Mid-week roundup: UnitedHealth-Change trial kicks off; Amazon’s One Medical buy questioned; Cionic’s neural sleeve designed by Yves Behar; Medable-Withings partner; Orion Health’s new CEO; IBM Watson Health’s Simon Hawken passes

August 3, 2022 | by

The Department of Justice lawsuit to block the $13 billion acquisition of Change Healthcare by UnitedHealth Group started on Monday. It is a bench trial in US District Court in the District of Columbia that will last 12 days, concluding on 16 August with a verdict date to be determined. The DOJ and the plaintiffs, including Minnesota and New York State, are presenting their case over seven days. UHG and Change will have five days. It’s expected that UHG CEO Andrew Witty and former chief David Wichmann will be testifying. The American Hospital Association (AHA) was a key player in pushing for a DOJ action (their article here). TTA recapped the main competitive issues in play on 23 March, along with this Editor’s opinion that the merger will be blocked given this current administration’s anti-trust stand. ‘It will be one for the books–the ones marked ‘Nice Try, But No Dice’. FierceHealthcare, HealthcareFinanceNews

Will Amazon’s acquisition of One Medical be reviewed by the Federal Trade Commission (FTC)? That is what Senator Josh Hawley (R-Missouri) is requesting. He cites that Amazon will have “access to enormous tranches of patient data. While HIPAA and other privacy laws exist to thwart the worst potential abuses, loopholes exist in every legal framework.” He also cites, somewhat broadly, that information of this type could be used to suggest over-the-counter blood pressure medications to a One Medical patient shopping at a Whole Foods Market. (What is meant here is that there are many supplements that claim to benefit blood pressure available OTC, such as Garlique; however, there are many OTC meds that can increase blood pressure such as decongestants.) This Editor agrees with Senator Hawley that the acquisition should be carefully reviewed by FTC and, to go further, HHS as it involves patient data.) Hawley Senate.gov page 

The Cionic Neural Sleeve, designed to aid people with mobility issues, is getting a design upgrade via Yves Behar and his fuseproject. The Neural Sleeve [TTA 30 June] aids the legs through sensors in the sleeve that monitor movement for muscle firing and limb position, then analyzes them through an app to optimize functional electronic stimulation (FES) delivered through the sleeve. The Behar team, according to the release, has delivered a neural sleeve “designed for everyday wear, and importantly, is easy to put on and take off – a critical design element for those with inhibited mobility. The lightweight, breathable fabric feels like an athletic legging, and is available in multiple colors and sizes. Paired with the intuitive CIONIC app, the sleeve enables the user to be in control of their own mobility journey.” Cionic is taking pre-orders for delivery in early 2023. Also The Robot Report.

Medable partners with Withings for clinical trials. Medable, a clinical trials platform, is partnering with Withings Health Solutions to connect Withings devices for monitoring at home. Withings devices will provide medical-grade measurements, including temperature, heart rate, blood pressure, sleep patterns, and weight to connect the data into Medable’s decentralized clinical trial platform. Direct monitoring also assists in attracting and retaining subjects in clinical trials, plus improving accuracy, by eliminating subject manual reporting and checkins. Financial terms and duration were not disclosed. Release, FDA News, FierceBiotech

Short international take: Orion Health, an Auckland, New Zealand-based health IT company headed by Ian McCrae for the past 30 years, announced he is stepping down for health reasons. Replacing him in late August as CEO will be Brad Porter, coming from Fisher & Paykel, a NZ-based medical device company. Mr. Porter is Mr. McCrae’s son in law.  Orion recently won what could be the largest health information exchange system in the world for Saudi Arabia, covering 32 million people. Healthcare IT News 

And a sad passing: Our UK and European Readers likely know Simon Hawken from his long career with IBM, including Watson Health (now Merative) and Merge Healthcare, and earlier with BEA Systems. HISTalk reported that he passed away on 25 July. This Editor has not been able to find other notices, so is asking for Reader help and comments.

Thursday news roundup: IBM Watson Health sale closed, now Merative; OneMedical inviting buyers–maybe; worst healthcare data breaches rounded up

July 7, 2022 | by

It’s a post-Independence Day and early summer holiday relatively quiet week….

It’s Merative, not IBM Watson Health anymore. Francisco Partners‘ buy from IBM of Watson Health closed last Thursday (30 June) but didn’t make the news until after the holiday. The announcement of the new brand, Merative, was splashed on HLTH’s website today (not HIMSS) with the usual language about how their data connects and transforms health through pioneering “cloud, real-world data and industry-leading AI” through health systems, hospitals, health plans, life sciences, and government. Speaking of data points:

  • HQ now in Ann Arbor, MI
  • New CEO Gerry McCarthy from CEO of eSolutions, a former Francisco Partners portfolio company that exited to Waystar in October 2020
  • The former general manager, Paul Roma, will be a Senior Advisor to Francisco Partners
  • Merative will have six product families: Health Insights; MarketScan; Clinical Development; Social Program Management and Phytel; Micromedex, and Merge Imaging 
  • Other investors include True Wind Capital and Sixth Street

Since 2015, IBM had built up Watson Health through four acquisitions and over $4 billion in investment. They sold it for perhaps $1 billion to get it off their books. Once upon a time they were the leader, now they’re up against Oracle and a dozen other competitors like IQVIA that sell connectedness and ‘actionable insights’ across and in chunks of their business (example, life sciences). Given the track record of the controlling private equity partner, Merative needs to become profitable quickly. Merative will not be a long term investment for them. FierceHealthcare. Our prior coverage: 7 Jan, 22 Jan, 25 Feb (Who needs Watson Health?)

Also apparently up for sale to the right buyer is One Medical. The clinic group flirted with but ultimately sent packing CVS Health. One Medical offers concierge in-person and telehealth primary care in seven metros and has over 700,000 members. They bought Medicare value-based primary care provider group Iora Health a year ago [TTA 11 June] but since then their stock (trading under 1Life Healthcare) and valuation has cracked by 75%. Not mentioned in the Bloomberg article is whether Iora is included in the possible deal.

And for those who like their Hackermania on the Wild Side, there’s a massive list over at Wired that racks up the Greatest Hits. It’s only halfway through 2022, but the data breaching and ransomware perps have multiplied. From Russia/Ukraine to extortion gangs like Conti and Lapsus$ to cryptocurrency theft and China, the Old Reliable Healthcare continues to star. Our recent list is here but topping out the Wired list are Shields Health Care Group, Baptist Health System, Resolute Health Hospital, Kaiser Permanente, and Yuma Regional Medical Center. Also Becker’s.

Short takes: 2022’s big kickoff with Babylon-Higi, Vera-Castlight buys; will funding slow down in ’22, eye-tracking telehealth for MS, vital signs tracking lightbulbs at CES 2022, and three catchups!

January 7, 2022 | by

Babylon Health closed out 2021 by acquiring health kiosk Higi for an undisclosed amount. Babylon had earlier invested in Higi’s Series B [TTA 30 May 20] and was reported in October to be exercising its $30 million option to buy Higi after closing their SPAC. Release

Vera Whole Health, an advanced primary care provider and clinic group based in Seattle, is acquiring Castlight Health, a data and care navigation platform. Vera will acquire Castlight in a $370 million all-cash deal. Strategic partners and investors include Anthem, Morgan Health (the JP Morgan Chase & Co business for the transformation of employee healthcare), Central Ohio Primary Care, and Clayton, Dubilier & Rice funds. Former Aetna chairman and CEO Ron Williams will become chairman. Release.

Which leads to the usual question…will funding in 2022 continue the hot streak of 2021? It’s one opinion, but Lee Shapiro of 7wireVentures, formerly with Livongo, is sensing a slowdown, citing increased interest rates (money), the US midterm elections (which don’t affect the rest of the world), less new money, and investors wising up on the length of time any healthcare or health tech investment takes to pay off. 2021 with 79 digital health M&As plus an abundance of SPACs that tailed off by end of year will be hard to match. Mobihealthnews

XRHealth, a telehealth clinic that provides treatments in patients’ homes based on virtual reality treatment, has integrated Tobii‘s eye-tracking technology into the XR platform and the Pico Neo 3 Pro Eye VR headset. XR Health provides rehabilitative and pain management therapies via VR. The Tobii system will enable treatment using the headset for multiple sclerosis (MS), Parkinson’s, and other neurological conditions. According to the release published in Multiple Sclerosis News Today, “detecting subtle changes in eye movement can help diagnose these diseases at an early stage, as well as assess disease progression and response to treatment. Tobii‘s eye-tracking technology is able to detect those changes in real time, providing data and insights to clinicians during therapy sessions.” Hat tip to Editor Emeritus Steve Hards

CES 2022 is on this week, far less splashy than before as an in-person/virtual hybrid event. Debuting at CES is the Sengled Smart Health Monitoring Light. Looking like a standard LED lamp bulb, it contains sensors that network and can take passive vital signs measurements of sleep quality, breathing, heart rate, and motion of occupants in the home. The more bulbs the better, of course. Whether or not they can detect falls, as the article touts, is likely an inference on motion. They feed into either Alexa or Google Assistant, plus Sengled’s app, using Frequency-Modulated Continuous Wave (FMCW) radar operating in the 2.4 GHz range. Expect it to be coming out towards the end of the year and probably twice the price of conventional LED smart bulbs. TechRadar Hat tip to Adrian Scaife via LinkedIn

Catching up…

Walgreens and VillageMD continue on the ‘go big or go home’ highway with nine more Village Medicals at Walgreens in San Antonio, Texas. Plans are to build 600 Village Medicals at Walgreens in more than 30 markets by 2025, growing to 1,000 by 2027. HealthcareFinance

Centene, the health payer conglomerate, finalized its $2.2 billion acquisition of Magellan Health, a major behavioral health management company. It will likely be CEO Michael Neidorff’s swan song, as an activist investor forced his retirement (at age 78 after over 25 years at the helm) this year and significant board changes. Magellan’s former COO and president Jim Murray will become Centene’s chief transformation officer, a new position, lead what they term the Value Creation Office as well as the Centene Advanced Behavioral Health division. Forbes, Centene release

And suitors with a spare billion or so may be lining up to buy IBM Watson Health. The first offers came in on 4 January with the winner to be announced possibly by end of the month. IBM spent over $4 billion over time to build up Watson Health, but now wants out, badly. Axios

IBM Watson Health’s stumble and possible fall

July 21, 2021 | by

This Editor hadn’t thought about or seen news about IBM Watson Health in over a year…and likely, neither did you. Granted, our minds have been Otherwise Engaged, but for the company that was supposed to dominate AI and health analytics, it’s notable that TTA’s last two articles mentioning Watson Health was 25 April 2019, on a report that its Drug Discovery unit was being cut back as the latest in a series of executive cutbacks and lawsuits (MD Anderson on a failed oncology initiative), and 14 Feb 2020 on 3M’s lawsuit on unauthorized use of their software.

The New York Times in an investigative piece (may be paywalled or require signup for limited access), brings us up to date on what is happening at IBM Watson, and it’s not bright for Watson Health. IBM, like so many other companies, badly underestimated the sheer screaming complexity of health data. Their executives believed they could translate the big win on the “Jeopardy!” game show in 2011, based on brute computing power, into mastery of healthcare data and translation into massive predictive models. The CEO at the time called it their ‘moon shot’. Big thinkers such as Clayton Christensen chimed in. IBM managers sang its praises to all in healthcare who would listen. This Editor, on a gig at a major health plan in NJ that was ‘thinking big’ at the time and used IBM consultants extensively, in 2012 was able to bring in speakers from Watson for an internal meeting.

But we haven’t been on the moon since 1972 (though probes have visited Mars). Since the big push in 2011-12, it’s been one stumble after another. According to the Times:

  • The bar was set much too high with oncology. Watson researchers knew early on in their research at the University of North Carolina School of Medicine that their genetic data was filled with gaps, complexity, and messiness. The experience was similar with Memorial Sloan-Kettering Cancer Center. The products growing out of the UNC and MSKCC research, Watson for Genomics and Watson for Oncology, were discontinued last year. These were in addition to the MD Anderson Cancer Center initiative, Oncology Expert Advisor for treatment recommendations, that was kicked to the curb [TTA 22 Feb 2017] after $62 million spent. At the same time, IBM’s CEO was proudly announcing at HIMSS17 that they were betting the company on multiple new initiatives. 
  • Watson Health, formed in 2015, bought leading data analytics companies and then didn’t know what to do with them. TTA noted in August 2018 that Phytel, Explorys, and Truven Health Analytics were acquired as market leaders with significant books of business–and then shrank after being ‘bluewashed’. HISTalk, in its review of the Times article, noted that along with Merge Healthcare, IBM spent $4 billion for these companies. IBM’s difficulties in crunching real doctor and physical data were well known in 2018 with revealing articles in IEEE Spectrum and Der Spiegel. 

Six years later, Watson Health has been drastically pared back and reportedly is up for sale. Smaller, nimbler companies have taken over cloud computing and data analytics with AI and machine learning solutions that broke problems down into manageable chunks and business niches.

What’s recoverable from Watson? Basic, crunchy AI. Watson does natural language processing very well, as well as or better than Amazon, Google, and Microsoft. Watson Assistant is used by payers like Anthem to automate customer inquiries. Hardly a moonshot or even clinical decision support. For business, Watson applications automate basic tasks in ‘dishwashing’ areas such as accounting, payments, technology operations, marketing, and customer service. The bottom line is not good for IBM; both areas bring in a reported $1 billion per year but Watson continues to lose money. 

News roundup: stroke rehab uses Hollywood technology, 3M sues IBM Watson Health on analytics software misuse, AI-based skin cancer detection apps fail, Dictum’s successful telemed use post-pediatric surgery, malware attacks Boston practice network

February 14, 2020 | by

Motion capture technology being used in stroke and TBI rehab. Best known for turning actors into cartoon superheroes, motion capture tech is now being used at Spaulding Rehabilitation Hospital in Boston for returning mobility to stroke and TBI patients. Attached to the patient are sensors–reflective markers–on key parts of the body. Using an array of infrared cameras, the patient is tracked on gait and other affected motion areas. Doctors and therapists can then better target therapy, plus assistive technologies from orthotics to full exoskeletons. Includes video. STAT

When Giants Sue. 3M is suing IBM Watson Health on their use of licensed 3M software in ‘unauthorized ways’ and charging direct copyright infringement and contract breaches. 3M’s Grouper Plus System analyzes claims and other coded data to help calculate reimbursement. 3M contends that IBM was licensed only for internal use dating back to a Truven agreement in 2007, years before their acquisition by IBM. The suit also adds that IBM then integrated the software into Watson platforms without a license transfer and expansion to cover the use, as well as dodged an audit of the use. The suit is in NY Federal Court. Becker’s Health IT Report

Algorithm-based dermatology apps fail to accurately detect risk for melanomas and similar skin cancer.  A just-published BMJ study determined that these smartphone apps, which use algorithms that catalogue and classify images of lesions into high or low risk for skin cancer and return an immediate risk assessment with subsequent recommendation to the user, are not effective. Six apps were examined, including two with a CE mark. None were FDA-approved and two were cited by the Federal Trade Commission for deceptive marketing. Only one, SkinVision, is still commercially available. Study results do not apply to apps that physicians use in direct telemedicine consults. IEEE Spectrum

Successful test and planned rollout of telemedicine tablet for post-surgery checks at Children’s Hospital of Richmond (Virginia–CHoR). The Dictum Health eVER-HOME tablet used for virtual visits had a 92 percent acceptance rate of telemedicine visits in place of in-person visits, zero return to hospital/ER events, earlier patient discharge post-surgery (12 to 24 hours), and avoidance of long-distance travel by patients for follow-up visits, a significant factor as CHoR is a destination hospital for specialized pediatric surgery. The rollout will include AI capabilities in Dictum’s Care Central platform to help determine rising risk and more. Dictum Health is a company best known for telemedicine units for remote workers (e.g. oil rigs) using their Virtual Exam Room (VER) technologies. Dictum release, mHealth Intelligence

CHoR is having a better week than a physician’s network affiliated with Boston Children’s Hospital. Pediatric Physician’s Organization at Children’s (PPOC) is the victim of a malware attack affecting computer systems at about 500 affiliated physicians and clinicians. The impacted systems have been quarantined and does not affect BCH. Becker’s Hospital Review, Health IT Security  Health IT Security also rounds up other recent data breaches, hacks, and phishing attacks.

Comings and goings: CVS-Aetna finalizing, Anthem sued over merger, top changes at IBM Watson Health

November 8, 2018 | by

imageWhat better way to introduce this new feature than with a picture of a Raymond Loewy-designed 1947 Studebaker Starlight Coupe, where wags of the time joked that you couldn’t tell whether it was coming or going?

Is it the turkey or the stuffing? In any case, it will be the place you’ll be going for the Pepto. The CVS-Aetna merger, CVS says, will close by Thanksgiving. This is despite various objections floated by California’s insurance commissioner, New York’s financial services superintendent, and the advocacy group Consumers Union. CEO Larry Merlo is confident that all three can be dealt with rapidly, with thumbs up from 23 of the 28 states needed and is close to getting the remaining five including resolving California and NY. The Q3 earnings call was buoyant, with CVS exceeding their projected overall revenue with $47.3 billion. up 2.4% or $1.1 billion from the same quarter in 2017. The divestiture of Aetna’s Medicare Part D prescription drug plans to WellCare, helpful in speeding the approvals, will not take effect until 2020. Healthcare Dive speculates, as we did, that a merged CVS-Aetna will be expanding MinuteClinics to create urgent care facilities where it makes sense–it is not a big lift. And they will get into this far sooner than Amazon. which will split its ‘second headquarters’ among the warehouses and apartment buildings of Long Island City and the office towers of Crystal City VA.

Whatever happened to the Delaware Chancery Court battle between Anthem and Cigna? Surprisingly, no news from Wilmington, but that didn’t stop Anthem shareholder Henry Bittmann from suing both companies this week in Marion (Indiana) Superior Court. The basis of the suit is Anthem’s willfully going ahead with the attempted merger despite having member plans under the Blue Cross Blue Shield Association meant the merger was doomed to fail, and they intended all along for “Anthem to swallow, and then sideline, Cigna to eliminate a competitor, in violation of the antitrust laws.” On top of this, both companies hated each other. A match made in hell. Cigna has moved on with its money and bought Express Scripts.

IBM Watson Health division head Deborah DiSanzo departs, to no one’s surprise. Healthcare IT News received a confirmation from IBM that Ms. DiSanzo will be joining IBM Cognitive Solutions’ strategy team, though no capacity or title was stated. She was hired from Philips to lead the division through some high profile years, starting her tenure along with the splashy new Cambridge HQ in 2015, but setbacks mounted later as their massive data crunching and compilation was outflanked by machine learning, other AI methodologies, and blockchain. According to an article in STAT+ (subscription needed), they didn’t get the glitches in their patient record language processing software fixed in ‘Project Josephine’, and that was it for her. High profile partner departures in the past year such as MD Anderson Cancer Centers, troubles and lack of growth at acquired companies, topped by the damning IEEE Spectrum and Der Spiegel articles, made it not if, but when. No announcement yet of a successor.

A sobering, mercifully hype-free view of AI in healthcare

October 3, 2018 | by

Way up there on the Peak of Inflated Expectations in the Gartner Hype Cycle is that two-letter creature, AI. Artificial Intelligence has been invoked in multiple tech fields, and Microsoft in the US currently is running 30 second commercials about how AI is “making tomorrow today” but without much explanation as to how.

If AI’s current puffery makes you dizzy, long-time observer of the Healthcare Scene Anne Ziegler’s article in Hospital EMR and EHR might stabilize the whirlies. In direct and brief terms, she classifies the realities of healthcare AI adoption in three areas:

  1. Lack of Transparency. How does AI reach its conclusions in making ‘good decisions’? Sometimes the logic of the conclusion is obvious, but often it is not, and what you get is physician and clinician bypass–and suspicion.
  2. That Old Monkey Wrench Tossed into Existing Processes. It’s taken a long time for organizations to fully integrate their EHR inputs and documentation. Throwing in an AI implementation even in a limited sense may require more adjustments than the outcomes are worth.
  3. It’s Too, Tooooo Much Data. Healthcare organizations do not suffer from a paucity of data. AI feeds on data. Sounds like a good match, doesn’t it. Except that a lot of this data isn’t usable without filtering and mining, and that takes a lot of processing. The future may have more advanced data processing and indexing tech to do that, but right now even natural language processing to identify useful information is rare in the field.

Widespread AI use in healthcare is, despite the IBM Watson Health hype, a long way off. In healthcare, the rubber must meet the road of patient care and clinical practicality to be useful to us with Non-Artificial Intelligence. Problems We Need To Address Before Healthcare AI Becomes A Thing

Coffee break reading: a ‘thumbs down’ on IBM Watson Health from IEEE Spectrum and ‘Der Spiegel’

August 9, 2018 | by

In a few short years (2012 to now), IBM Watson Health has gone from being a 9,000 lb Harbinger of the Future to a Flopping Flounder. It was first MD Anderson Cancer Center at the University of Texas last year [TTA 22 Feb 17] kicking Watson to the curb after spending $62 million, then all these machine learning, blockchain, and AI upstarts doing most of what Watson was going to do, but cheaper and faster, which this Editor observed early on [TTA 3 Feb 17]. At the end of May, IBM laid off hundreds of workers primarily at three recently acquired data analytics companies. All came on board as market leaders with significant books of business: Phytel, Explorys, and Truven. Clients have evaporated; Phytel, before the acquisition ranked #1 by KLAS in analytics for its patient communication system, reportedly went from 150 to 80 clients. IBM denies the layoffs were anything but much-needed post-acquisition restructuring and refocusing on high-value segments of the IT market.

IEEE Spectrum rated the causes as corporate mismanagement (mashing Phytel and Explorys; IBM’s ‘bluewashing’ acquired companies; the inept ‘offering management’ product development process; the crushed innovation) plus inroads made by competition (those upstarts again!). What’s unusual is the sourcing from former engineers–IEEE is the trade group for tech and engineering professionals. The former IBM-ers were willing to talk in detail and depth, albeit anonymously. 

Der Spiegel takes the German and clinical perspective of what IBM Watson Health has gone wrong, starting with the well-documented failures of Watson at hospitals in Marburg and Giessen. The CEO of Rhön-Klinikum AG, which owns the university hospital at Marburg, reviewed it in action in February. “The performance was unacceptable — the medical understanding at IBM just wasn’t there.” It stumbled over and past diagnoses even a first-year resident would have considered. The test at Marburg ended before a single patient was treated.

The article also outlines several reasons why, including that Watson, after all this time, still has trouble crunching real doctor and physical data. It does not comprehend physician shorthand and negation language, which this Editor imagines is multiplied in languages other than American English. “Some are even questioning whether Watson is more of a marketing bluff by IBM than a crowning achievement in the world of artificial intelligence.” More scathingly, the Rhön-Klinikum AG CEO: “IBM acted as if it had reinvented medicine from scratch. In reality, they were all gloss and didn’t have a plan. Our experts had to take them by the hand.”

Hardly The Blue Wave of the Future. Perhaps the analogy is Dr. Watson as The Great Oz.

Health and tech news that’s a snooze–or infuriating

May 26, 2017 | by

The always acerbic Laurie Orlov has a great article on her Aging in Place Technology Watch that itemizes five news items which discuss the infuriating, the failing, or downright puzzling that affect health and older adults. In the last category, there’s the ongoing US Social Security Administration effort to eliminate paper statements and checks with online and direct deposit only–problematic for many of the oldest adults, disabled and those without reasonable, secure online access–or regular checking accounts. The infuriating is Gmail’s latest ‘upgrade’ to their mobile email that adds three short ‘smart reply’ boxes to the end of nearly every email. Other than sheer laziness and enabling emailing while driving, it’s not needed–and to turn it off, you have to go into your email settings. And for the failing, there’s IBM. There’s the stealth layoff–forcing their estimated 40 percent of remote employees to relocate to brick-and-mortar offices or leave, while they sell remote working software. There’s a falloff in revenue meaning that profits have to be squeezed from a rock. And finally there’s the extraordinarily expensive investment in Watson and Watson Health. This Editor back in February [TTA 3 and 14 Feb] noted the growing misgivings about it, observing that focused AI and simple machine learning are developing quickly and affordably for healthcare diagnostic applications. Watson Health and its massive, slow, and expensive data crunching for healthcare decision support are suitable only for complex diseases and equally massive healthcare organizations–and even they have been displeased, such as MD Anderson Cancer Center in Houston in February (Forbes). Older adults and technology – the latest news they cannot use

The stop-start of health tech in the NHS continues (UK)

May 10, 2017 | by

Continuing their critique of the state of technology within the NHS [TTA 17 Feb], The King’s Fund’s Harry Evans examines the current state of incipient ‘rigor mortis’ (his term). Due to the upcoming election, the Department of Health is delaying its response to Dame Fiona Caldicott, the National Data Guardian for Health and Care (NDG), on her review of data security, consent and opt-outs (Gov.UK publications).

People have significant trust and privacy concerns about their data, which led to NHS England suspending care.data over three years ago. But with safeguards in place, public polling supports the sharing of health data for uses such as research and direct care. But…there’s more. Now there is ‘algorithmic accountability’, which may single out individuals and influence their care, much as algorithms dictate what online ads we’re served. What of the patient data being served to Google DeepMind, IBM Watson Health, and Vitalpac for AI development? Have people adjusted their concerns, and have systems evolved to better store, secure, and share data? And how can this be implemented at the local NHS level? The NHS and technology: turn it off and on again Hat tip to Susanne Woodman of BRE.

A reminder that The King’s Fund’s Digital Health and Care Congress is on 11-12 July. Click on the sidebar to go directly to information and to register. Preview video; the Digital Health Congress fact sheet includes information on sponsoring or exhibiting. To make the event more accessible, there are new reduced rates for groups and students, plus bursary spots available for patients and carers. TTA is again a media partner of the Digital Health and Care Congress 2017. Updates on Twitter @kfdigital17

AI as diagnostician in ophthalmology, dermatology. Faster adoption than IBM Watson?

February 3, 2017 | by

Three recent articles from the IEEE (formally the Institute of Electronics and Electrical Engineers) Spectrum journal are significant in pointing to advances in artificial intelligence (AI) for specific medical conditions–and which may go into use faster and more cheaply than the massive machine learning/decision support program represented by IBM Watson Health.

A Chinese team developed CC-Cruiser to diagnose congenital cataracts, which affect children and cause irreversible blindness. The program developed algorithms that used a relatively narrow database of 410 images of congenital cataracts and 476 images of normal eyes. The CC-Cruiser team from Sun Yat-Sen and Xidian Universities developed algorithms to diagnose the existence of cataracts, predict the severity of the disease, and suggest treatment decisions. The program was subjected to five tests, with most of the critical ones over 90 percent accuracy versus doctor consults. There, according to researcher and ophthalmologist Haotian Lin, is the ‘rub’–that even with more information, he cannot project the system going to 100 percent accuracy. The other factor is the human one–face to face interaction. He strongly suggests that the CC-Cruiser system is a tool to complement and confirm doctor judgment, and could be used in non-specialized medical centers to diagnose and refer patients. Ophthalmologists vs. AI: It’s a Tie (Hat tip to former TTA Ireland Editor Toni Bunting)

In the diagnosis of skin cancers, a Stanford University team used GoogleNet Inception v3 to build a deep learning algorithm. This used a huge database of 130,000 lesion images from more than 2000 diseases. Inception was successful in performing on par with 21 board-certified dermatologists in differentiating certain skin lesions, for instance, keratinocyte carcinomas from benign seborrheic keratoses. The major limitations here are the human doctor’s ability to touch and feel the skin, which is key to diagnosis, and adding the context of the patient’s history. Even with this, Inception and similar systems could help to triage patients to a doctor faster. Computer Diagnoses Skin Cancers

Contrasting this with IEEE’s writeup on the slow development of IBM Watson Health’s systems, each having to be individually developed, continually refined, using massive datasets, best summarized in Dr Robert Wachter’s remark, “But in terms of a transformative technology that is changing the world, I don’t think anyone would say Watson is doing that today.” The ‘Watson May See You Someday’ article may be from mid-2015, but it’s only this week that Watson for Oncology has announced its first implementation in a regional medical center based in Jupiter, Florida. Watson for Oncology collaborates with Memorial Sloan-Kettering in NYC (MSK) (and was tested in other major academic centers). Currently it is limited to breast, lung, colorectal, cervical, ovarian and gastric cancers, with nine additional cancer types to be added this year. Mobihealthnews

What may change the world of medicine could be AI systems using smaller, specific datasets, with Watson Health for the big and complex diagnoses needing features like natural-language processing.

Artificial intelligence with IBM Watson, robotics pondered on 60 Minutes

October 12, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/06/robottoy-1.jpg” thumb_width=”150″ /]This Sunday, the long-running TV magazine show 60 Minutes (CBS) had a long Charlie Rose-led segment on artificial intelligence. It concentrated mainly on the good with a little bit of ugly thrown in. The longest part of it was on IBM Watson massively crunching and applying oncology and genomics to diagnosis. In a study of 1,000 cancer patients reviewed by the University of North Carolina at Chapel Hill’s molecular tumor board, while 99 percent of the doctor diagnoses were confirmed by Watson as accurate, Watson found ‘something new’ in 30 percent. As a tool, it is still considered to be in adolescence. Watson and data analytics technology has been a $15 billion investment for IBM, which can afford it, but by licensing it and through various partnerships, IBM has been starting to recoup it. The ‘children of Watson’ are also starting to grow. Over at Carnegie Mellon, robotics is king and Google Glass is reading visual data to give clues on speeding up reaction time. At Imperial College, Maja Pantic is taking the early steps into artificial emotional intelligence with a huge database of facial expressions and interpretations. In Hong Kong, Hanson Robotics is developing humanoid robots, and that may be part of the ‘ugly’ along with the fears that AI may outsmart humans in the not-so-distant future. 60 Minutes video and transcript

Speaking of recouping, IBM Watson Health‘s latest partnership is with Siemens Healthineers to develop population health technology and services to help providers operate in value-based care. Neil Versel at MedCityNews looks at that as well as 60 Minutes. Added bonus: a few chuckles about the rebranded Siemens Healthcare’s Disney-lite rebranding.

IBM Watson Health computes into diabetes management, UK care budgeting (US/UK)

October 5, 2016 | by | 1 Comment

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/10/SugarIQ2-712.jpg” thumb_width=”250″ /]IBM Watson Health, the advanced cognitive computing division of IBM, with Medtronic has developed an app that may, when marketed after FDA approval, help to ease for diabetes patients their daily ‘Battle of Stalingrad’. Sugar.IQ is an app that finds patterns in diabetes data through combining Watson’s cognitive computing capabilities with diabetes data from Medtronic and other sources. The app then uses continuous glucose monitoring data from Medtronic insulin pumps and glucose sensors to give specific, personalized information to the patient on their health trends and how to better manage their diabetes. The analytic features are impressive. Glycemic Assist lets the patient ask the app to follow specific food or therapy-related actions and events to see their exact impact. The Food Logging feature can track specific foods in a diary to determine the effects of specific foods. It is being tested presently on 100 MiniMed Connect users. Previewed at last week’s Health 2.0 conference. HealthcareITNews (photo), Medtronic blog post, Medtronic release (PDF) (This MiniMed Connect is not to be confused with the Medtronic MiniMed 670G artificial pancreas–hybrid closed-loop insulin delivery system for type 1 diabetes patients–just approved by FDA. MedCityNews)

In the UK, Harrow Council in northwest London is using IBM Watson Health’s Care Manager for social care service matching and budgeting. Using “cognitive technologies that provide personalised insight and evidence based guidelines”, Watson will match individuals’ needs and budgets to providers, and will be further able to manage costs over the ten-year agreement by “control(ling) the contract and payments between the individual commissioning for support, and social care providers competing to supply the service.” It’s not entirely clear to this Editor how the individual flexibility of care and services works with the recipient, however. The IBM Watson Health announcement follows on last May’s announcement with Alder Hey Children’s NHS Foundation Trust and the Hartee Centre to transform Alder Hey into the UK’s first “cognitive hospital”. DigitalHealth.net  Hat tip to reader Paul Costello of Viterion Digital Health

IBM Watson Health adds 5 partners, 2 solutions

September 10, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/pillar.jpg” thumb_width=”150″ /]Breaking News  IBM Watson Health not only cut the ribbon on their new global HQ on Kendall Square in Cambridge, Massachusetts (and on their new General Manager Deborah DeSanzo), they also announced two more data crunching power platforms and five new partners.

  • The IBM Watson Health Cloud for Life Sciences is designed to help life science companies fast track the deployment of a GxP compliant infrastructure and applications while adhering to stringent requirements for hosting, accessing and sharing regulated data.
  • The IBM Watson Care Manager is a population health solution that integrates Watson Health, Apple ResearchKit and Apple HealthKit into a personalized patient engagement program to improve individual health outcomes.

The five new partners are Boston Children’s Hospital (pediatrics), Columbia University (Pathology & Cell Biology and Systems Biology), ICON plc (pharma clinical trial matching–Ireland), Sage Bionetworks (Open Biomedical Research Platform) and Teva Pharmaceuticals (treatments for chronic conditions–Israel). They join CVS Health, Medtronic and Yale University. On opening day, the new headquarters also hosted demonstrations by health ecosystem partners Best Doctors, Modernizing Medicine, Pathway Genomics, Socrates and Welltok. Release (PDF)

Previously in TTA on IBM Watson Health: their big announcement at HIMSS 15 and we do wonder about their work with the VA on clinical reasoning and mental health.

Medtronic favoring early-stage acquisitions, diabetes; American Well and Teva

June 4, 2015 | by

Medtronic plc, now firmly planted in the Auld Sod of Ireland, reported a tidy $7.304 bn in its 4th quarter global revenue closing 24 April versus a prior year of $7.257 bn, with a net loss of $1 million. Their report yesterday (2 June) was primarily centered around the integration of Covidien and the foreign currency loss. Results were especially strong in the US with an 8 percent gain in fourth quarter. Earlier speculation that the major Covidien acquisition in addition to Corventis, Zephyr Technologies (through Covidien) and telehealth provider Cardiocom would slow future investments seems to be the direction CEO Omar Ishrak is taking, based on his comments during the analyst call. The Covidien strategy of making early-stage company acquisitions is to his liking and with new revenues from Covidien (and a more favorable tax domicile) certainly there is not a lack of funds despite a small loss in fourth quarter revenues. Another change from being a cardiac-centric device company is apparent in the growth area of global diabetes, shifting from pumps to diabetes management. They have a minority investment in diabetes manager Glooko, a partnership with IBM Watson Health for diabetes management, and acquired a Dutch clinic and research center, Diabeter. Jonah Comstock at Mobihealthnews has more on that call.

In a surprising move, Israel’s Teva Pharmaceuticals is putting a reported ‘tens of millions of dollars’ into American Well and their telemedicine (virtual consult) platform. The pharma interest at once may be narrow in utilizing these consults in clinical trials, but as we have seen with Merck’s telemedicine clinics in Kenya, there’s also a focus on monitoring critical medication at long distances. Late last year American Well completed an $81 million Series C, but it is not clear whether Teva is a part of this and the news is just now catching up. MedCityNews, Globes (Israeli business website)

IBM Watson Health adds 2 companies, three partners, moves to Boston and into the cloud

April 13, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/04/IBM-Watson-Announcement.jpg” thumb_width=”200″ /]A Day with a Big Exclamation Point for Healthcare Data and Analytics. In a series of press releases late NY time on Monday and a spectacular announcement at HIMSS (photo hat tip to Sandeep Pulim via Twitter), the recently quiet-on-the-healthcare-front IBM Watson has announced multiple major moves that re-position it squarely into the healthcare arena as the 90,000 lb. Elephant.

  • IBM Watson Health is now a separate business unit headquartered in Boston. The Watson New York headquarters will be expanded, but that may be for their other businesses: travel, retail, veterinary care, cognitive computing, and IT security and support. IBM claims that Watson Health will be hiring up to 2,000 healthcare consultants, clinicians and researchers, folding in existing units such as Smarter Care and Social Programs.
  • The IBM Watson Health Cloud is now their secure, open and HIPAA compliant platform for health-related data: physicians, researchers, insurers and health and wellness companies.
  • Three new partnerships were announced, designed to bolster IBM in different aspects of what is to be done with All That Data being generated from health and fitness devices. IBM Watson Health Cloud will be the secure platform, storage and analytics for Apple’s HealthKit and ResearchKit. Johnson & Johnson will be working with Watson on pre/post-operative coaching and education and Medtronic on diabetes management using data from Medtronic devices. (more…)