TTA’s Autumn Falls #3: Theranos cost Safeway, Walgreens $520M; Walgreens buys majority of VillageMD, CareCentrix: Babylon, Devoted Health, Lark’s big raises–more!

 

 

 

Weekly Update

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

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!)

The trial of Theranos founder Elizabeth Holmes moves to the Hot Grill, with the former lab director turning slowly on the spit to ‘well-done’. Babylon Health is finally SPAC-ing–and buying US practices. And in TelehealthWorld, both Teladoc and Babylon are offering similar virtual full-service primary care to payers and employers for members.

Telehealth’s primary care wars heat up: Teladoc’s Primary360, Babylon 360 (Telehealth ain’t beanbag)

Babylon Health’s SPAC closing later this month at $4.2 billion value, buys California medical practices (Now to turn that red ink to black)
Theranos, The Trial of Elizabeth Holmes, ch. 2: the lab director’s contradictions, competence questioned (The best defense that money can buy)
 

The trial of Theranos founder Elizabeth Holmes slugfests on, with prosecution hammering away at knowing malpractice in patient care with the Edison labs, and the defense using every Perry Mason-like trick in the book to break witnesses. And back in the real world, Walgreens continues to explore outside of Drug Store World with a rumored pass at management services company Evolent Health.

Theranos, The Trial of Elizabeth Holmes: ch. 1 (The defense lawyers must have been paid in advance)
Walgreens may acquire Evolent Health: report (Possible reach into tech-based management services)

Google continues shedding Health initiatives with shutdown of NHS’ Streams clinical support app. But is health care too much for Big Tech accustomed to monetizing clicks and ads? Headspace and Ginger decide to merge rather than be bought, as digimental health stays hot. Beth Israel Deaconess shows how hospital IT can get its skates on with telehealth. And Cerner’s pay package for its new CEO shows you that crime does not pay, but healthcare certainly does!

Mental health apps Headspace, Ginger to merge into $3B Headspace Health (Better to merge than to be bought? The sprint of digital mental health continues.)
Another Google termination: Google Streams clinical support app used by NHS (Another broken healthcare toy)
Amazon’s Chime telehealth solution rang Beth Israel Deaconess Medical Center’s bells–case study (How hospital IT can innovate under pressure)
Is healthcare too much for Big Tech’s Google and Apple? Look at the track record. And David Feinberg’s $34M Cerner package. (Too much, too soon?)

Our weekend lead news is Google Health’s shutdown, with its head graduating to the Big Job at Cerner. Rockley Photonics may be revolutionizing the smartwatch with its photonic vitals sensors. Sharecare expands health ed and enters the once-sleepy home care biz. Humana also bets big on home care with Kindred, SDOH heats up, Maven’s a unicorn, and Carrots are on the healthcare plate with the trimmings.

Breaking: Google Health shutting down, most employees scattered to other divisions (And its head is now Cerner CEO)
Deal and news roundup: Humana closes $5.7B Kindred at Home buy, Unite Us SDOH buys Carrot Health for data, Carrot Fertility raises $75M, Maven Clinic at $1B value, Privia partners with Babyscripts for moms, Tyto Care and Prisma Health
Sharecare expands health education capabilities, acquires CareLinx home care for $65M (updated) (A healthcare conglomerate in the making?)
Comprehensive “clinic-on-the-wrist” digital health sensor system debuts. Apple Watch of future? (UK/US) (Rockley Photonics’ big leap)

The news isn’t taking a Summer Holiday, neither are deals. Honor just rocked the sleepy home care world with its buy of Home Instead. UnitedHealth will have to wait till end of year for Change. Morgan Health debuts with $50M in Vera Health. The Telehealth Teeter-Totter continues with Amwell’s gloomy forecast, Teladoc’s Aetna deal. And Voices Carry with stress testing and a neuroprothesis that may give communication back to those who cannot speak. 

Home care rocked: Honor Technology acquires home care provider Home Instead (It’s all about the caregivers and hospital-at-home)
News roundup: update on UnitedHealth/Change Healthcare DOJ check, Tunstall adds new CTO, Amwell’s gloomy second half, Teladoc’s Aetna deal, Fitbit and LifeScan diabetes
Hearing voices: Cigna-Ellipsis AI-powered voice stress test; UCSF/Weill neuroprosthesis decodes attempted speech (Giving speech to the speechless in the future)
News and funding roundup: patient outreachers Relatient, Radix merge; health apps top 350,000; Morgan’s $50M in Vera Health; Communicare247, Doro, TeleAlarm join Scottish Digital Telecare’s list

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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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What’s next for telehealth? Is it time for a correction?

crystal-ballThe boom may be over, between shrinking visit volume and a pileup of providers. Is a correction in the cards? The flood of funding that started in 2020 and has not abated was kicked off by the pandemic and a massive shift to telehealth visits in March/April 2020 from a barely-above-plant-life number in January/February.

Post-pandemic, the shift corrected.

  • The peak of 69% of visits tracked by Epic in April had tailed off to 21% as early as May 2020 [TTA 2 Sept 20].
  • National commercial claims data via FAIR Health was lower. They tracked its peak also in April 2020 at 13%, falling continuously monthly: May to 8.69%, 6.85% in June, 6% in August, and 5.61% in October [TTA 9 Jan].
  • By mid-year 2021, the claims numbers continued to lose altitude: June 4.5%, July 4.2% (FAIR Health monthly report).

Despite the numbers, telehealth companies raised $4.2 billion of a total $15 billion in digital health funding in the first half of 2021, according to Mercom Capital Group, a global communications and research firm. So…what’s the problem with les bon temps rouler?

CB Insights notes the increased specialization of new entrants and, as this Editor has noted previously, the blending and crossing of business lines.

  • Companies like Heal, Dispatch Health, and Amazon Care will send a clinician to your house for a checkup–no running to your urgent care.
  • Kidney disease? Monogram Health. Musculoskeletal pain? Hinge Health. Child with an earache or fever? Tyto Care. Check symptoms first? Babylon Health.
  • Telemental health has gone from cocktail party repellent to the belle of the ball, concentrating on cognitive remote therapies. For the past year, it moved to more than half of all telehealth claims, with currently over 60% of procedure codes–and it’s consolidating. AbleTo was bought by Optum, Ginger bought by Headspace, SilverCloud by Amwell.

So for the Major League–Teladoc, Amwell, Doctor on Demand, Grand Rounds, and MDLive–what does this mean? If this interview with Teladoc’s CIO is an example, they plan to segue to a ‘hybrid’ model of virtual quick response plus integrating providers into a continuing care model with patients, creating a relationship with history and familiarity. A model that’s very much dependent on IT, analytics, and connecting with willing providers. But in this free-floating sea of verbiage, it didn’t come into misty focus till the very end, when he mentions Primary360 [TTA 7 Oct] and a virtual primary care team. (And let’s not forget Babylon360 along similar lines.) He finally sketches a view of all the connections to conditions coming together on a very far horizon. 

One can say it’s a cloudy crystal ball, indeed. FierceHealthcare, HealthcareITNews (Teladoc CIO interview)

CB Insights rounds up a 2020 Digital Health Top 150

Actually this Editor added the ‘Top’ to the Digital Health 150, as it emulates the Top 40 or Top 100 when Music Radio ruled, but Billboard or Melody Maker would hardly recognize the format. CB Insights evaluates the promising, primarily US digital health startups from its research. It’s their second Digital Health 150 and like last year’s, it organizes the aspiring hot companies into groups and sub-groups. Many companies are repeats, though the categories are different than last year’s, reflecting a change in what is considered ‘hot’:

  • Administrative automation and digitization
  • Disease management and therapeutics
  • Screening and diagnostics
  • Drug discovery
  • Clinical trials
  • Clinical intelligence and enablement
  • Online-offline care
    • Primary and urgent care
    • Specialty care
  • Pharma supply chain
  • Health plans and benefit management
  • Real-world evidence (RWE)
  • Virtual care delivery

Telehealth is hot (of course) in the Online-Offline and Virtual Care categories. CB Insights singles out in telemedicine Heartbeat Health, Doctor On Demand, and Livi (UK) (Kry in the Nordics), while in remote monitoring they named Oura (a ring), Element Science (a cardiac wearable), and Dental Monitoring (a dental treatment/care management platform different than The Teledentists). We also noted Parsley Health’s NY clinics and VillageMD, a Chicago-based primary care provider group which just inked a major deal with Walgreens Boots [TTA 9 July]. Early-stage companies do well when they have big partnerships. 

CB Insights also provided a compare/contrast summary against the 2019 Digital Health list [TTA 10 Oct 19]:

  • Unicorns: 17 of the 2019 Digital Health 150 (11%) have remained or since become unicorns with a $1B+ valuation
  • Exits: 2 companies have gone public and 2 have been acquired
  • Deals, funding, and mega-rounds:  raised over $4bn across 70+ deals, including 14 mega-rounds ($100 million+ investments), as of 10 August

They do not mention that one, Proteus Digital Health, one of those unicorns, went bankrupt this year and was sold on Wednesday for its IP for $15 million.

2020 Digital Health 150

CB Insights names a Top 150 of digital health startups

Now the equivalent of Mrs. Astor’s Four Hundred? CB Insights has entered the list game with a brand new listing of digital health startups, the Digital Health 150, no ballroom needed–perhaps a convention hall? They are classified, sliced, and diced as follows:

Broad categories:

  • Digital therapeutics
  • Pharma supply chain
  • Insurance and benefits
  • Genomics
  • Consumer health and wellness
  • Providers: administrative tools, specialty care, primary care, clinical tools
  • Diagnostics: imaging, pathology, other diagnostics
  • Drug R&D: drug discovery and development, clinical trials, real-world evidence

Another slice is by deal stage from 2014 (the receding of seed funding and progression into Series B and C is notable), top well-funded companies, and ‘unicorn startups’. Unlike Rock Health, CB Insights also looks at where in the world the startups are from: 116 in the 150 from the US, 17 from Asia, 16 from Europe, and 1 from Canada (League employee health benefits).

Many of the usual suspects are here: 23andMe, Babylon Health (UK), American Well, Doctor on Demand, Proteus Digital Health, Iora Health, MDLive, Oscar, One Medical, the relentlessly advertised (in US) Noom, TytoCare, China’s WeDoctor and GoodRx (which last month acquired telemedicine provider HeyDoctor).  Others are surprising in various aspects: the new well-wired Medicare Advantage company Devoted Health, Let’s Get Checked (Ireland, though they list their HQ as NY on website), Protenus (breach tracking), Kry (Nordic/LIVI in UK), Zava (UK), Teckro (Ireland), AbleTo, Higi, ClearCare, and CarePredict. It’s nice to see nods to the un-sexy areas of senior telecare, home care, and cognitive health. CB Insights page

Jawbone out of the consumer fitness tracker business, going to clinical model, raising funds: report

Confirming reports from various sources last year [TTA 21 Dec] and prior (July) is a report in TechCrunch confirming what we already guessed: Jawbone is out of the consumer fitness tracker market, is aiming at a B2B2C market of health providers, and needs to raise a lot more money.

Key points in the article:

  • It intends to market a “health product and accompanying set of services sold primarily to clinicians and health providers working with patients”
  • It’s seeking additional funding from investors. TechCrunch‘s sources claim that is at an advanced stage, but no closings as of yet.

We noted in December that research/analytics company CB Insights calculated that 2015 wearable computing (a broader category that includes smartwatches) investment funding fell 63 percent from 2014 to a level comparable to 2012-13, in large part due to the cooling of the fitness segment. TechCrunch’s end of year report from eMarketer and other sources also noted that 2016 sales growth of the wearables sector, forecast at 60 percent, only achieved 25 percent growth and will be equally weak in 2017. Lack of demand, lack of loyalty (most fitness bands are discarded after 3-6 months), unreliable (TechCrunch makes much of customer displeasure), their looks and generally useless (in a clinical sense) data and the greater versatility (and appearance) of smartwatches for those who want them, are all factors. There’s a disenchantment here (‘who needs ’em?’) that mass marketing can’t overcome.

It is worthwhile reflecting that Jawbone, which started off in 1997 as an audio technology company, has burned through over $980 million in 14 funding rounds, generously provided by various VC luminaries of Silicon Valley. (One wonders how much equity is even left in the company, a la ‘The Producers’) (more…)

Seeing into 2017: Fitness trackers’ chill, clinical and specialized wearables warm up

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2012/12/crystal-ball.jpg” thumb_width=”150″ /]The first in a series of brief projections for 2017. Fitness wearables aren’t even lukewarm anymore, and it’s visible in consolidation and the nay-saying articles. In late November, Fitbit bought one of the pioneers, Pebble, for a cut price of $40 million (TechCrunch). Fitbit shares are also cut price at below $7.50, whereas the 2015 IPO debuted at $50. Editor Charles’ favorite, Jawbone, is moribund; the springtime rumors of company sale and shutdown of the fitness band line have not been contradicted since [TTA 27 July]. Research/analytics company CB Insights calculated that 2015 wearable computing (a broader category) investment funding fell 63 percent from 2014 to a level comparable to 2012-13, in large part due to the cooling of the fitness segment.

A sure sign that fitness bands have chilled is negative play in the consumer press. ‘My fitness band has made me fat’, spun off the JAMA article [TTA 28 Sep], is now the theme of hilarious ‘dieters gone wild’ articles like this from the New York Post (warning, eye bleach photos!). But The Sun (UK) waves a warning flag that the information could be sold, sent to your employer or insurance company to profile and/or discriminate against you, or cyberhacked. All this can knock a pricey band off the Christmas shopping list. And no, it hasn’t shifted to smartwatches as most insiders predicted, as smartwatch sales have leveled off–as expected–until their functionality and appearance improve to justify their high price.

What’s in our crystal ball? Clinical-quality and specialized wearables will rise from these ashes.

  • Doctors are simply not interested in the current poor quality of data generated by current wearables–‘it’s worthless, Jim!’ ZDNet’s much-discussed article on this subject paradoxically stresses this, then focuses in on the clinical quality data generated by startup VivaLnk’s eSkin for temperature and stress. Clinical quality data is what is required for a health and wellness research partnership like the one recently announced by RTI and Validic.
  • Industry buzz is that Fitbit bought Pebble for its better IP, apps and stable of developers, not its smartwatch hardware, and that IP includes clinical quality measurement.  Other biosensor companies on the rise according to CB Insights are Thync, Thalmic Labs, YBrain and mCube.
  • In specialty wearables, there’s the recent funding success of Owlet, the High Cute Factor baby monitor sock. Lifebeam transfers multiple sensing technology to helmets and hats for richer data.

And if sensor patches develop with speed, in two to three years they may eliminate all of these!

Unicorns to Series A–health tech funding gained in (perhaps) the nick of time

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/08/1107_unicorn_head_mask_inuse.jpg” thumb_width=”150″ /]Money, money everywhere–unicorns get the headlines, but the companies are still (largely) small

Up until early August, this Editor would have assumed that our Readers would look at this funding roundup as a bracing windup to a largely positive eight months and a veritable Corvette Summer for healthcare technology funding. We may have to give back the keys a little sooner than we imagined. Will the dropping market affect digital health as 2008-9 did–‘out of gas’ for years? Or will it barely affect our motoring onward? Despite the Dow Jones average hitting an 18 month low today, we hope it’s closer to the latter than the former. though the new and big entrant to digital health investing is the country most affected, China.

Our roundup of the August Action includes ZocDoc, Fitbit, Alphabet, PillPack, Owlet and more, along with a few comments:

**ZocDoc, a NYC-based online medical care appointment service that matches patients with doctors by location and schedule, had the most sensational round with last week’s Series D funding of $130 million, giving it a valuation of $1.8 bn. It took over a year after the filing (June 2014) and was led by two foreign funds (London-based Atomico and Edinburgh-based Baillie Gifford) with additional funding from Founders Fund, which previously participated in raises of $95 million.

Though it claims 60 percent coverage in the US  and ‘millions of users’ (numbers which have been quoted for some years), ZocDoc won’t disclose profitability nor volume–metrics that would be part of any IPO.

Direction? Points given for deciphering this windy statement (quoted from Mobihealthnews): (more…)