Comings, goings, and more: YouTube goes healthy, COVID vax distribution and EMA hack, IPO/M&A roundup, Japan’s health tech startups highlighted at CES

Short takes on news snippets from just about everywhere. It’s been that kind of a week. (Picture: the famous Raymond Loewy-designed ’49 Studebaker Commander, of which it was joked ‘you can’t tell whether it’s coming or going)

Google-owned YouTube has decided to take a more organized approach to healthcare content with the hiring from CVS Health of Garth Graham, MD, who will serve as its director and global head of healthcare. At CVS, he was chief community health officer and president of the Aetna Foundation. His portfolio will include the development of content from providers including the Cleveland Clinic, the Mayo Clinic, the National Academy of Health, and Harvard’s School of Public Health. It’s seen as a platform for video-formatted health education both US and globally. The importance to Google is evident in the reporting line: Dr. Graham will report to Karen DeSalvo, MD, the chief health officer at Google. One wonders if the next step is the curating (a/k/a demonetizing or removal) of health content not Google-generated. FierceHealthcare, YouTube press release

Some states have done well on COVID-19 distribution. Others haven’t. It apparently doesn’t matter if you’re large or small. In the US, states were given vaccines based on CDC information and consultation with them. The states then designed their own distribution and priorities. Here’s a running tally on Becker’s Hospital Review Meanwhile, back in Hackerville, the European Medicines Agency (EMA) confirmed on 12 January that data relating to regulatory submissions by Moderna, Pfizer, and BioNTech that were on a hacked server was leaked to the internet. Becker’s

In IPO/M&A news:

Centene Corporation is acquiring Magellan Health, a behavioral health, specialty healthcare, and pharmacy management company, for $2.2 billion. Centene continues its transformation into a UnitedHealthcare structured company, with payer programs on one side and health services including population health management, data analytics and other areas of health tech on the other side. Magellan will be operated independently. The deal requires Federal and state review, and is expected to close in second half 2021. Release  Magellan this week announced its lead investment in a $20 million Series B raise by Philadelphia-based NeuroFlow, a clinical behavioral health monitoring system. Philadelphia Business Journal

Amwell announced a public offering of over 11 million shares. The date and pricing for the offering were not mentioned in the release, but at the current share price of $28, this would raise in excess of $308 million. This is on top of their socko IPO last September which raised in excess of $700 million. 

Behavioral therapy continues to be hot, with online behavioral therapy company Talkspace going the SPAC ‘blank check’ route in merging with investor company Hudson Executive Investment. It provides them with $250 million cash. Estimated net revenue is $125 million in 2021, up 69 percent from 2020, creating an enterprise value of $1.4 bn, which is quite a reach. Healthcare Dive, release.

Medicare Advantage payer Clover Health of Jersey City, NJ also went the SPAC route this week with Social Capital Hedosophia Holdings Corp. III, giving it an enterprise value of approximately $3.7 billion. Clover Health styles itself as a health tech company as it analyzes member health and behavioral data to improve medical outcomes and lower costs for patients, many of whom have multiple chronic conditions or are classified as underserved.  Release

Israel’s Itamar Health, which focuses on integrating sleep apnea management into the cardiac patient care pathway, is buying SF-based Spry Health for an undisclosed amount. Founded in 2014, Spry has an FDA-cleared wrist-worn device, the Loop System, that monitors SpO2, respiration rate, and heart rate. Itamar plans to develop a wrist-worn device based on their Peripheral Arterial Tonometry (PAT) immediately, with initial market launch anticipated in 2022. Release

Hinge Health’s Series D raised $300 million and a new valuation of the company at $3 bn. (Remember when $1 bn was a unicorn amount?) Hinge’s specialty is musculoskeletal–a virtual MSK Clinic for back and joint pain care and rehab including access to physical therapists, physicians, health coaches, and wearable sensors to guide exercise therapy. Release

In startup news…Under the radar, Japan has been developing a crop of health tech startups. They were highlighted at this year’s virtual CES by Jetro–the Japan External Trade Organization. Their CES web page has a teaser video and sortable profiles on companies, many of which look very interesting. According to their materials, there are perhaps 10,000 Japan startups but few of them make it out of Japan. This Editor looked forward to their presentation on ‘Turning the Super Aging Society into a Super Smart Society’ yesterday evening, but virtual doesn’t mean that links work or events actually happen, so our reporting will attach some statistics on their super-aging society, as well as a comparison with other countries (PDF).

Japan as aging bellwether: experiential VR, claim that robots increase activity by 50 percent

Japan’s population is the oldest on average in the world, with over 27 percent of its population aged over 65 and the highest average life expectancy at 83.7 years. Writer Shiho Fukada spent a year researching aging tech supported by the Pulitzer Center. In STAT, he profiles innovation in two areas we’ve highlighted previously: VR experiences for those who are restricted in their mobility and the effect of robots in elder care.

Bringing experiences to the older person. A Tokyo therapist, Kenta Toshima, takes videos of his travels to 29 countries and 55 cities, then shares them with his patients on a smartphone mounted on an inexpensive cardboard viewer to simulate full VR. His concept, Virtually Able, has positive results and he is trying to develop a study. Yet in the US, Dr. Sonya Kim has been developing this in a commercial model via OneCaringTeam and Aloha VR.  [TTA 21 Nov 16 and 11 Nov 17These VR experiences for residents of long-term care are being researched for easing anxiety, increasing positive feelings, stimulation, and connectedness in older people with mobility difficulties or dementia, with Cedars-Sinai in LA evaluating VR for pain reduction with mixed results.

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2018/02/Pepper-daughter.jpg” thumb_width=”200″ /]Robotics in monitoring and connectedness. It’s another look at Palro and Pepper [TTA 24 Oct 17], this time in action at the Flos Higashi-kojiya Senior Care Facility in Tokyo, at a nursing home run by the Social Welfare Corporation of Tokyo Seishinkai, and in a home with an older couple. Robots, as we’ve noted, are stepping in the care and connectedness gap.

  • For older adults living at home by themselves, interactive robots like Pepper can aid with tasks but as you’ll see in the video, the wide-eyed Pepper becomes a ‘daughter-bot’ (left and above from the video) that remarkably increases engagement between this older couple in a typically crowded Japanese home.
  • In Japan, as in the West, there’s a shortage of care staff able to engage with residents in senior living. In the video, Palro struts across a table to the admiration of a group of older women in assisted living and leads them in an exercise routine.
  • In a Tokyo nursing home, a Guardian desktop robot not only monitors the well-being of patients in nursing care using audio and video, but also communicates interactively with the patient to give a feeling of personal attention and encouragement. Mr. Fukada at 06:14 quotes a study that residents living with robots are 50 percent more active and that 70 percent without robots are less active, but unfortunately this is not footnoted.

What is evident is that Japan continues to pioneer in robotics for care of older adults and in general (CES), but the takeup in other countries, with some exception for Europe, is not that great–yet. Previously in TTA: Japan’s workarounds for adult care shortage, Japan’s hard lessons on an aging population

 

The Theranos Story, ch. 45: a ‘Christmas present’ $100 million loan from Fortress averts bankruptcy (updated 8 Jan)

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/11/jacobs-well-texas-woe1.jpg” thumb_width=”150″ /]A present or a Trojan Horse? Revealed on Christmas Eve by the intrepid John Carreyrou of the Wall Street Journal (paywalled) is Theranos’ securing of a $100 million loan from Fortress Investment Group LLC. This Editor notes the word ‘loan’, and loans come with conditions. Mr. Carreyrou revealed that according to an email sent by (unbelievably still in place) CEO Elizabeth Holmes on Friday 22 December and reviewed by the WSJ, it is “subject to achieving certain product and operational milestones.” 

As our Readers know, with the Walgreens Boots settlement in August, cash on hand from June was about $54 million with a burn rate of $10 million per month [TTA 3 Aug]. Technically, Theranos was out of funds by December. This Editor thought the next article on Theranos would be an obituary issued from their warehouse in Newark, California. Updated: As of 8 Jan, there is no announcement on the Theranos website or comment to press.

According to the article, Fortress specializes in distressed investments. “The loan from Fortress is collateralized by Theranos’s patent portfolio and the deal grants Fortress warrants for 4% of the company’s equity, Ms. Holmes told investors in her email. She said she anticipated the loan would provide Theranos “sufficient liquidity through 2018” which is quite a fan dance.

Interestingly, Japan’s SoftBank Group completed its acquisition of Fortress yesterday (release). 

Our takeaway is that the IP is worth far more than the company and that is what has been bought. SoftBank would dearly like another entree into Silicon Valley for their tech portfolio and can use that IP, if not at Theranos, elsewhere. For Fortress, which has $36.1 billion in assets under management and now backed by SoftBank, $100 million is pocket change with a smidge of lint. Remaining investors also have likely written down the value on their investment. It’s a bit of a tweak on the expected denouement, but do not bet on Theranos and Ms. Holmes rising like phoenixes from the ashes of their Edison lab equipment.

Updated: Theranos’ last words on their website tout their accepted/presented publications and posters, but there is no further word on Theranos’ actual sale of Zika virus detection technology or the much-touted miniLab. It’s all a far cry from the palmy days three years ago of co-marketing with Walgreens and Ms. Holmes headlining Forbes, Fortune, and dozens of healthcare conferences and accumulating nearly a billion in funding as The Greatest Thing Since Sliced Bread.

Prediction for 2018: Ms. Holmes will be removed and replaced, then the company will be reorganized and/or renamed.

Full WSJ article on Yahoo! Finance. CNBC. Gizmodo. Our prior chapters on the Theranos Story are here

Japan’s workarounds for adult care shortage: robots, exoskeletons, sensors

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/10/robear.jpg” thumb_width=”150″ /]The problem of Japan’s aging population–the oldest worldwide with 32 percent aged 60+ (2013, RFE)–and shortage of care workers has led to a variety of ‘digital health solutions’ in the past few years, some of them smart, many of them gimmicky, expensive, or non-translatable to other cultures. There have been the comfort robot semi-toys (the PARO seal, the Chapit mouse), the humanoid exercise-leading robots (Palro), and IoT gizmos. Smarter are the functional robots which can transfer a patient to/from bed and wheelchair disguised as cuddly bears (Robear, developed by Riken and Sumitomo Riko) and Panasonic’s exoskeletons for lifting assistance.

Japan’s problem: how to support more older adults in homes with increasingly less care staff, and how to pay for it. The Financial Times quotes Japan government statistics that by 2025 there will be 2.5m skilled care workers but 380,000 more are needed. The working age population is shrinking by 1 percent per year and immigration to Japan is near-nonexistent. Japan is looking to technology to do more with fewer people, for instance transferring social contact or hard, dirty work to robots. The very real challenge is to produce and support the devices at a reasonable price for both domestic use and–where the real money is–export. 

The Abe government in 2012 budgeted ¥2.39bn ($21m) for development of nursing care robots, with the Ministry for Economy, Trade and Industry tasked to find and subsidize 24 companies–not a lot of money and parceled out thinly. Five years later, the Ministry of Health, Labour and Welfare determined that “deeper work is needed on machinery and software that can either replace human care workers or increase staff efficiency.” Even Panasonic concurred that robots cannot offset the loss of human carers on quality of services. At this point. Japan leads in robots under development with SoftBank’s Pepper and NAO, with Toshiba’s ChihiraAiko ‘geisha robot’ (Guardian) debuting at CES 2015 and Toyota’s ongoing work with their Human Support Robot (HSR)–a moving article on its use with US Army CWO Romy Camargo is here. (attribution correction and addition–Ed.)

The next generation of care aids by now has moved away from comfort pets to sensors and software that anticipate care needs. Projects under development include self-driving toilets (sic) that move to the patient; mattress sensor-supplied AI which can sense toileting needs (DFree) and other bed activity; improved ‘communication robots’ which understand and deploy stored knowledge. Japan’s businesses also realize the huge potential of the $16 trillion China market–if China doesn’t get there first–and other Asian countries such as Thailand, a favored retirement spot for well-off Japanese. In Japanese discussions, ‘aging in place’ seems to be absent as an alternative, perhaps due to small families.

But Japan must move quickly, more so than the leisurely pace so far. Already Thailand is pioneering smart cities with Intel and Dell [TTA 16 Aug 16] and remote patient monitoring with Western companies such as Philips [TTA 30 Aug]. There’s the US and Western Europe, but incumbents are plentiful and the bumpy health tech ride tends not to suit Japanese companies’ deliberate style. Can they seize the day?  Financial Times (PDF here if paywalled) Hat tip to reader Susanne Woodman of BRE (Photo: Robear)