News roundup: CVS cashing out notes, catching up with ISfTeH, India’s Stasis Labs RPM enters US, Propeller inhaler with Novartis Japan, Cerner gets going with VA

CVS Health is pricing out a tender offer for some notes. If you are holding one of a potpourri of notes with due dates of 2023 and 2025 from CVS, the company is making a cash tender offer, meaning they are cashing these notes out. This is usually done as part of rearranging financing, especially appropriate in the wake of the Aetna acquisition. The details are here in their release of 12 August. The collective value for both note years is approximately $3 bn each. An update is here on Seeking Alpha.

We have been remiss in not maintaining our following the Swiss-based International Society for Telemedicine and eHealth (ISfTeH) so we will direct your attention to their August update which features the effect of COVID on teledermatology, women’s health, teleurology, and news on members and developers. Their Journal, still edited by Professor Maurice Mars of South Africa, has published once this year in January.

India’s Stasis Labs, developer of a remote patient monitoring (RPM) platform utilizing a smartphone, vital signs devices, a bedside monitor connected into a platform, is entering the US market. It monitors six vital signs in a single monitor: heart rate, blood oxygen, electrocardiogram, respiratory rate, blood pressure, and temperature. Awarded a 510(k) clearance in April, Stasis, out of the Cedars-Sinai Accelerator program, has had a limited deployment at Texas-based emergency-care provider Hospitality Health ER and California-based Glendale Surgical Center and Orthopedic Surgery Specialists. It has also deployed to 50 cities in India. Mobihealthnews

Smartphone-connected inhaler sensor company Propeller Health has inked a deal with Novartis in Japan. Patients prescribed Novartis’ drugs for uncontrolled asthma, the Enerzair or Atectura Breezhaler, can now enroll in Propeller’s digital-management program. Data about their inhaler use will be transmitted from the sensor on the inhaler to Propeller’s smartphone app. The app also pings users with reminders and usage data. Propeller was acquired last year for a stunning $225 million by ResMed. Propeller this past May gained 510(k) FDA clearance for a sensor/app for use with AstraZeneca’s Symbicort inhaler.

Cerner’s EHR implementation with the US Department of Veterans Affairs finally took a step forward after many delays with the launch last Friday of a new scheduling system at the VA Central Ohio Healthcare System in Columbus, Ohio. Cerner migrated the information of some 60,000 veterans in preparation. The full EHR at the Mann-Grandstaff VA Medical Center in Spokane, Washington, originally scheduled for March, will go live this fall. Healthcare Dive

News roundup: LabCorp CRO boosts Medable, Propeller Health gains 510(k), EU’s 34 medtech startups, Amazon’s healthcare moves, Google’s Arizona privacy lawsuit

It does seem ages since our last one! One major winning category for digital health is clinical trials. LabCorp has one of the largest CROs (contract research organization), Covance. LabCorp has partnered with startup Medable, a Palo Alto-based company that decentralizes the gathering and analysis of clinical trial data from recruited participants through apps and telemedicine. Mobihealthnews  Confirming this trend: earlier this month, Medable cleared a $25 million venture round from GSR Ventures. Crunchbase  This does make rival CRO PRA Health Science’s pickup of Care Innovations from Intel late last year, for an undisclosed amount, look like a prescient (and likely a bargain) purchase.

Propeller Health, which specializes in digital respiratory health with sensors connected to inhalers and apps, gained 510(k) FDA clearance for a sensor/app for use with AstraZeneca’s Symbicort inhaler. This medication is used for asthma and COPD. It does not seem that long ago (2014) that the startup was at trade shows like NYeC and mHealth Summit with an exceedingly modest display of popups and brochures. Their 2019 acquisition by ResMed for the stunningly premium price of $225 million made news in late 2018. Mobihealthnews

In Europe, COVID-19 has boosted at least 34 medtech startups, including 11 in UK alone, followed by Switzerland and Sweden. This is based on a study by Oxford University data visualization spin-out Zegami. One of them happens to be Zegami on a project in using a limited dataset to distinguish between x-rays of COVID-19 infections and infections caused by viral or bacterial pneumonia, as well as images of healthy lungs. On the list are (naturally) Babylon Health and the slightly mysterious Medopad. Sweden’s Kry (LIVI in the UK) is also on the list. Kry/LIVI last made some news when Juliet Bauer of NHS Digital ankled to Kry in early 2019, Med-techInnovationNews, Mobihealthnews

Amazon’s latest stretches into healthcare are noted in a brief Becker’s Health IT article which notes AWS’ deals with Cerner and addition of healthcare-specific features with hospitals using AWS. Mayo Clinic has partnered with Alexa for voice responsive ‘Mayo Answers’. Some Amazon employees now have access to telehealth benefits (this Editor wonders why not all, beyond those Seattle warehouse workers). Industry research company CB Insights is projecting that Amazon’s next move will be a benefits marketplace for employers and payers. Meanwhile, their partnership with JP Morgan Chase and Berkshire Hathaway, Haven, has stumbled with its CEO Atul Gawande, MD, leaving the post to return to practice after less than two years. Executive turnover has been high, and the company has yet to announce a major initiative. FierceHealthcare 

Meanwhile, Arizona’s attorney general has sued Google for violating state privacy laws. Seems like Android users are trackable, even if they turn off location on their phones, through Google apps like Maps and Weather. The lawsuit also charges that Google changed its default tracking settings without informing users, using data for targeted ads. Becker’s Health IT 

Why they matter: the $225 million acquisition of Propeller Health; Hill-Rom’s integration of EarlySense’s bed monitor

It’s all about the integration of newer technology and partnerships into established, older tech–or furniture. In late 2014, a seven-year-old early-stage company from Wisconsin had a booth at the NYeC Digital Health Conference. Their digital, connected monitors attached to prescription inhalers and tracking app interested this Editor enough for her to discuss it with a telehealth company she consulted for at the time as a natural fit for their digital remote monitoring of COPD and asthmatic patients. The startup had a few major clients, mainly drug companies, and would have been boosted by Viterion’s VA business. (Editor note: it didn’t go anywhere)

Flash forward to November 2018, and after $70 million in funding and marketing in 16 countries, integration with nearly 90 percent of commercial inhalers, Propeller Health is being acquired by the much larger ResMed for $225 million, closing in March 2019. This is surprising as Propeller never exceeded $10 million in revenue (Research2Guidance).

Why it matters: Propeller brings to ResMed’s older respiratory technology not only new yet proven technology, but also established partnerships with pharma, healthcare, and payer organizations. They inhabit a huge and growing worldwide market. According to WHO, asthma affects 334 million people worldwide; COPD 250 million people. Digital solutions could be targeting as many as 270 million patients by 2023. Propeller also brings eight US FDA 510(k) clearances and CE markings. All of this makes this small digital medical company worth a serious multiple of revenue with the prestige of being a standalone unit within ResMed led by the co-founder. Read more about it from Research 2 Guidance’s “ten major reasons” why Propeller was worth it, Mobihealthnews, and MedCityNews.

An even smaller monitoring company, Early Sense, has made a significant lift (sic) in a partnership with leading hospital bed manufacturer Hill-Rom. Early Sense has been featured at many CES Unveileds (New York) as one of many Israeli companies with a growing US presence. While starting in the hospital area years ago with bed and chair sensors, within the past two years this Editor noted their move into consumer with an under-mattress sleep sensor unit that could track (via an app) your sleep, stress, heart rate, breathing–and fertility. Their clinical version tracks heart and respiratory rates, alerted for patient falls out of bed, and patient movement (or lack thereof) as an indicator of risk for pressure ulcers. Hill-Rom, which claims to be the world leader in hospital beds, is adding the Early Sense technology to its Centrella model to create a smart hospital bed–one that will monitor heart and respiratory rates over 100 times a minute. A 2015 study quoted in the release stated that mortality related to “code blue” events was reduced by 83 percent, cardiac arrests by 86 percent, and reported overall hospital length-of-stay was reduced by 9 percent ICU days by 45 percent.

Why it matters: Even hospital equipment has to differentiate versus competition, and one way is going digital RPM integrated into the bed itself. The least expensive way of doing so is to buy new technology and incorporate in your ‘traditional’ offering. For the smaller company, it is worth its weight in gold in publicity and the potential business through the giant company. ReleaseMedCityNews, Mobihealthnews

Shouldn’t we be concentrating on digital therapeutics rather than ‘health apps’?

Where the money and attention are going. The first generation of Quantified Self apps was all about viewing your data and storing it online in a vault or graphs…somewhere, usually proprietary. Your Pebble, Fitbit, or Jawbone tracked, you crunched the numbers and found the meaning. At the same time, there are wellness companies like Welltok, ShapeUp, Keas, Virgin HealthMiles, and RedBrick Health, usually working with companies or insurers, that use various methods (money, gamification, other rewards) to influence lifestyle and improve a person’s health in a quantified, verifiable, but general way. What’s happened? There are now apps that combine both data and behavior change, focusing on a specific but important (again) condition, coach to change behavior and verify results rigorously through clinical trials. Some, like Omada Health, prove through those clinical trials that their program successfully changes pre-diabetic indicators, such as weight loss, decrease cholesterol and improved glucose control–without medication. This results in big savings for insurance companies, one reason why a $50 million Series C was led by Cigna. Another model is to work with pharmaceutical companies to better guide treatment. Propeller Health with its asthma/COPD inhaler tracker is partnering with pharma GlaxoSmithKline on a digital platform to better manage lung patient usage, and surely this will go through a clinical trial. We will be seeing more of this type of convergence in medical apps. (The rebooted Jawbone Health Hub is moving in this exact direction.) The Forbes article, while short, is written by someone who knows the business of apps– the co-founder of the AppNext distribution/monetization platform. He does achieve his aim in making us think differently about the potential of ‘health apps’. 

Pulmonary telehealth gets hot: FDA clears MTI’s Bluetooth spirometer for home use

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/05/GoSpiro.jpg” thumb_width=”150″ /]Monitored Therapeutics, Inc. (MTI) of Dublin, Ohio received FDA 510(k) clearance for a new home spirometer (left) specifically designed to connect via Bluetooth to smartphones, tablets, and PCs. According to Michael Taylor, MTI’s Chief Development Officer, “The GoSpiro is the only spirometer currently on the market that has met the latest and more stringent ISO and FDA device requirements for home use.”

Bill Zimlich, MTI’s CEO, told this Editor more about their market and the reasons for its development. “The GoSpiro is the first to be developed specifically for the home, and also the first to pass the home use FDA requirements. “Slow spirometry” is an added differentiating feature for highly impaired patients with idiopathic pulmonary fibrosis (IPF), amyotrophic lateral sclerosis (ALS), cystic fibrosis and other conditions who would have difficulty with the fast exhalation needed for the FEV test.”

Spirometers collect information on the patient’s inhaling and exhaling air in amount (volume) and speed (flow). The GoSpiro measures forced vital capacity (FVC) and slow vital capacity spirometry (SVC) which are the two main tests used to measure lung function in patients. It connects to MTI’s proprietary platform, CarePortal, based on Qualcomm 2Net, and their GoHome Patient Health Monitor. Specifications are listed here but it appears that MTI will not be selling direct to consumer.

Currently, spirometers are infrequently used in the home, which has been to the detriment of patients with pulmonary diseases such as asthma and COPD, plus associated conditions such as heart disease. Existing units have been expensive (from hundreds to thousands of dollars, excepting some new entrants), bulky, and require manual or cabled input to telehealth platforms. While cost is not disclosed, the MTI GoSpiro appears to be the first FDA-cleared home use device to fully change this picture, and in size and type can be easily bundled with a telehealth kit. Press release. Mobihealthnews.

Others in the now-hot pulmonary game are not far behind. (more…)

Who’s getting what!

Denny Hatch, the master direct mail copywriter and creative thinker, for decades had a private direct mail marketing newsletter called ‘Who’s Mailing What!’ This came to mind with some very big funding rounds in the past few weeks:

  • Omada Health’s Series C $48 million raise in September to boost validation, enhance its Prevention program and expand to state Medicaid for low-income patients. Current clients include Humana and Costco. Forbes attributed the size of the round to Omada’s approach in tying participant outcomes to over 50 percent of its compensation. MedCityNews.
  • Propeller Health‘s Series C of $21.5 million. This is a sensor on asthma meds such as inhalers that connects to an app. With 45 programs and clients like Dignity Health and Molina Healthcare, Propeller has been growing intensively since this Editor last saw them at the 2014 NYeC Digital Health Conference. Their total funding is now $45 million. TechCrunch.
    • And now that we mention it–don’t forget that TTA Readers receive a 10% registration discount on this year’s conference 6-7 December–use code TTA when registering. Click on the advert in the right sidebar to enter registration or view their event website.
  • Spain’s biotech sector got a boost when Ysios BioFund II Innvierte exceeded the initial fund target of €100 million (US$110 million), closing at €126.4 million (US$140 million). It recruited existing investors and multiple Spanish and European economic interest groups. With their Biofund I, Ysios has €191.4 million (US$220 million) in assets under management. MedCityNews
  • iRhythm closed its IPO on Tuesday with an over-allotment. Shares from last Thursday’s offering of 6.3 million shares at $17 on NASDAQ initially soared 65 percent to $28 before closing at $26.05. iRhythm’s Zio service is a cardiac monitor patch and long-term monitoring to determine whether a patient has an arrhythmia or atrial fibrillation. WSJ, Reuters
  • And before you have that AFib, if you are living in California, Heal can provide you with an in-person doctor house call from your smartphone for $99, which may be covered by a participating insurer. Series A round of $26.9 million. VentureBeat

COPD Navigator app in pilot with Mount Sinai Hospital (NYC)

An app to help make life easier for a reported 24 million COPD patients in the US has been developed jointly by Mount Sinai Hospital, the affiliated National Jewish Health Respiratory Institute in New York and LifeMap Solutions. The COPD Navigator app encourages patient self-management through visualizing patient data and patterns, including symptoms, medication, treatment adherence, and quality of life, coupled with alerts about local air quality and weather which can dramatically influence risk. Patient data is transmitted to their physician, with an emphasis on fitting into office workflows. LifeMap is also tracking when the patient uses an inhaler through their self-designed Bluetooth LE device, though it uses any Apple HealthKit enabled inhaler. (more…)

Qualcomm (Second) Life: a conversation with Jim Mault

One of the surprises for this Editor, and for others attending the mHealth Summit, was to see the sizable presence of Qualcomm Life on both the exposition floor and during the sessions. From a near-nil presence at ATA 2014 and gone dark on news, the floodlights snapped on last week with new partners and a new emphasis: coordination of chronic and transitional (hospital to home) care management (CCM/TCM).

On the show floor, the spotlight was on the partner companies which mixed the established with (mostly) the early and mid-stage. Readers will recognize names such as AliveCor, Telcare, OMRON, Nonin and Airstrip; not so well known are Vaica, Orion Health, Monitored Therapeutics, IMPak Health, Vital Connect, Care Connectors, toSense (CoVa), Dexcom, InteliChart, TruClinic, ForaCare, VOXX, vitaphone (outside of Europe), Propeller Health and Noom Health (a NYeC Digital Health Accelerator 2014 graduate). The partners occupy different parts of the management continuum, integrating communications, record sharing, population health management, sensor-based monitoring, traditional and non-traditional vital signs monitoring, medication management, behavioral change methodologies and PHRs. The 2net Hub is still present for data transmission, sharing and storage, but more prominent is Qualcomm Life’s HealthyCircles platform which provides the clinical management ‘glue’: secure communications, record sharing and care team coordination. HealthyCircles was purchased in mid-2013. Founder James Mault, MD, FACS joined Qualcomm Life as VP/Chief Medical Officer.

We had some post-mHealth Summit reflection time by telephone this Wednesday while Dr Mault was in Boston. (more…)