Rounding up fundings and startups: Override(ing) pain; brainy Synchron and In-Med Prognostics; Click off migraine; Cardiosense and CHF detection

Looking at the brighter side–new companies and fundings, even the modest ones:

Override, a virtual pain management startup, emerged from stealth mode this week with $3.5 million in hand. The company’s program applies an interdisciplinary methodology to virtual pain management in a continuity from diagnosis and physical therapy through to pain coaching and mental health. According to their release, the company combines the “latest in pain neuroscience research to help patients make functional, behavioral, and movement-related changes needed to calm the nervous system and rewire pain neural pathways. The program strives to transform people dependent on opioids, chiropractors, and repeat injections into self-managers of their own pain experience and broader health.” Pain coaching is offered nationwide, while pain physicians, physical therapy, and pain psychology treatment are only available to residents in FL, Maryland, New Jersey, Virginia, and Texas. Services may be purchased à la carte or bundled. Override’s present model is direct to patients first, then piloting with employer and health system partners.

What is also intriguing is that Override is a family affair–David Shulkin, MD, former VA Secretary, and his daughter, Jennie Shulkin, a lawyer who is herself a chronic pain sufferer. Dr. Shulkin is also experienced in this via the VA’s opioid treatment program. Seed funding of $3.5 million was raised from 7wireVentures and Martin Ventures, joined by SignalFire and Confluent Health. Prior to coming out of stealth, Override used the funding to purchase pain management coach Take Courage Coaching. Something very needed for the estimated 50 million Americans with chronic pain. Hat tip to HISTalk 16 Dec.

Recent fundings rounded up concentrate on the brain and heart:

The largest is brain-computer interface (BCI) developer Synchron with an oversubscribed Series C of $75 million. Lead investor was ARCH Venture Partners, joined by heavy hitters such as Gates Frontier, Bezos Expeditions, Reliance Digital Health Limited, and 11 others. Synchron’s value proposition is centered on a minimally invasive, surgically inserted brain implant (Synchron Switch) for what they term Neurointerventional Electrophysiology (Neuro EP). FDA granted them Breakthrough Device designation in 2020 for the Stentrode device, an implant delivered to the brain through blood vessels to give paralysis patients the ability to control digital devices with their thoughts. It is currently in human clinical trials in the US and Australia. The fresh funding will be used for additional development. A number of these funders have made public their interest in BCI for other uses for which thought tracking and action might be useful. Mobihealthnews, Crunchbase, VC News Daily 

Speaking of brains, Pune, India’s In-Med Prognostics has received $2.13 million in a seed round from Exxora and other angel investors. In-Med has developed AI diagnostics to aid in the assessment and early detection of neurological disorders such as dementia, Alzheimer’s, and Parkinson’s. The funding will further develop their NeuroFlow analytics platform; NeuroShield, an app powered by NeuroFlow that provides ethnicity-specific volumetric brain analysis within 20 minutes; and VivoShield Sports for performance analysis. Currently, they are marketed in Africa but In-Med has offices in Australia and San Diego.  VCCircle (India), Mobihealthnews 

And for that pain in the head known as migraine, Click Therapeutics has received FDA Breakthrough Device Designation for its prescription digital therapeutic for episodic migraine. CT-132 is being developed as an adjunctive preventive treatment for episodic migraine in patients aged 18 years+. In April, Silicon Valley Bank loaned them $15 million to retire an earlier term loan from K2 Health Ventures. Release 16 Dec, Release 15 April, Mobihealthnews

Moving from the head to the heart, Cardiosense garnered a $15 million Series A for its AI-based detection of cardiovascular disease. In February, it received Breakthrough Device designation from FDA for combining monitoring of  seismocardiogram, electrocardiogram and photoplethysmogram readings from the CardioTag wearable sensor with AI algorithms to determine pulmonary capillary wedge pressure (PCWP). PCWP is a measure of congestive heart failure (CHF) that at present can only be assessed through catheterization. The new funding will speed up other products in its portfolio as well as studies to further refine and validate the CHF algorithm over a diverse population. Leading the Series A were Broadview Ventures and Hatteras Venture Partners joined by four others.  Release, FierceBiotech

Ten years on from the WSD: is the future brighter for telehealth? Can wind farms help?

As Prof Mike Short pointed out recently, 2016 is the tenth anniversary of the start of the Whole System Demonstrator (WSD) programme that in retrospect, because of poor trial design, probably slowed the uptake of digital health in the UK more than any other single action. It seems appropriate therefore to look at how telehealth* has fared over that period, and perhaps even more importantly, is poised for the next ten years.

The mistakes of the WSD are well documented (eg here, here & here) – suffice it to say that it proved beyond all reasonable doubt, at least to this editor, that unlike medicine-based interventions, which seem less sensitive to their care pathway, digital health delivers most of its benefit through enabling a different, patient-centred care delivery, so every digital health intervention needs to be evaluated holistically, and in its own care pathway. Sadly over the ten years, much of the academic work looking at the benefits of telehealth has continued to evaluate the technology in the time-honoured way that medicines have been evaluated, with predictably largely equivocal results.

Those of us who have delivered telehealth projects though have a sense of disconnect as, time and again, a focused implementation – not a pilot – in which the staff delivering the service understand that it will be a permanent change for which they need radically to change the way they deliver care, yields huge returns on investments through savings typically in the 50-90% region. (more…)

CHF readmissions cut 53 percent with telehealth tablet

Favorable news for the growing area of tablet-based telehealth. A six-month trial of an tablet-based telehealth system for congestive heart failure (CHF) with patients at Philadelphia-area Penn Medicine’s (University of Pennsylvania) post-discharge program reduced readmissions from an already low 8 percent to 3.8 percent, a 53 percent positive change, versus the national average of 19.5 percent. The provided 4G tablet+app program through Health Recovery Systems is used by the patient for an average 85 days. He or she sends vital signs, symptoms, medication information (including side effects) to a nurse care coordinator; the app on the tablet provides coaching via patient education, instructional videos and individualized self-care plans coordinated with the telehealth nurse on the program. (more…)

4 year telehealth study charts ~40 percent CHF readmissions reduction

Finally an encouraging long-term, large N study on telehealth reducing same-cause hospital readmissions. Pennsylvania’s Geisinger Health Plan, the managed care arm of integrated health system Geisinger Health, has released findings from a four-year (2008-2012) study of 541 GHP Medicare Advantage beneficiaries with congestive heart failure. Hospital readmissions after 30 days were 44 percent lower and after 90 days 38 percent lower. Return on investment: “for every $1 spent to implement this program, there was approximately $3.30 return on this investment in terms of the cost savings accrued to GHP.”

Patients were assigned case managers and provided with a relatively simple program combining Bluetooth-connected weight scales and interactive voice response (IVR) calls to answer questions such as shortness of breath, swelling, appetite and on prescription medication management. The case managers used a platform to aggregate the data (more…)

Cigna, Care Innovations expand Tennessee CHF care management pilot

Healthcare payer Cigna’s Healthspring Medicare plan unit has been piloting a congestive heart failure (CHF) care management program with Intel-GE Care Innovations in Tennessee to reduce same-cause hospital  readmissions. The initial year-long 50-patient program is being expanded to 250 patients who have had a CHF diagnosis plus a previous ER visit or hospital admission. Patients are supplied at no cost a blood pressure cuff, a scale and the Care Innovations Guide on a tablet platform. Daily biometrics are sent to Cigna-HealthSpring nurse practitioners, and also complete an educational program to help them manage their CHF at home. After a 90-day minimum, once certain goals (e.g. weight loss, blood pressure and heart rate) are met, the patients stay in the program, the tablet is withdrawn but they continue to monitor and log their vitals with a case manager. What is curious about this seemingly anodyne (more…)