Wednesday AM roundup all about money: $28B Oracle-Cerner closes today, 9 June strategy talk; Teladoc class-action lawsuits begin; Cigna’s look at loneliness

June 8, 2022 | by

As you read this, Oracle has closed on their acquisition of Cerner Corporation. According to the Oracle release, approximately 204,280,589 shares, or 69.2% for $28 billion, have been validly tendered and other conditions, such as passing antitrust approvals, have been satisfied. If there are other loose ends to tie off, they aren’t impediments to the closing.

Interested Readers can register to hear Larry Ellison, Oracle’s chairman, and other speakers outline Oracle’s strategy to “redefine the future of healthcare” (a song we’ve heard before) on 9 June at 3pm Central Time. If our UK Readers have been wondering what former PM Tony Blair’s been up to, he’ll be on this call. Other UK speakers are David Walliker, chief digital officer of Oxford University Hospitals, and Kevin Jarrold, joint CIO of Imperial College Healthcare. Another outside speaker is Meharry Medical College‘s CEO, James E.K. Hildreth, MD, PhD. Meharry, located in Nashville, is the second oldest medical school founded (1876) to educate black Americans in medicine and dentistry.  

Here we go with class-action lawsuits against Teladoc based on loss of share value and misleading statements. Teladoc, whose stock has taken a long jump off a very tall building (90% loss from the high), is being sued in US District Court for the Southern District of New York by a shareholder, Jeremy Schneider. This is a Federal securities class-action lawsuit (text here) with Mr. Schneider representing shareholders who purchased Teladoc shares between 28 October 2021 and 27 April 2022 (the date of announcing Q1 2022 results). The charges involve materially false statements that Teladoc made on its business, operations, and prospects including minimizing competition leading to increased advertising costs, unrealistic projections for revenue made in the period, and the impact of the Livongo writeoff announced Q1–a noncash goodwill impairment charge of $6.6 billion, or over $41 per share [TTA 4 May recaps Q1].

A lookup on Justia indicates that Mr. Schneider is being represented by Jeremy Alan Lieberman of Pomerantz LLP. The filing names Jason Gorevic, CEO, and Mala Murthy, CFO as individual defendants along with Teladoc. Mr. Schneider is not a large shareholder; his investment was a little over $250,000 from December 2021 to February 2022. Other shareholders may join the suit by contacting Pomerantz.

What usually happens after this is other firms file class-action suits in the same court representing other shareholders. An example of this trolling is this announcement/release from Bernstein Liebhard LLP. 

If you like risk and volatility, TDOC and AMWL shares remain relatively cheap (the latter below $5) and haven’t recovered. TTA reflected on Amwell’s equally shaky Q1 and growing losses in May 

If and when they’ll recover is anyone’s guess, with increased direct-to-consumer competition from retail (CVS, Walmart) and with providers maintaining their own telehealth systems, homegrown and whitelabeled (Bluestream Health, Zipnosis). Healthcare Dive, Mobihealthnews recap much of what led to this point.

If you feel a little lonelier after your Teladoc (or other telehealth) shares tanked, or you feel like life hasn’t gotten back to normal now that the pandemic is really over (despite the hoo-hah over monkeypox), Cigna’s latest research commissioned from Morning Consult will be on point. Isolation is a function of lower income, lower physical and mental health, and being a single parent or mother. Contrary to the usual assumption, young adults 18 to 24 feel lonelier and more left out (79%) compared to those aged 66 and over (41%). (Your Editor speculates that the office and workplace are more necessary for socialization by those starting their careers than those toward the end who’ve built their networks.) What’s also a little surprising is the increased indication of loneliness among racial lines with black/African American (68%) and Hispanics (72%) feeling significantly lonely. The impact at work is less productivity and more unhappiness with their jobs. The study recommends increases in work and community activities, work flexibility, improved benefits, and workplace inclusion. A bit more along with quotes from Cigna’s Evernorth subsidiary in FierceHealthcare. 

Flow depression treatment headset/app addresses UK ‘lockdown loneliness’ of as high as 27% (UK/EU)

November 26, 2020 | by

A depression treatment headset and app called Flow is being marketed in the UK and Europe by a Malmö-based company to help treat depression through brain stimulation. The user applies the headset to the forehead area and operates it through the smartphone app. The brain stimulation uses transcranial Direct Current Stimulation (tDCS) to restore brain activity in the frontal lobe to decrease depressive symptoms in as little as three weeks. tDCS has been found in randomized controlled trials to have a similar effect to anti-depressant drugs, but without the side effects. The treatment and company were formed by Daniel Mansson, a clinical psychologist, and neuroscientist Erik Rehn. The system is available for purchase for €45/monthly or outright purchase for €459. (Not available in the US)

‘Lockdown loneliness’ is a renewed concern as the pandemic won’t go away and we are both being advised to restrict our movements, physically distance, normal gathering places are closed or restricted, and in many areas, we are being asked to isolate again from family, friends, and co-workers. A study published in PLOS One from a 1,900+ sample of UK adults 18-87 years of age in March-April indicated the prevalence of self-reported loneliness was very high–27 percent. 49 to 70 percent of respondents reported feeling isolated Reported risk was higher in the younger age group, among those who are separated or divorced, or already meeting clinical criteria for depression or emotion regulation difficulty. Loneliness was measured using the Three-Item Loneliness Scale. With holidays coming up soon, this initial report does not bode well for the rest of the year. 

Can technology help to bridge the Loneliness Factor?

February 4, 2016 | by

The Guardian’s impassioned article on how common and harmful loneliness is among older adults led to some reflection by this Editor on how difficult and ‘multi-part’ an approach to help can be, even if you call it ‘The Campaign to End Loneliness’. “Studies have found loneliness can be more harmful than smoking 15 cigarettes a day, increases the risk of premature death by 30% and the chances of developing dementia by 64%. More than one million people aged over 65 are thought to be lonely – around 10-13% of older people.”–statistics from the article and AgeUK’s press release on their recent study, ‘ Promising approaches to reducing loneliness and isolation in later life’.  GPs see a lot of them, and some more for an ‘event of the day’ than actual medical need. Loss of hearing, sight and mobility further isolate the older person, particularly those in rural areas where everyone and everything is at a distance requiring driving, creating dependency among those who can no longer. Even among the middle-aged, loss of hearing reduces engagement in social situations. (And the article does not include the disabled.) It closes with suggestions that councils need to budget for and organize programs to reach out to lonely adults, including carers, and that not one approach can fit all, but emphasizes more personal approaches such as groups and one-on-one support. Hat tip to Malcolm Fisk via Twitter

Is a way to fight the Loneliness Factor located in technology, even remote patient monitoring? That’s been the primary reason for some systems such as GrandCare, but even in RPM, whether hub-based or smartphone/tablet based, the reminders and active clinician monitoring part of chronic care management can and do engage. Older people are using smartphones and tablets–perhaps not as fully as a 40 year old, but they are using Skype, calendaring and social media (Facebook, LinkedIn and news/opinion sites). A big help here, according to Laurie Orlov, would be voice recognition and integration into safety/alarm technologies. This Editor also sees proactive alerting to changes in condition as a still-untapped area.  There’s $279 billion of potential in ‘silvertech’ as estimated by AARP and Parks Associates–it’s a matter of getting young techies/entrepreneurs excited about it, and the Sand Hill funder crowd realizing that yes, it’s sexy too. Long Term Living