Care Innovations goes East–down home to Kentucky

Intel and GE’s joint venture, Care Innovations, is opening an IT and product development center in Louisville KY’s Norton Commons live/work community. According to reports, the 10-person office was opened to develop “software for medical monitoring systems that allow people to measure their vital signs in own homes and that will analyze the data for health care providers”, which sounds like a description of Health Harmony as mentioned further in the article. Also cited by CEO Sean Slovenski was the recent acquisition of several major clients in Mississippi, Louisiana, Kentucky and Tennessee. Headquarters will remain in Roseville, California, northeast of Sacramento and far east of Silicon Valley. Why Louisville? It’s the headquarters of Humana, currently in the early stages of a merger with Aetna. Mr Slovenski is an alumnus of Humana who undoubtedly recognizes that there’s always talent which shakes loose with any merger, often proactively. He has reorganized the company top to bottom since the days in the doldrums under Louis Burns, and added initiatives such as the Validation Institute plus academic relationships with the Jefferson School of Population Health, Xavier University and the University of Mississippi. Louisville is also a lot closer to Washington DC (1.5 hour flight time) and all those wonderful Federal programs with lots and lots of funding.  Louisville Business First, release.

Speaking of the Aetna-Humana merger, it now has a strong boss man to make sure it works–Rick Jelinek, CEO for a year of OptumHealth, 19 years at predecessor now unit UnitedHealthcare including leading the Medicare Advantage and Medicaid businesses. The stakes are high in that the merger will create the second-largest managed care company in the US. Mr Jelinek also will lead Aetna’s enterprise strategy division, and will report directly to Aetna’s CEO. The timeline, unless the Feds put on the brakes, is to close in second half 2016. The combined operating revenue is projected at about $115 billion, with about 56 percent from government-sponsored programs, such as Medicare and Medicaid. The plan, according to Louisville Business First, is to headquarter the combined Medicare, Medicaid and Tricare businesses in Louisville. But, as they say, the meal is still being prepared, and assuredly not everyone at either company will find a seat at this table, or one they want to sit in.

When disruptive healthcare tech disrupts the wrong things, including safety

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/04/Thomas.jpg” thumb_width=”150″ /]Last week’s Health 2.0 conference was (of course) a three-ring circus of new technology and its corollary, a lot of hype. An astute writer new to this Editor, Michael Millenson, draws together the key points of two prominent, but not hyped speakers there: Robert Wachter, MD and Michael Blum, MD, both practicing in University of California San Francisco’s (UCSF) medical center. Dr Wachter, chief of the Division of Hospital Medicine, has been profiled in these pages earlier this year in a review of an excerpt from his book, The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine’s Computer Age. There he wrote about the example of Pablo Garcia, nearly dying from over-prescribed doses of an antibiotic that a chain of errors in their EHR started. Dr Blum is Director of UCSF’s Center for Digital Health Innovation. But their points are on the same track: “the danger of disruptive technology that disrupts the wrong things: upsets checks and balances that keep patients safe, makes working conditions more stressful and simply doesn’t play well with others.” His conclusions are on the money: #1, it’s not the technology but the adaptive change that front and back line clinicians will need to make; #2, entrepreneurs with whiz-bang tech that zips data to the clinician without fitting it into a care process are doomed to fail; #3 some kind of curation is needed. But whether that will be Care Innovations’ Validation Institute or Social Wellth (which purchased the late Happtique from GNYHA) is another story. Key for Health IT Entrepreneurs: Don’t Disrupt the Wrong Thing (Forbes)

ONC gets in study game in designing the Consumer Centered Telehealth Experience

ONC (the Office of National Coordinator for Health Information Technology, HHS) in the spring conducted a design session on creating a more consumer-centered telehealth experience, commissioning the engagedIN research firm to help select a panel, run it and produce the study. The white paper focuses on how telehealth can either further fracture or integrate PHR (study pages 7-11), and what’s needed to make telehealth and telemedicine more convenient and effective for consumers. The panel avoided the big telemedicine providers (a bone that Mobihealthnews picks with the study) which typically dominate these panels–to this Editor a positive action–but included other telehealth providers like Qualcomm Life, Care Innovations and Zipnosis, as well as the US’ largest user of telehealth, VA Home Telehealth. Among the key drivers of telehealth are HHS’ and private insurers (UHC) shift to value-based payments; CMS’ target of 50 percent of Medicare value-based care is cited (page 5). There are nine principles at the end (pgs 13-16) to guide the way forward. Designing the Consumer Centered Telehealth and e-Visit Experience (PDF) (Though it is confusing why e-Visit was used rather than ‘virtual visits’ or, in fact, telemedicine.)

GE Healthcare staying together: CEO (updated)

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/04/2000px-General_Electric_logo.svg_.png” thumb_width=”150″ /]It’s ‘black and white’ but not GE blue all over! During an investor conference Wednesday, GE Healthcare’s CEO John Flannery insisted that “Bottom line is we have been black and white that all aspects of healthcare are part of our portfolio,” reported in Reuters. Investors have questioned the flatlining of both revenue and profit and the fact that GEHC doesn’t seem to fit well in the engineering/manufacturing bent of the Immelt-ized GE.

The speculation by investors and we in the healthcare press is rational. Earlier this year, GEHC announced the phaseout of the Centricity Enterprise (hospital) EHR. [TTA 15 April] Healthcare Financial Services and the services it would provide were also up in the air. Currently it lends to healthcare entities including hospitals and other health facilities to purchase equipment (made by GE) and real estate/facilities (not made by GE). Initial indicators was that GE would continue to finance what it sells. The real estate financing then is questionable, and undoubtedly an issue for healthcare facilities, as GE Capital has been sold. GE also sources funding for healthcare innovation through the Healthymagination Fund and GE Ventures, and of course has an interest in the Intel-GE JV, Care Innovations. What shape this financial arrangements will take in the future is not clear from the available information.

Also announced, according to Biospace, is $1 billion funding over the next five years for education to reach more than two million healthcare professionals worldwide–physicians, radiologists, technologists, midwives, nurses, biomedical engineers–geared to local needs. It will include new clinical, product application, technical and leadership training and education. A forward commitment of this magnitude does seem to confirm that GEHC is in the healthcare game.

A trip back in time to telecare, circa 2009–and maybe the future

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/08/Cape-May-Point-fade-to-dark.jpg” thumb_width=”150″ /]As the season winds down, our thoughts turn backwards. Your Editor remembers Jersey Shore vacations, travel, great airshows, collector car shows, old friends and good times. She also remembers When Telecare Was New (2006-9) with Living Independently Group (now Care Innovations), helping to pioneer the QuietCare system in senior housing. At that time, universities like Virginia and Florida were on the cutting edge in developing smart homes and pioneering systems for monitoring health in older adults and the disabled. Those smart homes and research initiatives vanished years ago, replaced by incubators, accelerators, the size of your funding round, Big Data, wearables, IoT….

Sigh. Your Editor is in Error. The University of Missouri is still at it 12 years later with its sensor-based behavioral/activity/proactive care system in the Tiger Place assisted living community near Columbia. And it seems much the same: bed and residential motion sensors, fall detection tracked by a variety of sensors, gait analysis and analysis of activity changes (changes in behavior=changes in health, which still doesn’t excite those in senior care the way it should) . You have to admire the persistence of vision the founders/researchers have had (Marilyn Rantz, professor emeritus with the School of Nursing, and Marjorie Skubic, a professor with MU’s College of Engineering). Their research model has now spread to 13 communities and hospitals in Missouri, and they are commercializing it with a former student, George Chronis, with Foresite Healthcare to convert it into a reliable, robust assisted living/hospital monitoring/care transition system with a simpler, affordable ‘health at home’ version. Besides the nostalgia and supporting fellow ‘true believers’, what they have designed is still needed AND not achieved by RFID (a big fizzle) or ancient PERS. We can all wish them luck in a competitive and much changed market. MU researchers taking sensor system from lab to marketplace (Columbia Daily Tribune)

Previously in TTA: Quantifying early detection capabilities of telecare (July 2012) and Editor Steve’s first look in October 2009 at ‘magic carpet falls’.

What’s news at the end of the week

Care Innovations harmonizes seniors, Panasonic adds diabetes, Jawbone and Fitbit bite, the first EHR/PHR Hack and Concussion in Cleveland. Converging its interests in remote patient monitoring with its long-time footprint in senior housing resident monitoring (QuietCare), Intel-GE Care Innovations is testing its Health Harmony remote patient monitoring system, partnering with two California-located Front Porch communities and the Front Porch Center for Innovation and Wellbeing. The residents selected have poor chronic condition management or have returned after a discharge from a skilled nursing facility. No disclosure on projected number or duration–and it doesn’t appear that QuietCare is part of the monitoring. Release….Panasonic just bought Bayer Healthcare’s diabetes/blood glucose monitoring device unit for $1.13 billion as Bayer continues to shed non-life science businesses. While old-school prick-and-bleed monitors are being eclipsed by continuous glucose monitors (CGMs) and mobile-based devices such as Telcare in the US and in Europe, there’s plenty of market remaining in the West, and new ones in Asia and the Middle East for simple devices. It joins Panasonic’s existing blood pressure monitors. MedCityNews….Jawbone and Fitbit continue to snap at each other in court, with the former on Wednesday filing a second lawsuit on patent infringement, specifically “a wellness application using data from a data-capable band”, with the added fillip of going to the International Trade Commission, which could ban the import of Fitbit products or component parts. The 28 May lawsuit was about Fitbit’s hiring of five former Jawbone employees who allegedly stole IP. The companies between them have hundreds of patents, and as this Editor has noted in previous IP and patent troll articles, the US Patent and Trademark Office (USPTO) is not especially rigorous in ensuring that patents are not overbroad. Wonderful for the IP attorneys, but not exactly what Fitbit wants as a runup to their expected IPO next week. Wall Street Journal….Now an EHR and PHR join Hackermania Running Wild. Medical Informatics Engineering reported Tuesday that in May their server was cyberattacked, exposing PHI of patients in five clients and separately information contained in the NoMoreClipboard PHR subsidiary. POLITICO reports that this is the first recorded instance of an EHR compromise. MIE ReleasePOLITICO Morning eHealth….If you are in the Cleveland, Ohio area and have an interest, Concussion: A National Challenge is a free, two-day event on detection and diagnosis sponsored by the National Academy of Engineering, the Institute of Medicine, Case Western Reserve University, Metro Health and Taipei Medical University. Advance registration required.

Aetna may ‘buy into’ more analytics, digital health

Rumors now mainstreamed into press surround Aetna’s apparent interest in fellow insurers Humana and Cigna. Forbes last Friday started the ball rolling with an article last Friday focusing on the main event driving insurance payer consolidation: the transition of Medicare from fee-for-service to value-based bundled payments and accountable care organization (ACO) models. Humana has substantial Medicare business and a foot in home care (SeniorBridge), but has innovated in digital health: partnerships (Healthsense, TTA 20 Dec 13), purchases (what remained of Healthrageous, TTA 16 Oct 13), employee wellness (Vitality) and app development. Cigna is a major insurer with corporate business, but has struggled a bit in the digital health arena with the flashy-but-flopped patient engagement platform GoYou. It’s piloted telehealth to reduce readmissions with Care Innovations [TTA 7 Oct 14]  and Coach by Cigna, a mobile health platform in conjunction with Samsung for the Galaxy S5 and S6 phones.

Aetna has had some success with working with ACOs, with 62 contracts covering about 1 million lives, but this Editor counts over 400 practice-based ACOs in the Medicare Shared Savings incentive program alone. Their experiment in consumer app aggregation, CarePass, came to a quiet end last August and Healthagen, their ’emerging businesses’ unit, has had some swerves in rationale including iTriage and even ActiveHealth Management, their long-time population health analytics arm. While digital health is part of it (see Mobihealthnews), (more…)

Do startups truly threaten the ‘healthcare establishment’?

Or are successful startups fitting into their game? Chris Seper in MedCityNews paints the picture of one side of a quandary. The ‘healthcare establishment’ fundamentally and to its detriment does not understand and is threatened by the startup and innovation process. A startup may begin with an idea which is, in his words, ‘almost always flawed, sometimes deeply’. If the founders are smart, they will test their ideas, validate them and change them appropriately. If not, they will fail. But it is easier for the Establishment to point at the most egregious of the bad ideas and use them to rationalize the status quo.

But being congenital contrarians, we paint the house on the other side of the street. Has the Establishment caught up with–or in some cases, co-opted startups, making them and their funders ‘do their diligence’ and be more cautious before emerging? This Editor would argue yes, and largely for the better.

**The ‘Wild West’ days are over. A few years ago, a truly bad or deeply flawed health tech idea or could easily find funding, because it was all blank slate, new and ‘transformative’.The sexiest hooks were Quantified Self, sleep, employer health incentives, interactive coaching, genomics, app prescribing and (last) wearables. A lot of founders imagined themselves as the Steve Jobs of Healthcare, down to the black turtleneck. Now there is a history of success and failure. The railroads reached the dusty frontier towns.

**There’s now a ‘Startup Establishment’. National accelerators (more…)

Care Innovations, UMMC Telehealth Center to expand care outside the home

Intel-GE Care Innovations, which markets both telehealth and telecare (QuietCare, one of the pioneers in behavioral telemonitoring) products, announced today a broadened relationship with the University of Mississippi Medical Center’s Center for Telehealth. CI will help them to establish the Innovation Living Lab which will create and evaluate new models of care via remote technology and techniques for behavioral change. The Lab will open at UMiss’ Venyu Technology Center sometime in 2016. UMMC and CI’s goal is to extend care models so that the home is a key location for care delivery. In the past year, both had partnered on the Diabetes Telehealth Network. CI since their change of management has made several interesting moves in the past year, including grouping telehealth systems under Health Harmony and creating a Validation Institute. Business Wire.

News highlights for Friday

AnthemHealth didn’t encrypt, Blueprint Health collects, HealthSpot funds again, Sense4Baby goes to Europe, Apple Health pilots in hospitals and buddi gets bigger still.

Another hack attack claimed major US health insurer AnthemHealth, the former WellPoint. It’s estimated that 80 million of its customers, former customers and employees had data breached: names, addresses, dates of birth, emails, employment information, income, medical IDs and SSIs. The Wall Street Journal reports that Anthem didn’t encrypt data for analytics reasons. It’s unconfirmed where the hackers originated but Bloomberg’s latest report tags the usual Chinese state-sponsored suspects. Unusually, it was reported within days of discovery; Anthem has called in Mandiant (FireEye) to beef up its cybersecurity. Other reports: WSJ, Modern Healthcare….The Blueprint Health accelerator has a new initiative, the Collective. It is designed to pair up major healthcare providers and payers with startups and early stage companies. So far signed up are Aetna, AstraZeneca, HP, Montefiore, North Shore LIJ, New York-Presbyterian, Samsung, EmblemHealth, Philips and Razorfish Healthware. More information here….The HealthSpot Station telehealth/telemedicine kiosk is readying a $11.6 million funding round from four investors soon, based on (more…)

An interesting COPD telehealth pilot, mangled in the reporting

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/10/blue-blazes.jpg” thumb_width=”150″ /]Our first ‘Blue Blazes’ of 2015 is the kind of press coverage that makes a PR pro or marketing director cringe.

Intel-GE Care Innovations along with OSF (Order of St. Francis) HealthCare and the University Of Illinois College Of Medicine at Peoria, the latter which have an interestingly named collaborative called Jump Trading Simulation and Education Center, are using the home telecare activity tracker Lively in a COPD patient tracking pilot. Reading the two articles found to date, one can eventually glean that vital signs like weight, blood pressure, O2 levels, lung capacity and qualitative feedback questions, as well as activity, is being tracked. The combination of activity + vital signs is interesting and different, but it takes detective work–viewing the video on the CIProud.com website (which charmingly turns sensors into senors in the headline)–to discover that the activity tracker is Lively, a CI partner. Lively does not report vital signs. How they are being collected remains a mystery as the Peoria Public Radio website article doesn’t furnish details other than a picture with an unidentified desktop hub/display (Health Harmony? It doesn’t look like it). Lack of detail + abundance of typos = bad reportage. In any case, the pilot of 30 patients continues into March, when it will be expanded to 200. Related: OSF/Care Innovations announcement from June 2014.

Looking back over Telehealth & Telecare Aware’s predictions for 2014, part II

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/01/magic-8-ball.jpg” thumb_width=”150″ /]Editor Charles has treated you to a look back on his 2014 predictions, daring Editor Donna to look back on hers. Were they ‘Decidedly so’, ‘Yes’, ‘Reply hazy, try again’ or ‘My sources say no’? Read on…

On New Year’s Day 2014, it looked like “the year of reckoning for the ‘better mousetraps’”? But the reckoning wasn’t quite as dramatic as this Editor thought.

We are whipping past the 2012-13 Peak of Inflated Expectations in health tech, diving into the Trough of Disillusionment in 2014.

There surely were companies which turned up ‘Insolvent with a great idea’ in Joe Hage’s (LinkedIn’s huge Medical Devices Group) terms, but it was more a year of Big Ideas Going Sideways than Crash and Burns.

Some formerly Great Ideas may have a future, just not the one originally envisioned. (more…)

Health apps presently of little use, says Australian telehealth expert

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/10/Margelis.jpg” thumb_width=”120″ /]”Immature” and “focused on low-lying fruit such as fitness tracking and not focused on the big issues of management of disease” are also two of the compliments that Dr George Margelis of the University of Western Sydney’s TeleHealth Research & Innovation Laboratory (THRIL) has bestowed on the current state of health apps. Until the collected data ‘plugs into other digital platforms’–he mentions the Australian government’s PHR, eHealth–apps will not help those who need it the most. “Unfortunately, managing these diseases, in particular the chronic diseases that are a major part of the current burden, requires more than just tracking a few physical parameters which is what the app world is up to.” Dr Margelis called for collaboration between app developers and healthcare professionals; while he scores Apple’s HealthKit, that may be the means to make his vision come true. It should be noted that Dr Margelis (more…)

Telecare helping Alzheimer’s patients live in the ‘connected home’

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/08/140825141047-lively-pillbox-sensor-story-top.jpg” thumb_width=”150″ /]There’s life in telecare–it’s (finally) morphing into ‘connected home’. Is this ‘slope of enlightenment’ and ‘plateau of productivity’ time?  We haven’t had a spotlight on the part of telecare which is sensor-based behavioral monitoring, but here’s one that shines on not just one but four systems which indicates a big change in focus, long developing: SmartThings, Lively, BeClose and certified Grizzled Pioneer GrandCare Systems. CNN.com crafted an article out of a fairly obvious placement by the Alzheimer’s Association, but all to a good end.

Notably SmartThings by Physical Graph (just purchased by Samsung for a reported $200 million after raising $15.5 million through Series A, undoubtedly for their algorithms and in its health reach strategy versus Apple Health) pitches itself on its website as simple home automation, yet this article is all about older adult safety. Lively, which is depicted with an interesting connected pill dispenser (above) and BeClose carve their approaches close to caregivers.  All three are DIY systems. GrandCare remains the anomaly, with the highest (custom) home install price ($699 and up) but with a home tablet that engages the older person with virtual visits, music, pictures, daily updates and family/clinician connectivity. They were also first to move in this direction; this Editor recalls their pioneering in the home automation area with CEDIA, the home electronic design association.

After years, are we finally seeing a shift in consumer perception?  (more…)

Eric Dishman’s ‘view from the top’ on genomics

Eric Dishman of Intel’s Health & Life Sciences Group credits genomics with changing the course of treatment for his life-threatening cancer about two years ago. With new treatment based on his genomic sequencing, he became cancer-free in three months and eligible for a kidney transplant, which he received in early 2013 from, as it turned out, a fellow Intel-er [TTA 12 Apr]. His keynote at HIMSS14 was about what he calls ‘N=1″ personalized medicine, which is based on three Bs plus one: body, biology and behavior, plus beliefs. Dishman also recounted a story around the original Intel Health Guide of a woman caregiving for a mother with Alzheimer’s whose diabetes worsened because she could not make clinic visits; with the addition of remote monitoring to the care plan this was reversed. No mention of Care Innovations (the Intel-GE JV), but he presented the Sotera Wireless ViSi Mobile wireless patient monitor as an ‘ICU on a wrist’ (Intel is an investor). Neil Versel reports in MedCityNews.

More on the data analytics and integration behind genomics from an unexpected source–the chief medical officer of Northrop Grumman. If like Editor Donna, you had no idea that this company had a footprint in healthcare, prepare to be surprised. Thanks to our friends at HITECH Answers.

Powerhouse DC lobbying for telehealth, telemedicine

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]The Gimlet Eye observes from a houseboat anchored at a remote Pacific island, with coconuts and occasional internet to Editor Donna.

Telehealth and telemedicine have reached a US milestone of sorts: the formation of a Washington, DC-based ‘advocacy’ (a/k/a lobbying) group constituted as a business non-profit. The Alliance for Connected Care is headed by three former Senators (two of whom were ‘amigos’) from both sides of the aisle and backed by a board including the expected (giants Verizon, WellPoint, CVS Caremark, Walgreens)–and the surprising (much smaller remote consult provider Teladoc and HealthSpot, the developer of the HealthSpot Station kiosk–hmmm, must be a fair chunk of their marketing budgets there) flanked by six well known ‘associate members’ including Cardinal Health and Care Innovations (another hmmm). There’s also a hefty ‘advisory board‘ including the American Heart Association and the NAHC (home care). The leadership team members are all members of major Washington law/lobbying firms. Tom Daschle is recognized as one of the most influential former Senators in town via DLA Piper, though himself not a registered lobbyist (OpenSecrets.org). Trent Lott and John Breaux hung out their own shingle and were recently bought by mega-lobbyist Patton Boggs. To put a fine point on it, more high-powered one does not get. The Eye sees that the time is prime for the Big Influence and…

What the Eye sees is Big Financial Stakes: Private insurers are required to cover telehealth in 20 states, as does Medicaid in most. The VA is a major user. But the great big trough of Medicare is new territory; covering 16 percent of the population, the use of telemedicine and telehealth is limited to certain geographic areas. (MedCityNews) This marks the infamous tipping point: the clarion call to ‘build significant and high-level support for Connected Care among leaders in Congress and the Administration’, ‘enable more telehealth to support new models of care’ and ‘establish a non-binding, standardized definition of Connected Care through federal level multi stakeholder-input process’ (whew!) Big companies want in, insurers want reimbursement, and they want it from somewhere as well. Toto, we’re not in the Kansas of Small anymore with ‘connected health’–we are now in the Oz of Big Money and Power Players. Alliance release (Oddly the website looks preliminary despite the big announcement and backing.)

More on this strategy: It’s called ‘soft lobbying’ and it is the latest thing in the Influence Wars. The Alliance for Connected Care is a 501(c)6 non-profit, similar to a business league like the Chamber of Commerce, and this has become a popular tactic. It’s also a less regulated, less transparent way to shape coverage, public opinion and exert influence on legislators. See this well-timed examination from the Washington Post on the corn syrup versus table sugar wars. ‘Soft lobbying’ war between sugar, corn syrup shows new tactics in Washington influence