Breaking news confirmed: Bosch exiting healthcare and telehealth in US–UPDATED

June 19, 2015 | by

Breaking News–UPDATED with Bosch response

Bosch has confirmed they are closing their telehealth business in the US. Please see their statement at the end of this article.

A home care industry newsletter, along with our own reliable industry sources, have confirmed the recent industry discussion that Bosch Healthcare, since January a solely US operation, is winding down its business without a definite turnover to a buyer. This Editor, in calling various departments in their Palo Alto, California offices for confirmation on Thursday, was (when she reached a human being) forwarded to HR where she could leave only voice mail. An email to marketing also received no response. All sources indicate that staff layoffs took place last Monday.

Editor’s Note: Bosch’s official press response follows this article. We have also made certain corrections to this article (see in red).

  1. The Home Care Technology Report, published by industry consultant Tim Rowan, on Wednesday posted two articles stating that Bosch laid off nearly all of its staff on Monday (15 June) save for customer service and some key operating areas. His information indicated that Health Buddy sales–new and existing orders–have been terminated. This includes orders placed through its McKesson partnership. Non-VA service will be terminated in 60 to 90 days.
  2. Home Care Technology also reported that Bosch’s business with the Veterans Health Administration (VA) will be maintained through April 2016, which is near to the contract end in May, but no new units will be delivered. The original contract was with Health Buddy hub developer Health Hero Network, sold to Bosch in 2008. With the later acquisition of ViTel Net, Bosch developed into one of the two leading VA Home Telehealth remote monitoring hub suppliers–the other being Cardiocom. VA Home Telehealth is the largest telehealth program in the US with over 156,000 patients (Federal Year 2014) (Ed. Note: VA has a third authorized and active VA supplier, Viterion).

As Mr Rowan did, this Editor will speculate on the reasons why there is this reported exit without a sale or spinoff, despite the substantial VA and other healthcare placements of Health Buddy. Our take is somewhat different than his: (more…)

Tunstall Goes Hawaiian with Kupuna Monitoring acquisition

June 11, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /] Tunstall Americas is acquiring Kupuna Monitoring Systems of Aiea (northwest of Honolulu), Hawaii, a medical alarm and medication manager provider. In the press release, CEO Casey Pittock confirmed that Tunstall Americas’ strategy is to acquire regional monitoring services, as we noted in their Mountain Home (Denver) purchase last year. Locally owned (kama’aina) and serving the four major islands, Kupuna (‘elder’) is currently using Philips Lifeline monitors and Philips med dispensers. We hope they are welcomed with warmest aloha. (Hawaii as a market and culture is like no other in the US, and in this Editor’s experience in a totally different industry, can be fiercely local.)

Home telehealth now focused on the ‘superusers’ of healthcare

May 28, 2015 | by

A noticeable trend in telehealth has to do with focusing less on the generic virtues of at-home vital signs monitoring for routine patient care and more on managing specific high-cost populations to avoid or reduce costs. Some of the impetus in the US has come from new regulations by CMS (Center for Medicare and Medicaid Services) intended to move Medicare fee-for-service (FFS) patients into a reimbursed chronic care management (CCM) model. Banner Health is Arizona’s largest private employer (which does say something about Arizona as a retirement haven) and since 2006 has been experimenting with remote monitoring since 2006. Starting in 2013 Banner piloted Philips‘ post-discharge program now called ‘Hospital to Home’ as Banner iCare, combined with Philips Lifeline PERS, but made it available to those only with a stunning five+ chronic conditions–the top 5 percent that is reputed to account for 50 percent of healthcare spend. Banner combined the tech with intense support by a multi-layered care team. At ATA they announced the following results with the initial cohort of 135 patients, now up to 500:

  • 27% reduction in cost of care
  • 32% reduction in acute and long term care costs
  • 45% reduction in hospitalizations

The article in Forbes is a bit breathless in profiling the program and the ‘superusers’ of healthcare (with a windy but false analogy from John Sculley) but provides a level of detail in the program that most articles do not. One wonders how Philips makes money on supplying what is at least $2,500 worth of kit, with peripherals that must all be Bluetooth LE. It’s also not stated, but the TeleICU and TeleAcute programs also appear to be Philips’. Video

Short takes for a spring Friday: wounds, babies and ‘frequent fliers’

May 8, 2015 | by

Starting off your spring weekend….WoundMatrix, which uses generally older model smartphones to take pictures of wounds which are uploaded either to their own or to a destination clinical platform, with proprietary software that helps a clinician analyze the wound remotely and then to track healing progress, has gone international with Honduras’s La Entrada Medical and Dental facility run by non-profit Serving at the Crossroads, and in Rwanda in the care of nearly 1000 patients by the Rwanda Human Resources for Health Program, established by their Ministry of Health with the cooperation of several American universities. At ATA they also announced a new release of software. Release (PDF attached)….A BMJ (British Medical Journal) article critiquing the surge in what we call ‘telehealth for the bassinet set‘ scores the Mimo onesie (Rest Devices), the Owlet sock and the Sproutling band as taking advantage of concerned parents. It’s too much continuous monitoring of vital signs that can vary and yet be quite normal, and no published studies on benefit. A reviewer did find that Owlet is in clinical tests at Seattle Childrens and University of Arizona. MedPageToday (BMJ requires paid access)….A surprise from Philips, which we in the US associate with the Lifeline PERS. They have quietly moved into telehealth focusing on post-discharge programs that target the most costly patients, often dubbed ‘frequent fliers’ based on their frequent stays in hospital. The ‘Hospital to Home’ telehealth pilot with Banner Health in Arizona, dubbed for them the Intensive Ambulatory Care (IAC) program, focuses on the top 5 percent of complex patients which are the highest cost and most care intensive. IAC results among 135 patients over six months reduced hospitalizations by 45 percent, acute and long-term care costs decreased by 32 percent and overall cost of care by 27 percent. However, is this program continuing–or transitioning their patients?  iHealthBeat, PR Newswire

Philips enters hospital readmissions reduction fray

October 9, 2014 | by

Perhaps this Editor has attended too many new-company pitches of late, but there is another US ‘gold rush’ similar to EHRs (2009-12). This time, the gold glinting in the stream is reducing same-cause (disease) readmissions after the patient departs through the hospital doors. The latest prospector with pan, pick and shovel, quite amazingly, is Philips USA with the Transition to Ambulatory Care (eTrAC) (!) post-discharge program. Their first two applications, eCareCoordinator and eCareCompanion, just received FDA 510(k) clearance. (more…)

A trio of September meetings

September 20, 2014 | by

AAL/Bucharest, The Guardian and Kings Fund

As previously highlighted on Telehealth & Telecare Aware, last week was indeed the week of connected health events. This editor made it to three:

AAL/Bucharest

As very much of a supporting act – presenting to researchers on how to do business with the different health organisations across Europe – my principal challenge was getting to the city after the ‘information’ kiosk in the airport told me the hotel I was booked into didn’t exist. Thankfully they were wrong. What I saw of the conference looked good, though there were some bizarre rules on who could have free WiFi.

The Guardian

Wednesday evening brought the Guardian information sharing event which proved especially interesting. (more…)

Philips, Salesforce dive into health data integration

July 2, 2014 | by

Philips Healthcare and Salesforce announced last week their partnership to construct a connected, multi-point and collaborative data platform to benefit providers, payers and patients. The initial step is the launch later this summer of the Philips eCare Coordinator app for healthcare providers and a patient-centered Philips eCare Companion app, which will uptake data from Philips Healthcare medical devices into a variation on the Salesforce1 cloud platform. What’s emphasized in the releases and information from media sources is that it will be designed as an open platform for other device and software providers. (Data security problems down the line are anyone’s guess.) While Philips’ global CEO was part of the announcement and it’s expected that Philips will be lead dog for this, the only two customers mentioned were US and Salesforce’s. There were also few details on how clinical staff would access and use the data.

Cui bono from this? Philips of course, which of late has been lagging (more…)

Delays in ‘game-changing’ PERS

October 14, 2013 | by

Both Philips GoSafe and Lifecomm have apparently blown past at least two in-market dates.

Philips Lifeline GoSafe: Announced at CES in January [TTA 11 Jan], it is a mobile, souped-up PERS chunky neck-worn pendant with the fall detection features of Lifeline Auto-Alert plus GPS detection through multiple systems such as Skyhook, Wi-Fi and ‘intelligent bread crumbing’. The CES-announced debut was March, reconfirmed in February to Leading Age [TTA 14 Feb]. Then a small blog, The Senior List, confirmed with Philips in June that in-market would be delayed till fall. Now that fall is here, an industry insider tipped us to the further delay till December, confirmed by a later article in the The Senior List blog. Notably Philips is beefing up its website and video demo presence, apparently building up to an announcement near the end of the year. In the PERS category, one of the peak selling seasons is post-New Year’s, after holiday get-togethers bring the realization that a loved one is getting frailer and in need of some protection.

On the polar opposite, the Lifecomm PERS (from the Qualcomm/Hughes Telematics-now-Verizon/AMAC-now-Tunstall JV) seems to be hanging in limbo–again. (more…)

Hands-free telehealth-telemedicine crossover consult

October 14, 2013 | by

A neuroscience research team at the Medical College of Georgia (MCG) in Augusta has developed a way to decipher a video image of a person to measure a person’s heart and breathing rates. Using any single-channel video camera, including a web or cell phone cam, in day, low-light or even at night using near-infrared images, they have developed algorithms to track how the body moves slightly from the way light is reflected off of it and recorded. This can determine within fair clinical accuracy of physical measurements, with false positives only 3 percent of the time and false negatives less than 1 percent. If produced to work with systems to scale, this could vastly assist telemedicine consults especially at distance and facilitate hands-free in-person examinations. Research published in PLOS ONE with a summary in Healthline News. Philips in July started marketing a ‘Vital Signs Camera’ app for $1.99 in the iTunes Store that also measures heart and breathing, but not to clinical quality.

Philips, Accenture examining Google Glass

October 5, 2013 | by

Philips and Accenture announced their test of a proof of concept which seamlessly transfers Philips’ IntelliVue patient monitoring data into a Google Glass display. The test is on how a surgeon could simultaneously view vital signs data while performing surgery and not having to turn away. In addition, the surgeon could consult with doctors in other locations in real time. Ready of course is a glossy YouTube video simulation (02:57). For the trend-spotters, (more…)

ABI Research surveys…telecare

October 4, 2013 | by | 1 Comment

It is refreshing to note a commercial research study that concentrates on straightforward home monitoring for the senior care market, a segment that doesn’t get the cocktail party chatter or anything resembling buzz.  ABI Research looks at eight home monitoring companies–BeClose, Care Innovations, GrandCare Systems, Healthsense, independa, Philips, pomDevices (Sonamba) and Tunstall Healthcare–and judges them on several analyses. On the Competitive Assessment, measuring product innovation as well as implementation, the three leaders were (in rank order) Healthsense, pomdevices (Sonamba), and GrandCare Systems. Both Healthsense and GrandCare are prominent ‘grizzled pioneers’ evolving their model considerably over the years; Sonamba is a tablet-based relative newcomer so low profile that we haven’t heard about them since their 2011 debut at CES. Whither Philips and Tunstall? (more…)

Well someone thinks telehealth is good news!

August 12, 2013 | by | 2 Comments

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…

Sleep apnea tracking goes mobile

April 26, 2013 | by

Philips Respironics goes mobile in combining their System One PAP (positive airway pressure) device for treatment of obstructive sleep apnea with a self-management and education tool. The user can view on SleepMapper therapy feedback, set goals and access information, resources and tutorials about sleep apnea online on their PC or smartphone (iPhone and Android). Badly needed support for a major and life-threatening condition. Philips release.