TTA’s Newsy April Shower: Microsoft’s $20B Nuance buy, Mayo’s platform+2 companies, Oscar Health grows a +, dogs detect COVID and so does CVS, more!

 

 

Weekly Alert

All new between a busy news week and some catchup. Deals continue to roll–$20B buys a lot of Nuance for Microsoft. Mayo Clinic finally rolls out its clinical decision platform, along with two companies to support it. Oscar Health starts marketing its systems, software you don’t have to clear with FDA, and a brand new event from HLTH and CHIME. And dogs can be trained to detect COVID–is there anything they can’t do?

News roundup: dogs sniffing out COVID, CVS rolling out OTC COVID tests, Hydrogen Health launches, Alcidion UK acquires ExtraMed (Man’s Best Friend can do anything but talk!)
Insurtech’ Oscar Health adds +Oscar tech platform to market health plan and member engagement services (Slightly overshadowed by this week’s Oscars for movies no one has seen?)
Mayo Clinic creates AI-powered clinical decision/diagnostics support platform, two digital health portfolio companies (What Dr. John Halamka’s been up to)
A new event–and not all virtual! HLTH and CHIME to launch ViVE in March 2022. (Another sign of normal business)
Good news! Eight software functions no longer classified as medical devices under FDA. (One for the techies. And anything you don’t have to clear with FDA makes for a good day.)
News and deal roundup: Microsoft’s $20B deal for Nuance; Cigna Evernorth finalizes MDLive; GoodRx buys HealthiNation; Papa’s $60M Series C (And the money is still rolling)
‘Most Reputable’ healthcare technology companies ranked (A few surprises)

We take stock of a killer Q1 in funding/M&A, Zipnosis triage acquired by an insurtech, a repositioned Google-powered patient info search tool, Care Studio–plus news from US to Down Under.

Short takes 9 April: Doro phones to elderly isolated; funding to Vesta Healthcare, Zedsen; Anthem partners with Canvas EMR, Health Metrics (AU) new owner
Google’s Care Studio patient record search tool to pilot at Beth Israel Deaconess Medical Center (Steering clear of the Project Nightingale controversy)
Deal and news roundup: Therapy Brands’ big KKR investment, AppliedVR’s non-painful $29M Series A; Akili tests cognitive-boosting games; Firefly Health lights up $40M; Mastercard-b.well partner, two big IPOs filed, more   (Whew!!)
A smash Q1 for digital health funding–but the SPAC party may be winding down fast (SPACs under scrutiny; popularity has its downside)

Zipnosis, health system telemedicine/triage provider, acquired by insurtech Bright Health Group (Extending their care delivery capabilities tied to insurance)

For Easter Holiday week, we took a break from the M&A action with only an early SPAC, SOC Telemed, buying rival Access Physicians, and one notable raise. DOJ decides that the Optum buy of Change Healthcare needs a closer look. And an interview with Amwell’s CEO touching on Amazon Care and a POV on the uneasy marriage of healthcare and tech needing a pre-nup.

Weekend reading: the strange reasons why Amwell doesn’t consider Amazon a competitor; ground rules for the uneasy marriage of healthcare and technology (Both articles revealing in their own way. Do healthcare and tech need a pre-nup?)
Deals and news roundup, April Fool’s Edition: SOC Telemed’s $196M acute care telehealth buy, HIMSS takes over SCAN Health, Livongo’s Burke joins Owlet board, CirrusMD text app raises $20M (A quieter week than most recently!)
US Department of Justice decides additional scrutiny needed of $13bn Optum acquisition of Change Healthcare (Change won’t come quickly to Optum)

Have a job to fill? Seeking a position? Free listings available to match our Readers with the right opportunities. Email Editor Donna.


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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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A new event–and not all virtual! HLTH and CHIME to launch ViVE in March 2022.

Does it seem like forever that there’s been a new digital health conference, fully in-person–and not labeled HIMSS? HLTH, a relatively new entrant to the big healthcare event calendar starting in 2018 in Las Vegas, and CHIME, The College of Healthcare Information Management Executives, will launch ViVE on 6-9 March 2022 at a location (TBD) in Miami Beach. They are positioning it as an annual event for digital health leaders innovating across the spectrum of health and care. 

The event will incorporate CHIME’s spring forum, a full plate of networking events and presentations, matchmaking, the ViVE Expo, and a gala. For more information on the event or to register interest as a sponsor or partner, see the ViVE page. Release

(This Editor admits that the thought of a new and in-person conference is exciting. It’s nice to contemplate normality!)

CHIME is a 5,000-member association of C-level and senior healthcare IT leaders across 56 countries. The organization parted from the annual HIMSS event this year in Las Vegas 9-13 August, which will be a hybrid in-person and virtual conference [TTA 4 Feb]. Registration and information on the event have been updated.

The HLTH 2021 next event is in Boston 17-20 October. Like HIMSS, it’s scheduled to be a combination in-person and virtual event. HLTH is more broadly inclusive of healthcare care models and consumer health issues. The in-person portion will be at the Boston Convention & Exhibition Center, located in the Seaport District. 

A smash Q1 for digital health funding–but the SPAC party may be winding down fast

An Overflowing Tub of Big Funding and Even Bigger Deals. The bubble bath that was Q1 deals and funding is no surprise to our Readers. Your Editor at one point apologized for the often twice-weekly roundups. (Better the Tedium of Deals than COVID and Shutdown, though.)

Rock Health provides a bevy of totals and charts in its usual quarterly summary of US digital health deals.

  • US funding crested $6.7 bn over 147 deals during January through March, more than doubling 2020’s $3.1 bn in Q1 over 107 deals.
  • Trending was on par through February, until it spiked in March with four mega-deals (over $100 million) over two days: Clarify (analytics), Unite Us (SDOH tech), Strive Health (kidney care), and Insitro (drug discovery). These deals also exceeded 2020’s hot Q3 ($4.1 bn) and Q4 ($4.0 bn).
  • Bigger, better. Deals skewed towards the giant economy size. $100 million+ deals represented 66 percent of total Q1 funding
  • Deal sizes in Series B and C were bigger than ever, with a hefty Series B or C not uncommon any more. Series B raises were on average $49 million and C $77 million. One of March’s megadeals was a Series B–Strive Health with a $140 million Series B [TTA 18 Mar].
  • Series A deal size barely kept up with inflation, languishing in the $12 to $15 million range since 2018.
  • Hot sectors were a total turnaround from previous years. Mental health, primary care, and substance use disorders, once the ugly ducklings which would get their founders tossed out of cocktail parties, became Cinderellas Before Midnight at #1, #2, and #3 respectively. Oncology, musculoskeletal (MSK), and gastrointestinal filled out the Top 6 list.
  • M&As were also blistering: 57 acquisitions in Q1, versus Q4 2020’s 45

Given the trends and nine months to go, will it blow the doors off 2020’s total funding of $14 bn? It looks like it…but…We invite your predictions in the Comments below.

Les bon temps may rouler, but that cloud you see on the horizon may have SPAC written on it. A quick review: Special Purpose Acquisition Companies (SPACs) typically are public companies that raise money through their own IPOs for the express purpose of buying other companies. Often called a ‘blank check’, they have no purpose other than buying one or two other companies–in the latter case, merging them like the announced Cloudbreak and UpHealth last November–and converting over to the company’s identity and business. The timeframe is usually two years. Essentially, the active company goes public with a minimum of the messy, long, expensive, and revelatory process of filing directly with the SEC (in the US). This quarter, Rock Health’s stat on SPACs was that they raised $83.1 bn this quarter, exceeding by $0.5 bn all SPAC activity in 2020, mainly late in the year. Their count was two SPACs closing in Q1 and 8 more announced but not yet closed (counting Cloudbreak/UpHealth as one).

As an exit door for investors, it’s worked very well–but is dependent on private equity and public investors having confidence in SPACs. One thinning of the bubble may be the scrutiny of Clover Health’s SPAC by the SEC [TTA 9 Feb] over not revealing that they were under investigation by the Department of Justice (DOJ). Certainly this was a material circumstance that could dissuade investors, among other dodgy business practices later unveiled. Mr. Market tells a tale; Clover went public 8 Jan at $15.90 and closed today at $7.61. Their YahooFinance listing has a long list of law firms filing class-action lawsuits on behalf of shareholders.

Clover may be the leading edge of a SPAC bust. SPACs are losing their luster because there are too many going through, jamming bandwidth at the bank and law firm level. As time ticks by and deals are delayed, the private funders of SPACs are growing squeamish, according to this report in National Review’s Capital Note (yes, National Review has a finance newsletter). “In the past two weeks alone, four blank-check deals have been halted, with SPAC shares declining significantly from their highs early this year. The slowdown follows an influx of short-sellers into the opaque financial vehicles and a sell-off in high-profile SPACs such as Churchill Capital Corp IV.” Reasons why: lower quality of companies available to go public via SPAC–the low hanging ripe fruit has been picked–and the last mile in SPACs, which is PIPE funding (private equity-investment-in-public-equity financing) is getting skittish. The last shoe to drop? The SEC in late March announced an investigation into SPACs, making inquiries into several banks seeking information on their SPAC dealings, which is alluded to near the end of the Rock Health report. CNBC  (Read further down into the NR article for a Harvard Business Review dissection of the boom-bust dynamics of ‘controversial practices’ like reverse mergers as a forecast of what may happen to SPACs. Increased popularity led to increased negativity in reverse mergers.)

And speaking of SPACs...Health tech/digital health eyes are upon what Glen Tullman and the ‘late of Livongo’ team will be doing with their SPAC, Health Assurance Acquisition Corp., which is backed by Hemant Taneja’s General Catalyst, also a former Livongo funder. Brian Dolan, who is now publishing Exits and Outcomes. His opinion is their buy will be Color, formerly Color Genomics: opinion piece is here. Messrs Tullman and Taneja are also leading Transcarent, a company that brings together employers, employees, and providers in a seamless, app-driven integrated care model. Forbes

The cool-off in SPACs may burst a few bubbles in the bath–and that may be all to the good in the long term.

Rock Health/Stanford U Digital Health Adoption Report: high gear for telemedicine, digital health, but little broadening of demographics

It’s good news–and an antidote to the bubble at the same time. Rock Health and Stanford University Medicine-Center for Digital Health’s just-released report found that, unsurprisingly, that telemedicine/telehealth use rocketed during the pandemic and gained ground that would not have been true for years otherwise, as of September 2020. However, the growth was not largely from new demographics, but largely among the adopters of telehealth in 2019 and prior. It also rolled back to about 6 percent of visits. Wearable use also boosted, especially for better sleep, as did self-tracking. But overall healthcare utilization cratered from March onward, barely reviving in the late summer, and telemedicine use declined to a steady state of about 6 percent of all visits–far more than the near-zero it was pre-pandemic. Here’s our rundown of the highlights.

Telemedicine user demographics haven’t changed significantly. It accelerated among those in the 2019 and prior (through 2015) profile: higher-income earners ($150K+), middle-aged adults aged 35-54, highly educated (masters degree and higher), urban residents, slightly male skewed (74 percent men/66 percent women/67 percent non-binary)and those with one or more chronic conditions (78 percent) and high utilizers (87 percent with 6+ visits/year). This profile apparently sustains across racial and ethnicity lines. (page 15) The non-user profile tends to be female, over 55, lower-income, rural, not on a prescription, and Hispanic. (page 23)

More usage of live virtual video visits than before–11 points up from 32 to 43 percent. These reduced reliance on non-video communications: telephonic, text, asynchronous pictures/video, and email. (page 12) And respondents largely accessed live video and phone visits through their doctor, indicating a pivot on practices’ parts: 70 percent of live video telemedicine users and 60 percent of live phone telemedicine users. (page 17) But the reasons why were more acute than this Editor expected: 33 percent for medical emergency, then minor illness (25 percent), then chronic condition (19 percent). (page 16)

Barriers to use remain significant in telemedicine and have not changed year to year except for awareness of options. (page 22-23)

  • Prefer to discuss health in-person (52 percent)
  • Not aware of options (much less this year)
  • Provider didn’t recommend
  • Cost
  • Poor cellular or broadband connection is minimal (3 percent). There is also no barrier of ‘inability to use’, though this may be skewed by the survey group being online (see methodology).

Wearables and digital information tracking accelerated, but ‘churn’ continued. 54 percent of respondents adopted wearables, up 10 points, while information tracking increased by 12 points.  (page 11) Unpacking this:

  • The populations with the highest rate of digital tracking were those with heart disease, diabetes, and obesity as chronic conditions
  • The leading reasons for wearables remained fitness training and weight loss. However, right behind these were major year-to-year spikes in better sleep (27 to 52 percent), managing a diagnosed condition (28 to 51 percent), and managing stress (24 to 44 percent).
  • The surprise uses of wearables? Managing fertility tracking and menstrual cycle.
  • Yet wearables churn continues. From the study: 55 percent of respondents who owned a wearable in 2020 stopped using it for one or more purposes (though they may continue using it for another purpose). The demographics tend to mirror telemedicine users for adoption and stopping use. (pages 24-28)

Healthcare utilization overall, telemedicine or not, has barely revived versus the March baseline, using the Commonwealth Fund data TTA profiled here. The report usefully digs into the groups that delayed care: 50 percent of 35-54-year-olds, women, Northeast residents, chronic conditions, and mental health. (page 34)

Yet trust in health information remains with the person’s physician, family, hospital, payer, and pharmacy. Overall, there is a reluctance to share data with entities beyond these. Health tech and tech companies aren’t trusted sources, along with social media, and lag to less than 25 percent, along with less willingness to share data with them. COVID-19 data is broken out in sharing, generally following these trends except for more willingness to share this data with governmental entities and research. (pages 29-31) 

The report recommends that for telemedicine to go deeper into adoption, refocusing is in order: (page 21)

  • Shift from a transactional model to a continuous virtual care or ‘full-stack’ model
  • Seek a different kind of customer. One-third of telemedicine visits were for emergencies. A more sustainable model would concentrate on chronic condition management and lower-acuity care.
  • Accept that new care models are disintermediating the patient-provider relationship especially in the younger age groups

The methodology of the survey: N=7,980 US adults, matched to US demographics; dates conducted 4 September-2 October 2020; online survey in English only. Rock Health summary, link to free survey report download, Mobihealthnews article.

Funding, acquisition news roundup, round 2: Lyra Health’s $187M Series E, DarioHealth-Upright, GetWellNetwork-Docent Health, Hillrom-BardyDx (updated)

Our cowgirl has been keeping busy rounding up more news on funding and acquisitions. Significance? Nearly all are major rounds only dreamed of a year ago for these relatively small companies boosting valuations into the stratosphere. The acquisitions also extend these companies into multiple lines of business.

Lyra Health, a mental health therapy benefit company for employers, closed an additional $187 million in a Series E round led by Addition Capital. This adds to a torrid 2020 $185 million Series C and D bringing their total funding to $475 million. The company claims a valuation of $2.3 billion and doubling its customer base in 2020 to 2 million members, with marquee clients such as Genentech, Morgan Stanley, and Zoom. Lyra Health uses cognitive-based therapy (CBT) models using virtual self-care, coaching, and therapists. Also announced was a partnership with ICAS World, an employee-assistance provider. Lyra is one of many companies in an increasingly crowded category using the CBT model to save employers and payers money on employee and member mental health with and without chronic conditions such as diabetes. Earlier this month, the Talkspace app, which focuses on direct to consumer therapy, announced they were going public through a ‘blank check’ SPAC with Hudson Executive Investment Corp, in a deal valued at $1.4 billion, including debt. Release, Mobihealthnews

DarioHealth, an Israeli-US company concentrating on digital diabetes and hypertension management, extended into musculoskeletal (MSK) therapeutics with the $31 million acquisition of Upright Technologies Ltd., another Israeli-US company. Upright uses a $100 sensor that provides biofeedback and vibration reminders to correct posture plus digital coaching. Last year, Upright was heavily advertised on US television. The buy will transfer to Upright $1.5 million in cash and $29.5 million in stock, and is expected to close in about 10 days. Dario also completed a $70 million private placement for 3,278,688 shares of its common stock at a purchase price of $21.35 per share. Dario has about 150,000 users and Upright 90,000 users. Dario is projecting a 2020 revenue of $7.6 million. Release, Mobihealthnews

GetWellNetwork, a relatively small player in patient engagement and communications in the inpatient care journey, announced it has acquired patient-messaging company Docent Health for an undisclosed sum, beefing up capabilities in data analytics and directing patients to additional services. According to Crunchbase, GetWellNetwork has funding to date of $19 million.  Release, Mobihealthnews

Wrapping it up is cardiac monitoring giant Hillrom’s acquisition of Bardy Diagnostics for $375 million plus future potential payments based on the achievement of certain commercial milestones. Hillrom is also acquiring net operating losses valued at more than $20 million and 230 employees. The BardyDx Carnation Ambulatory Monitor (CAM) is a lightweight cardiac patch monitor for heart rhythm diagnostics using P-wave-centric ECG detection. The irony here is that BardyDx positioned itself squarely against Hillrom’s Holter monitors. Nothing like buying out the competition! Release, MedCityNews

COVID-19 and telehealth–promise or peril? And the perils of digital health in conflict countries and India.

The Journal of the International Society for Telemedicine and eHealth (JISfTeH) has published its latest issue today (13 Jan). JISfTeH is one of the few journals which shine a bright spot on digital health in developing countries. This month concentrates on conflict countries and COVID in India: 

  • Scaling Up Digital Health In Conflict Countries discusses the lack of any form of digital health and coordination in Afghanistan, Somalia, Sudan, and, with some exception, Nigeria. It compounds the extreme lack of healthcare services–for instance, 23 percent of Afghanis have poor access to healthcare, resulting in a high mortality rate. It can change. Rwanda, once synonymous with war, has one of the best healthcare systems in Africa due to the use of digital health services. India is using digital health in combating the TB explosion of 300,000 cases in one year. The exception in Nigeria is the liftoff of 54Gene, a genomic studies company in the world’s most genetically-diverse continent, which has secured $4.5 million in seed funding.
  • Speaking of India, telehealth has been kickstarted there due to COVID-19. The Indian Government is prioritizing the use of telehealth in the population and both public and private institutions have rolled out initiatives. India’s challenges are how patients pay for it (70% of healthcare expenses out of pocket) and how it reaches the two-thirds of population in rural areas where there is inadequate telecom and broadband for services. The irony, of course, is that India is a huge exporter of software and telecom services to the world. COVID-19 As A Catalyst for Telehealth Growth In India: Some Insights.

The editorial by Richard E. Scott of Canada and Prof. Maurice Mars of South Africa, COVID-19 and eHealth: A Promise or Peril Paradox?, cautions on the floodgates opening for telehealth in COVID’s wake. Spontaneous telehealth, where “healthcare providers themselves saw the value of an eHealth solution and implemented it independently and without traditional steps or approval” is quite separate from evidence- and needs-based telehealth. There is a lot of pressure at the national level, by the WHO, and by vendors to ‘make hay while the sun shines’. “Enthusiasm must be tempered with thoughtful guidance” on multiple and quite variable factors.

Digital Health as Boom Town: 2020’s dizzying funding rounded up by Mercom Capital, StartUp Health

BOOM! Mercom Capital Group published their Q4 and 2020 roundup of global digital health investment and, no surprise, the investment picture for just about anything digital health was in sharp contrast to most of the COVID-afflicted world economy.

The topline:

  • Global VC funding (private equity and corporate venture capital) was $14.8 bn across 637 deals. It was a 66 percent increase in funding compared to 2019’s $8.9 bn in 615 deals. The modest increase in deal number and huge increase in funding points to the acquisition of more established companies requiring Big Deals.
  • Total corporate funding, including VC, debt, and public market financing, totaled $21.6 billion

 

In a stunning change, telemedicine was Top Of The Pops, with $4.3 bn in investment, 139 percent over 2019’s $1.8 bn. It was over double the former star categories of data analytics and mHealth apps.

The top five disclosed M&A transactions in 2020 they tracked were:

  • Teladoc’s acquisition of Livongo Health for $18.5 bn
  • Blackstone’s acquisition of a majority stake in Ancestry.com for $4.7 bn (despite the ‘bloom off the rose’ of consumer genetic testing)
  • Philips’ acquisition of BioTelemetry in cardiac monitoring for $2.8 bn
  • Invitae’s acquisition of ArcherDX for $1.4 bn
  • WellSky’s acquisition of Allscripts’s CarePort Health (CarePort) for $1.35 bn

The Executive Summary is available for free download at the link in the release. The full report will set you back $599 – $999, depending on the version.

StartUp Health has slightly different numbers but in total investment tracks almost to Mercom Capital’s estimate at $21.5 bn. For telemedicine, it still triples year-over-year but StartUp’s totals are lower: 2019’s $1.1 bn to 2020’s $3.1 bn. Part of the difference may be remote monitoring, which StartUp considers separately. It doubled from $417 million to $941 million. Their deal counts were also higher: 764 in 2020 compared to 716 in 2019. Another fun fact in their tracking are their city leaders in health innovation funding: Beijing, Tel Aviv, and London, confirming that New York and the San Francisco metro no longer have money, interest, or their former attraction. A fuller list would have been interesting. More is in their Part 1 study. Part 2, to be released next week, will cover their dozen ‘health moonshots’.

Breaking: Teladoc and Livongo close merger in $18.5 billion deal, staff/board changeovers

Breaking: Today (30 October) Teladoc announced the closing of its merger with Livongo. The release itself is pro forma. The acquisition is interesting in how rapidly it was completed: from ‘git to gone’ in under three months. By contrast, Teladoc’s close on much smaller InTouch Health took eight months. It is, of course, still positioned as a merger, but it is clearly a purchase based on the terms and their branding. (More of Editor Donna’s thoughts on this here and here.) 

Livongo shareholders will receive 0.5920 Teladoc shares plus cash of $11.33 for each Livongo share (including the special dividend declared by Livongo). The Motley Fool did the math and valued it at $18.5 million after the shareholder approval. Current Teladoc shareholders will own 58 percent, with Livongo investors holding 42 percent. Mr. Market continues to be cross, as the day started with TDOC above $215 with the current price (1pm Eastern time) at just above $197, though Teladoc’s 3rd Q earnings were excellent. TDOC’s share price just before the acquisition hovered in the $230s.

This Editor has already noted the reported exodus of many of Livongo’s top management, presumably to the bank: CEO Zane Burke, President Jennifer Schneider, MD, CFO Lee Shapiro (widely conceded as the merger engineer), and SVP of business development Steve Schwartz. David Sides, Livongo’s COO, and Arnnon Geshuri, Cheif (sic) Human Resources Officer, retain their same position as at Teladoc. According to their latest (29 Oct) 8-K, new members of the board effective 19 November will include Glen Tullman (formerly Livongo Executive Chair), Chris Bischoff (Kinnevic AB), Karen L. Daniel, Sandra Fenwick, and Hemant Taneja (General Catalyst, of which more follows).

MedCityNews detailed the above plus that R&D will be headed on an interim basis by Yulun Wang, PhD, who came over from InTouch. Also, a number of Livongo execs (Glen Tullman, Schneider, and three other managers) are putting their new wealth to work for their futures with General Catalyst’s Hemant Taneja, a Livongo backer. An S-1 was filed on 19 October to create a new special-purpose acquisition company with the goal of raising $500 million. Commonly dubbed a ‘blank-check’ company, a SPAC is a public company designed to quickly take a private company public versus the slower process of an IPO. Recent healthcare examples have been Hims Inc. and SOC Telemed

Livongo’s website as to management is already updated and cut over. The Teladoc site does not have a Livongo page other than on press releases and a landing page here. Much remains to be seen in this consolidation of telemedicine and monitoring/coaching, including whether the combined company can deliver on much-needed profits.

Withings closes $60 million Series B round to fund expansion, B2B development

Withings, a digital health developer with devices ranging from smart scales to analog-style smartwatches , this week closed on a substantial Series B funding of $60 million. Led by Gilde Healthcare, the round also had participation from long-term Withings partners and investors, Idinvest Partners and Bpifrance through their Large Venture funds, as well as BNP Paribas Development, Oddo BHF Private Equity, and Adelie Capital. Their total funding is now estimated at $93.8 million. According to their release, Withings will be using the funds to globally scale its dedicated business-to-business division MED PRO and further develop consumer health devices. With this, they will also add about 100 positions in the US and France, including expansion of sales, marketing and R&D.

Founded in 2008 in France, TTA has tracked Withings since 2009 with a scale that Tweets your weight (at a hefty $159). In April 2016, the company was sold to Nokia for a hefty €170 million and became Nokia Digital Health. Nokia’s hope was to use Withings and its pricey (at least in the US market) but stylish and innovative IoT devices to spur its own development of consumer digital health. Two years later, Nokia sold back Withings to co-founder and former chairman Éric Carreel, having not experienced much success in the consumer sector. Shortly thereafter, they premiered a revived Go (with an e-ink face) and the Steel HR Sport smartwatch, then progressed into heart and sleep monitoring.

MED PRO is a relatively new division that concentrates on professional uses of their devices and data analytics within health systems, health plans, disease management programs, and academic and pharma research. Withings also appointed a new global Medical Advisory Board which includes Dr. John Halamka, President of the Mayo Clinic Platform, Dr. Stéphane Laurent, former Head of Clinical Pharmacology in Hôpital Européen Georges Pompidou in Paris, and Craig Lipset, former Head of Clinical Innovation at Pfizer.  MobihealthnewsCrunchbase

Virus-(almost) free news: Cera’s $70m raise, Rx.Health’s RxStitch, remote teledentistry to rescue, Alcuris responds, Caravan buys Wellpepper, and Teladoc’s heavy reading

Keeping calm and carrying on (but taking precautions, staying inside, and keyboarding with hands that resemble gator hide), yes, there IS some news that isn’t entirely about COVID-19:

This Editor had put aside the $70 million funding by the UK’s Cera at end of February. What is interesting is that Cera Care is a hybrid–specializing in both supplying home-based care, including dementia care, and providing tech-enabled services for older adults. The funding announcement was timed with the intro of SmartCare, a sensor-based analytics platform that uses machine learning and data analytics on recorded behaviors to personalize care and detect health risks with a reported 93 percent accuracy. It then can advise carers and family members about a plan of action. This sounds all so familiar as Living Independently’s QuietCare also did much the same–in 2006, but without the smartphone app and in the Ur-era of machine learning (what we called algorithms back then).

The major raise supports a few major opportunities: 50 public sector contracts with local authorities and NHS, the rollout of SmartCare, its operations in England and Wales, and some home healthcare acquisitions. Leading the round was KairosHQ, a US-based startup builder, along with investors Yabeo, Guinness Asset Management, and a New York family office. Could a US acquisition be up next?  Mobihealthnews, TechEU

Located on NYC’s Great Blank Way (a/k/a Broadway), Rx.Health has developed what they call digital navigation programs in a SaaS platform that connect various programs and feed information into EHRs. The interestingly named RxStitch engine uses text messages (Next Gen Reminder and Activation Program) or patient portals to support episodes of care (EOC), surgeries, transitions of care (TOC), increasing access to care, telehealth, and closure of care gaps. Their most recent partnership is with Valley Health in northern NJ. Of course they’ve pitched this for COVID-19 as the COVereD initiative that supports education, triage, telehealth, and home-based surveillance as part of the workflow. Rx.Health’s execs include quite a few active for years in the NY digital health scene, including Ashish Atreja, MD.

Teledentistry to the rescue! Last summer, we focused on what this Editor thought was the first real effort to use telemedicine in dentistry, The TeleDentists can support dentists who are largely closing shop for health reasons to communicate with their own patients for follow up visits, screen new patients, e-prescribe, and refer those who are feeling sick to other telehealth providers. For the next six weeks, patients pay only $49 a visit. More information in their release. Hat tip to Howard Reis.

What actions are smaller telehealth companies taking now? Reader and commenter Adrian Scaife writes from Alcuris about how their assistive technology responds to the need to keep in touch with older people living alone at home. Last week their preparations started with giving their customers the option to switch to audio/video conferencing with their market teams. This week, they reviewed how their assistive technology and ADL monitoring can keep older people safe in their homes where they may have to be alone, especially after discharge, yet families and caregivers can keep tabs on them based on activity data. A smart way for a small company to respond to the biggest healthcare challenge of the last 30 years. Release

Even Caravan Health, a management services company for groups of physicians or health systems organizing as accountable care organizations (ACOs) in value-based care programs, is getting into digital health with their purchase of Wellpepper. The eight-year-old company based in Seattle works with health plans to provide members with outpatient digital treatment plans, messaging services, and an alert system to boost communication between care teams and patients. Purchase price was not disclosed, but Wellpepper had raised only $1.2 million in debt financing back in 2016 so one assumes they largely bootstrapped. Mobihealthnews

And if you’re stuck at home and are trying to avoid chores, you can read all 140 pages of Teladoc’s Investor Day presentation, courtesy of Seeking Alpha

Babylon Health fires back at critic @DrMurphy11; Dr. Watkins–and Newsnight–return fire (UK)

Last month, this Editor took note of the Twitterstorm around Babylon Health on the issues raised surrounding diagnosis of women’s cardiac symptoms. @DrMurphy11, who has been raising performance issues with the Babylon chatbot for the past three years, ran a test on the app. First using a male patient, then a woman, with identical cardiac symptoms, the app returned two different diagnoses: the man was advised to go to an ED on an emergency basis and given information on a heart attack, the woman to her GP in six hours and given information on a panic attack.

@DrMurphy11 came out earlier this week to BBC Two’s Newsnight’s Emma Barnett on a profile of ‘healthcare juggernaut’ Babylon as Dr. David Watkins, a consultant oncologist. You can see him on YouTube here (at the 1 minute and 3 min. 30 mark). He demonstrates the response of the chatbot, using as the patient an older male smoker with chest pains. The chatbot advises him that he might have either gastritis or ‘sickle cell crisis in chest’–and to go to his GP in 6 hours. What is far more likely than sickle cell with this history is, of course, a heart attack, as a consultant cardiologist, Dr. Amitava Banerjee confirmed on the program. Dr. Banerjee has also been critical of Babylon’s chatbot on cardiac diagnosis and Health Secretary Matt Hancock in his visible advocacy of Babylon in the NHS alone (at 6 min.) According to Dr. Watkins, he has been documenting chatbot problems to the MHRA and the CQC since 2017, and the problems haven’t been fixed.

Timed with the Newsnight piece, Babylon fired back with a press release labeling Dr. Watkins a “troll” and stating that only 100 of his 2,400 tests demonstrated any concerns with the chatbot. According to the release, Babylon’s staff “have attempted to start a positive conversation with this anonymous person. We have invited him in to start a dialogue, to test our AI, and to meet with the senior doctors who build our products” without response. Babylon has also cited that all of Dr. Watkins’ trials were theoretical tests and cites millions of real uses without a single report of harm, that it meets regulatory standards in five countries including use in the NHS, and that its real life users are highly satisfied (85 percent at 5 stars).

At 6:48 to 12:40 in the video, Newsnight’s Emily Maitlis grills both Babylon’s Dr. Keith Grimes and Dr. Watkins. She brings up that Babylon’s former head of regulatory affairs, Hugh Harvey, had stated that no one has assessed how well the app works. Dr. Watkins also counters Babylon’s non-contact claim that he contacted one of the Babylon leadership members back in 2018 on chatbot problems. Dr. Grimes responded to Ms. Maitlis’ remark that founder Ali Parsa is not a doctor that over 600 doctors work for Babylon. This Editor will leave it to Readers to decide what side won, or if it was a draw. Also Mobihealthnews global edition. (For US Readers, Newsnight and Ms. Maitlis conducted the exclusive, disastrous–for Prince Andrew–interview on his relationship with the late Jeffrey Epstein.)

A potpourri of upcoming NYC events

Thursday 27 February, 6-8 pm, WeWork Soho
Behavioral Modification and Big Data: How Digital Health Helps Patients with Medication Adherence

HITLAB, which is a digital health research, teaching, and advisory services organization with the objective to improve healthcare delivery worldwide, is presenting a talk on digital health, eye care, and medication adherence. The featured speaker is Dr. Thomas Wong, an Associate Clinical Professor and Director of New Technologies at SUNY Optometry. Cost is $6.93 including Eventbrite’s take! Event information and tickets here.

Upcoming in HITLAB’s Seminar Series are When Patients Lose Patience: The Healthcare Consumer in 2020 (19 March) and The New Clinical Trial: Medication as a Core Business Strategy to Improved Drug Trials (23 April). Future events and notification signup here

Friday 28 February, 8 am to 6.30 pm, CONVENE West 46th Street
Columbia Business School’s 16th Annual Healthcare Conference

Speakers at this CBS conference will focus on the transformative impact New York City is having on the healthcare industry, and are from a cross-section of established healthcare organizations, emerging companies, and investment firms will present informed views. The Conference includes four panels, an inaugural CBS Start-up Showcase, and a Sponsor Expo. It also includes a buffet breakfast and lunch as well as a networking happy hour from 4:30 – 6:30 pm. Cost is $350, $200 for Columbia alumni, and only $75 for students. Conference information and tickets here.

Tuesday-Thursday 12-14 May
Columbia Business School Digital Health Executive Education Course

This three-day intensive executive education course sponsored by Columbia Business School Executive Education and HITLAB is an industry-first program that distills how digital technologies can transform life science research, clinical development, patient experience, operations, and business models. Upon completing the program, participants will earn three days toward a certificate with select alumni and tuition benefits. Application and additional information here.

Tuesday-Thursday 1-3 December, Bryant Park Ballroom
2020 HITLAB Innovators Summit

Mark your calendars for this three-day conference which will focus on the diffusion of digital technologies in the healthcare system, with speakers and attendees who are on the front lines of identifying, validating, integrating, and scaling emerging technologies that are improving patient outcomes. Preliminary conference information and 2019 information here.

Hat tip to HITLAB chair Stan Kachnowski, Ph.D., MPA

100% increase in physician telehealth and virtual care usage in three years: AMA study

The American Medical Association’s newest physician survey has a lot of good news for those of us in healthcare tech. It found greater across-the-board physician adoption of digital tools, whether virtual consults, patient visits, adoption of patient portals, workflow enhancements, or clinical decision support.

While current usage was greatest for other tools, the greatest increases were virtual visits via telemedicine, doubling from 14 percent to 28 percent, and remote monitoring for improved care from 13 percent to 22 percent of the over 1,300 physicians surveyed in both years. 

AMA last surveyed physicians on their digital health adoption in 2016. Both the 2019 and 2016 surveys were performed by WebMD and examined seven key digital tools. In current use, 2019/2016:

  1. Remote monitoring for efficiency: 16%/12%
  2. Remote monitoring and management for improved care: 22%/13%
  3. Clinical decision support: 37%/28%
  4. Patient engagement: 33%/26%
  5. Tele-visits/virtual visits: 28%/14%
  6. Point of care/Workflow enhancement: 47%/42%
  7. Consumer access to clinical data: 58%/53%

Also notable was that primary care physicians (PCPs) see greater advantages in digital health more than specialists, though in top two boxes, they are equal. Multi-specialty groups like digital health best.

Providing remote care is also a driver for digital health adoption, the only one which increased several points in the very/somewhat important indicator.

Not surprisingly, older physicians are less enthusiastic about digital health, but they have increased adoption much in line with younger cohorts.

And way back in the appendix of the study, doctors look to emerging technologies to assist them with their chronic care patients, with millenials not that far behind.

Articles: Health Data Management, HealthLeaders
Study: Summary, AMA Digital Health Study 2019

Propel@YH opens again for 2020 accelerator candidates

Yorkshire & Humber AHSN (Academic Health Science Network) today opened applications for the second year of its Propel@YH digital health accelerator. The accelerator is aimed at helping digital health innovators of startup and scale-up size navigate the NHS in the Yorkshire and Humber region and who are already there or are willing to establish an operation there.

10 companies will have access to expert partners such as NHS providers, commissioners and academic institutions. The program this year is being supported by the University of Leeds’ innovation hub, Nexus; Barclays Eagle Labs national incubator network, leading health law firm Hill Dickinson, and Leeds City Council.

Last year, their six finalists were DigiBete, Healthcare Engineering, HeteroGenius, Medicsen, Medicspot and Scaled Insights. 

But hurry–applications close on 12th March. Release, Propel@YH website, application

Considering 2019’s digital health investment picture: leveling off may be a Good Thing

2019 proved to be a leveling-off year for digital health investment. The bath may prove to be more cleansing than bubbly.

We noted that the always-fizzy Rock Health engaged in some revisionist history on its forecasts when the final numbers came in–$7.4bn in total investment and 359 deals, a 10 percent drop versus 2018. When we looked back at our 2019 mid-year article on Rock Health’s forecast [TTA 25 July], they projected that the year would end at $8.4 bn and 360 deals versus 2018’s $8.2 bn and 376 deals. That is a full $1bn under forecast and $0.8 below 2018. Ouch!

In their account, the 10 percent dip versus 2018 is due to average deal size–decreasing to $19.8M in 2019–and a drop in late-stage deals. Their analysts attribute this to wobbliness around some high-profile IPOs, citing Uber, Lyft, and Slack, as well as the near-collapse of WeWork right before its IPO towards the end of 2019.

New investors and repeat investors increased to 627 from 585 in 2018, with no real change in composition.

The headliners of 2019 were:

  • Amazon’s acquisition of Health Navigator adding symptom-checking tools to its health offerings
  • Google’s buy of Fitbit
  • Optum’s purchase of Vivify Health, which gives it a full remote patient monitoring (RPM) suite (right when CMS is setting reimbursement codes for RPM in Medicare)
  • Best Buy’s addition of Critical Signal Technologies for RPM
  • Phreesia, Livongo’s and Health Catalyst’s IPOs. For Livongo and Health Catalyst, current share prices are off from their IPOs and shortly after: past $25 for LVGO and $31 for HCAT. Phreesia closed today at a healthy $33, substantially up from PHR’s debut at $15. (Change Healthcare, on the other hand, is up a little from its IPO at $16, which isn’t bad considering their circumstances on their financing.)

Rock Health only counts US deals in excess of $2 million, which excludes the global picture, but includes some questionable (in this Editor’s estimation) ‘digital health’ players like Peloton, explained in the 25 July article.

Rock Health’s analysts close (and justify their revisions) through discussions with VCs expecting further headwinds in the market–then turn around and positively note the Federal backing of further developments in building the foundation for connected health as tailwinds. No bubbly forecasts for 2020–we’ll have to wait.

Is this necessarily bad? This Editor likes an occasional dose of reason and is not displeased at Rock Health’s absence of kvelling.

Confirming the picture is Mercom Capital’s analysis which also recorded a 6 percent dip 2019/2018: $8.9bn with 615 deals, dropping from the $9.5bn and 698 deals in 2018. Their ‘catchment’ is more global than Rock Health, and encompasses consumer-centric and patient-centric technologies and sub-technologies. Total corporate funding reached $10.1bn.

Over half of Americans of all ages use digital health tools, self-diagnose after internet search: ResMed/Edelman survey

Compensating for shortcomings? ResMed, a remote patient monitoring company, with Edelman Intelligence, found in their research on the consumer acceptance of digital health technology some interesting behavioral information as well that demonstrates frustration with the status quo in healthcare. Over 3,000 individuals were surveyed, across 37 percent Baby Boomers, 26 percent Gen Xers, 28 percent Millennials and 9 percent Gen Zers. 

  1. 56 percent of those surveyed currently monitor their health with at least one digital data collection tool
  2. 60 percent attempt to diagnose themselves after browsing symptoms on the Internet – including 76% of millennials (confirming an earlier survey by Harmony HealthcareIT citing 73 percent of millennials self-diagnosed via internet research)
  3. 78 percent stated it should be easier to find medical care
  4. 63 percent said they were sick of feeling like their healthcare doesn’t matter in the current healthcare system
  5. 47 percent of responders said they would like to communicate through text
  6. 38 percent said they would like to participate in video chats.

While the percentages in #5 and #6 have been fairly standard responses over the years in other surveys and to this Editor should be higher by now, the frustration level experienced in #3 and #4, after years of ‘new healthcare models’ that supposedly empower the patient and the rise of urgent care clinics almost everywhere, is perhaps indicative of an increasing awareness of the flaws of the healthcare system and its shortcomings. It’s not cost–it’s delivery. ResMed release, Mobihealthnews