinical check-ins.) Vivify’s system is all new–and not inexpensive, especially at the high-risk level. From their website, Vivify uses BYOD for the lower levels and the integrated kit for the highest and poorer outcome patients. This Editor notes they offer a voice telephony care solution which presumably is IVR. This gives them a welcome flexibility in price, but also a complexity which will be a training issue with VA care coordinators.

Other factors affect mobile-based solutions. Many at risk at-home veterans are older and thus don’t have smartphones or tablets. Reliable broadband connectivity is also an issue. Many don’t have Wi-Fi, which is a prerequisite for tablet use, and may live in areas with poor cellular reception.

The other work and labor-intensive parts for Vivify and Iron Bow are to integrate their reporting platform into VA’s complex and secure systems, which also involves a highly structured updating process: CPRS (computerized patient record systems), the VistA EHR and whatever replaces it (Epic is being trialed in Boise, Idaho–scroll down to ‘Big Decisions’ and Dr Shulkin).

Founded in 2009, Vivify has compiled an impressive track record with CHRISTUS Health (TX), RWJ Health (NJ), Trinity Health (MI), Centura Health (CO) and other large systems plus home care. It has also been conservative in its venture funding, with $23.4 million to date and its last big round from LabCorp and others in 2014 (CrunchBase).

Release. Hat tip to Vivify’s Bill Paschall via LinkedIn.  P.S. Stay tuned for an announcement of 1Vision’s partner. 

Editor’s clarification: The VA Home Telehealth contract is structured as a one-year base period, followed by four one-year optional periods, for five years total. The awarded amount over the five-year period is $258 million for Iron Bow/Vivify. It is the same amount/term for each of the three other awarded companies, totaling just over $1 billion for the five-year program. This is comparable to the 2011 five-year program value of $1.3 billion divided over six awardees. Thanks to Josie Smoot of Iron Bow Technologies’ press office.

Forced to wear a fitness tracker for insurance? (US)

For those covered by corporate health policies, the day is not far away where employee health insurance programs will require wearing a fitness tracker and meeting certain metrics, such as walking a million steps or sleep quality. Already some programs have the employee log food, exercise, blood glucose, heart rate and other vital signs to qualify for a discount. The trajectory is much like BYOD–once unheard of, now it is expected to be the norm in 50 percent of US companies by 2017, with a concomitant loss of personal security and privacy. CVS Caremark and other companies have already made the stick, not the carrot, the norm of employee wellness programs [TTA 12 April 2013]. Writer Adrian Kingsley-Hughes asks: “How much access do we want our employers to have to our medical data? How much access to our daily activities do we want our employers and insurers having?” And what about spoofing those Fitbits and Jawbones? His ZDNet article notes the interest that Apple (plus Samsung and Google, despite Sergey’s and Larry’s vapors–Ed.) has in health, then takes it out a few more yards with Wearables and health insurance: A health bar over everyone’s head (and do check out the comments.)

Healthcare BYOD unleashed, and the consequences

A just-published Cisco study estimates that nearly 89 percent of healthcare workers Bring Their Own Device–in this case, smartphones only, so really BYOS. For employers who largely do not subsidize usage, it’s a huge benefit–overall in the eight industries studied, 90 percent of employees receive no subsidy yet 92 percent use their smartphone for work weekly. But the employees don’t bring their own good security practices. In healthcare alone (classed as a ‘sensitive industry’): 41 percent do not password protect, 53 percent access unknown/unsecured Wi-Fi networks and 52 percent don’t disable Bluetooth ‘discoverable’ mode. And this does not include iPads, Android tablets and the like which are also often left unsecured. According to FierceMobileHealthcare, which referenced a late 2012 Amcom Software study, “more than 65 percent of responding healthcare facilities do not have a documented mobility strategy in place. What’s more, 37 percent of the survey’s respondents do not have plans to implement such a strategy in their organizations.”  It makes one long for the days of IT department-issued cranky CrackBerries. BYOD Insights 2013: A Cisco Partner Network Study  Hat tip to David Albert, MD of AliveCor @DrDave01 for the link via Twitter.

Is there a BYOD backlash? Ken Congdon of Healthcare Technology News spoke at HIMSS 2013 on the unstoppability of BYOD and counters the naysayers.