DARPA’s continued research on deep brain stimulation (DBS) implants to treat PTSD and TBI, as well as other neuropsychological conditions, is given the once-over in this Defense One article. New information from the time this Editor last wrote about it in December is that the SUBNETS program (Systems-Based Neurotechnology for Emerging Therapies), funded with $12 to 26 million, will work with the University of California at San Francisco, Lawrence Livermore National Lab and Medtronic to create an implant with electrodes reaching into the brain and which does not require staying still under a machine in a lab. The prototype development is expected to take five years. The article also points out the US Air Force initiative studying the effects of low amounts of electricity on the brain to boost alertness delivered by an external cap.
Medtronic and Aetna: the good and bad implications
A break in the ‘Perpetual Battle of Stalingrad’ that is also a Pointer to the Big2Big Future
Last week US insurance giant Aetna announced a partnership with medical device Gargantua Medtronic to pilot a program for uncontrolled Type 2 diabetes. Aetna will use claims data to identify 300 members who meet candidate standards for insulin pump therapy, Medtronic will reach out to them through their physicians to enroll them in the Getting2Goal program–as long as the insulin pump is Medtronic’s. The two-year program’s metrics will evaluate overall health outcomes and medical costs such as reduced ER and hospital stays. This is a fairly solid, albeit small N program for both. Other Aetna/Medtronic partnerships are a program for congestive heart failure (CHF) detection announced at HIMSS14, where Aetna plans to monitor device data to track the extra water retention that is usually an indicator of progressing heart failure; and an implanted glucometer program to monitor insulin levels for diabetics to avoid hypoglycemia.
Is this a Pointer to a Limited Future for Small, Innovative Independent Companies? Is this now signalling the US’s Big Payers only want to deal with Big Medical Device? “Value-based arrangements with companies like Medtronic” (release) make it ‘one-stop shopping’ for payers when it comes to physician relationships, IT implementation, data sharing and analysis. Will the end result be that payers stifle the revenue opportunity for small to midsize innovators by saying ‘don’t bother to knock”? Are these financially and technologically the best solution for the patient and for outcomes? (It’s like specifying only one hip or knee implant for all, and may sound familiar to our UK readers who have been following our recent articles on a certain telecare provider.) Aetna release, MassDevice, MedCityNews
Now three medical device maker networks hacked
St. Jude Medical, Medtronic and Boston Scientific targeted. The San Francisco Chronicle reported earlier this week, from what they termed a source close to the companies, that all three companies had data intrusions that lasted for several months during 2013, and were not aware of them until alerted by Federal authorities. None of the companies, nor the FBI, confirmed or commented on this for the Chronicle. The attacks were “very thorough” and the source stated that they showed signs of being committed by hackers in China. The attraction of all three companies–Medtronic being the world’s largest– is their intellectual property and of course patient data, with the article mentioning confidential patient data collection from clinical trials. Also iHealthBeat.
Previously in TTA: US health data breaches hit record; Healthcare.gov backdoored?
Medtronic’s telehealth strategy begins to emerge (UK & US)
Hot on the heels of our two recent posts (12 August and 27 August) on Medtronic’s takeover of Cardiocom, maker of telehealth devices, came the news in the FT yesterday that Medtronic had won cardiology management contracts with NHS hospitals (University Hospital of South Manchester NHS Trust and Imperial College Healthcare NHS Trust). They will also develop local cardiac services.
Now in an article today, Fierce Medical Devices explains how the two fit together (more…)
Medtronic confirms forecast direction change, the market reacts, and brains are stimulated
The ‘reasons why’ we (and others like David Shaywitz in Forbes) proposed back on 12 August for Medtronic’s purchase of Cardiocom were fully confirmed by their CEO Omar Ishrak in Bloomberg (21 August) and an analysis in Forbes (24 August). However, the Forbes article continues on to dump a bucket of cold water on Mr. Ishrak’s ‘solutions provider’ strategem (so reminiscent of 2008-9 with different companies), positing that telehealth belongs with wireless/mobile companies (Qualcomm), companies further downstream (Allscripts, a major US pharmacy benefits manager) or other technology/monitoring companies. Mr. Market held the roses though (Deutsche Bank’s reiterated hold rating in Benzinga reflecting the consensus in Yahoo Finance).
What is interesting are their advances in brain stimulation to relieve pain in two areas. (more…)
Signs of a home monitoring bubble?
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/Ambio-health.jpg” thumb_width=”175″ /]Suddenly home-based remote monitoring is very warm, if not hot. The news of investments at all levels–from Medtronic’s purchase of Cardiocom [TTA 12 Aug] to a $525,000 third angel round investment in AmbioHealth (which this Editor doubts would have been on MedCityNews’ radar a year ago)–sounds like home telehealth is finally, finally gaining traction with investors, which have been more attracted to hospital-based and fitness monitoring. But is it the right type of traction based on reasonable expectations? We were among the first to point out in 2010 in positing the FBQs* that where the data goes, how it’s being used and who’s taking action on it was critical. Now Robert Pearl MD in Forbes is also examining the new song of home RPM and finding a few off notes (or to mix metaphors, finding a pan of fool’s gold):
That’s because some promoters of home monitoring technology believe doctors will carefully scrutinize each EKG or blood sugar reading and use the information to tailor perfect regimens for their patients. This is not how medicine works.
and
Looking at thousands of EKG tracings won’t add much value either. In fact, putting all that information into an electronic medical record (EMR) only makes it more difficult for doctors to identify other, more vital pieces of information. Instead, doctors need to understand which of a few possible patterns are happening to determine the appropriate course of action.
Dr. Pearl’s prescription is for smartphones to embed telehealth monitoring capabilities at a price point slightly above the current cost, but less expensive than stand-alone devices (more…)
Well someone thinks telehealth is good news!
Medtronic has just announced a $200m takeover of Cardiocom, the telehealth device maker. If you can get through the paywall, the WSJ article is here (updated link not paywalled–Ed. Donna). FierceMedical quotes Medtronic as saying that “At-home monitoring is a proven method of reducing the rates of hospital readmission…and that translates to savings for payers, providers and governments.” First area of joint working is expected to be heart failure. Recent US regulations on Medicare, and increasingly insurance payers, penalize hospitals for 30-day same-cause repeat admissions. Medtronic press release.
Editor Donna: The announcement of Medtronic’s (#4 in worldwide revenue) acquisition of Cardiocom (both Minnesota-based companies) created quite a stir in the US as Medtronic is a ‘traditional medical device’ company best known for its implantables: cardiac shunts, stents, heart valves, pacemakers, insulin pumps and interestingly, a wide range of neurostimulators for different conditions. Now with the acquisition of Cardiocom, Medtronic moves into the post-implant/post-discharge/post-diagnosis chronic condition management continuum– not only into telehealth via Cardiocom’s devices and hubs, but also their clinical and care management systems. $200 million in cold cash is a fair bet even though Medtronic’s market cap is north of $55 billion. Medtronic has to see the opportunity to make a bottom line difference to providers and payers. It is also reacting to a narrowing in its profitable core market–medical devices are now taxed, there have been recent product defect-related ‘scandals’ tarring the industry, and there is pressure to reduce pricey device costs to fit a cost-constrained environment, driven by the new healthcare ‘scheme’ (in both the British and American English senses!) Forbes‘ David Shaywitz has a smart take on it today (though he won’t hold his breath for the pharmas to follow), as well as VC TripleTree’s Chris Hoffman ‘connecting the dots’ and coming up with what we’ve been talking about for some time–integration making sense. It is also most definitely a shot over the bow for major competitors such as Alere, Bosch and Philips plus a raft of smaller companies which have been working with a scattering of hospital discharge areas, integrated delivery systems, ACOs and home health agencies, looking nervously over their shoulder–and other leading medical device companies such as Stryker, BD, Baxter and yes….GE. (Bosch also sued Cardiocom on patent infringement this time last year [TTA 7 Aug 2012]; presumably as this suit was not announced as settled or decided, Bosch is now dealing with a company its own size!)
It also should be noted that Medtronic’s CEO, Omar Ishrak, is well acquainted with home health. Mr. Ishrak was formerly the CEO and president of GE Healthcare through mid-2011–and the driver behind making what was an ultimately failed bet in getting GEHC into home health. That was in 2008-9 with a tiny company called Living Independently Group, developer of a telecare system called QuietCare, which ultimately went to the Care Innovations JV with Intel. (Disclosure: I was head of marketing at the time of the acquisition.) Like GEHC, Medtronic is acquiring a closely-held company in a very different line of business with drivers quite unlike its own; they are retaining the former CEO as a general manager of the division but whether other management or the brand name will survive is not disclosed.
Whilst on the subject of telehealth devices, Heartwire reports a meta-analysis of 52 studies that shows that just measuring your blood pressure regularly results in a significant reduction in both systolic and diastolic levels after six months. Sadly the paper itself in the latest issue of the Annals of Internal Medicine is behind a paywall so it’s not possible to try to understand how the final comment in the synopsis of the paper on the Annals website that: “Additional support enhances the BP-lowering effect.” fits with the comment in Heartwire that “Low-strength” evidence from 13 studies comparing self-monitoring plus additional support vs self-monitoring alone “failed to support a difference” between the two strategies.”
Meanwhile back in the UK, Medvivo has become the first company to be accredited to the telehealth elements of the TSA’s Integrated Code of Practice. Sadly the TSA website will only release the Code to members (TTA isn’t one) or those aspiring to achieve accreditation (TTA fails on that one too) so it’s not possible to make meaningful comment. However the prospect of a Battle of the Codes is looking up with word from Malcolm Fisk that the final version of the European Code of Practice for Telehealth Services will be available for all to read and download on the TeleSCoPE website within a month. There has been talk of a third code being developed too…
Most Recent Comments