TTA’s Waiting for Spring 2: raises for Owlet, Zus Health, SpectrumAi, OpenLoop; Oracle Cerner VA EHR tagged with 4 deaths; ATA conference news; TytoCare clearance, more!

March 18, 2023 | by | No Comments

 

 

Weekly Update

Despite banks investing in health tech forgetting about their own risk management, there is some good news: raises for Owlet, Zus, SpectrumAi, and OpenLoop, with PointClickCare picking up an EHR. TytoCare picks up another FDA clearance. ATA hot topic discussion on proposed post-PHE controlled substance prescribing procedures plus their Innovators Challenge winners.  But VA and Oracle Cerner can’t catch a break in the Senate either, with four deaths attributed to the EHR implementation and four major safety issues revealed by their own sprint team. Contract review due in May.

Week-end roundup: Owlet in rebuilding mode including FDA submissions, Zus Health raises $40M, Spectrum Ai’s autism therapy $20M Series A (Someone’s getting money)
VA EHR update: four deaths traced to Oracle Cerner EHR; four safety issues identified by VA EHRM Sprint Team (The Leaning Tower of Trouble’s contract is up for review in May)
Mid-week roundup: TytoCare’s Wheeze Detection clears FDA, OpenLoop telehealth’s $15M Series A, PointClickCare buys PatientPattern EHR, last info session for Health Wildcatters’ 2023 accelerator
News from ATA 2023: debate over DEA in-person prescribing requirement, winners of Telehealth Innovators Challenge, 2024 board chair announced 

Not a lot of articles, but a lot of news. A busy M&A week for a change with Transcarent, VillageMD, and WW buys. Will Theranos’ investors see a penny in restitution? All while prison dates loom for Holmes and Balwani. Plus digital switchover/TECS meetings courtesy of UKTelehealthcare, Best Buy’s move into hospital-at-home, and Color pop health/testing says bye to 300.

News roundup: Transcarent buys 98point6’s virtual care; Best Buy-Atrium hospital-at-home; Walgreens/VillageMD buys another practice group; WW-Sequence digital weight management; UKTelehealthcare events; 300 out at Color
Did Theranos collapse because of Holmes’ criminal conduct? Holmes says no–and no to investors’ claims (The restitution debate ensues–and the defendant’s accounts are empty)

A short time to spring, but a bleak week of multiple reckonings.  Comeuppances range from the failing VA EHR rollout to former high-flyers Bright Health and Cerebral flirting with failure. FTC now wields a Lizzie Borden-worthy ax on DTC online health. Past the hype, Oak Street and One Medical show their downsides. One CEO thought insider trading was OK in 2021! Yet a few hopeful daffodils push through, like Theranica, Walmart Health, and Pixel Watch’s hard fall alert.

Week’s end roundup: Theranica clears, Pixel Watch fall alert, Veradigm delays, Walmart adding 40+ clinics by 2024, Bright Health’s dim future, Ontrak founder charged with insider trading
FTC takes off the gloves: $7.8M fine for Teladoc’s BetterHelp, warns Amazon (and everyone else) on One Medical patient privacy (Call the lawyers)
More VA-Oracle Cerner fallout? Deputy secretary, EHR executive director depart agency (More setbacks and delays in store?)
More gimlety views on CVS-Oak Street Health, Amazon-One Medical acquisitions (Some needed reconsideration going on)
Mid-week roundup: another hurdle for Oracle Cerner VA delay, Walmart builds out clinic infrastructure, Cerebral round 3 layoff of 15%, Evolent Health’s 9% layoff, Quil Health age-in-place tech shuts

A Magic 8 Ball of a week. Amazon-One Medical cheered–but is FTC eyeing them for a wider antitrust suit? Teladoc’s financials continue cloudy. David wins one against Goliath with AliveCor’s ITC review win. Theranos’ Balwani and mom x 2 Holmes appeal as coming appointments with Club Fed near. UHG widens its home care footprint with LHC Group. And is a PBC model a good one for your company?

Should your healthcare organization become a public benefit corporation (PBC)? (A business model that may fit your purpose)
News roundup: UHG closes $5.4B LHC deal, Teladoc’s record $13.7B ’22 loss, Olive AI divesting UM, Cigna exec can’t join CVS, VA anti-suicide program awards, Equiva-Infiniti ACP initiative, Newel Health’s Parkinson’s device
Breaking: Amazon closes One Medical $3.9B buy, despite loose ends–and is the Antitrust Bear being poked? (A contrarian and very gimlety view)
Theranos’ Balwani seeks to remain free during appeal, argues he owes nothing in restitution (updated for Holmes appeal) (Club Fed nears for both)
Breaking: AliveCor wins presidential review on ITC Final Determination on Apple patent infringement (David v. Goliath go on to the PTAB)

Revelations and reorganizations this week. Babylon’s Parsa admits the SPAC was cracked after all. GoodRx’s whacking on ad trackers only the FTC’s first strike. Skepticism reigns about CVS’ buy of Oak Street Health–and Amazon’s One Medical. Avaya has a Chapter 11 reorg and a few more companies lay off to get by. But keeping the blue side up–companies are still getting funding, a lovely Valentine tribute to Dame Esther Rantzen–and we’ve secured a tidy discount to ATA for our Readers.

ATA 2023 Annual Conference 4-6 March–a special deal for our Readers (ATA, San Antonio, for $250 less!)
Short takes: Avaya’s Ch. 11; Aetna sells India telehealth; fundings for IncludeHealth, Senniors, Thatch, Previa, MDI; layoffs at Collective Health, Vicarious, Olive AI (Our best to Avaya and those seeking work)
A Valentine’s Day tribute to Dame Esther Rantzen (Silver Line UK’s mover & shaker)
Is CVS’ Oak Street Health deal genius? Or a waste of time and $10B? (The skeptics are out for this one)
Mid-week news roundup: Parsa admits Babylon SPAC was ‘big mistake’, FTC’s strategy on GoodRx action, Oracle signs Accenture for VA training, Constellation delays ’22 reports, Emirates Health launches Care.ai and Digital Twin

This was the week the bills came due. DTC telehealth companies now under Federal scrutiny for monetizing patient data via ad trackers. Amazon’s One Medical buy further blocked–are health practices the right move facing a $2.7B loss? Football players pay the butcher’s bill with high rates of CTE. NHS Digital’s bill is that their magic tech fails nurses in the field. And Oak Street Health, facing the red ink bill, took the $10B deal from CVS. 

Digital technology falling (even) short(er) in NHS nursing: QNI report (UK) (When you are failing the nurses in the field, you have a problem, London)
Ad tracker action heats up: Congress questions DTC telehealth companies on sensitive patient health data sent to advertisers (No such thing as free money, and the bill is coming due)
Chronic traumatic encephalopathy (CTE) found in over 90% of deceased NFL player brains: BU study (We return to a past, heavily covered topic in time for Super Bowl)
CVS opens the checkbook, does the Oak Street Health deal for a generous $10.6B (Latest in CVS-Walgreens-UHG war–and DOJ waits in wings)
Amazon gets all tangled up on their $3.9B One Medical buy as FTC widens antitrust scrutiny (Will Amazon stay with it, given their losses?)

Can VA’s Oracle Cerner Millenium Be Saved in the looming Congressional Showdown? Can Congress save telehealth expansion? Can healthcare be saved from relentless cyber attacks? And can Matt Hancock be saved from his run of Bad Luck? Much more this week, plus a Must Read on Teladoc’s mishandled Livongo buy.

Week-end roundup: more House actions on telehealth benefits, VA EHR; Oracle exec moves to FDA digital health; Angle Health raises $58M; layoffs at Akili, Innovaccer, Athenahealth, Mindstrong
News roundup: GoodRx pays $1.5M to FTC on Meta Pixel use, ATA concerns on Covid PHE end, defending Livongo sale to Teladoc, Philips lays off 18K, Amazon health layoffs–and big ’22 loss, Ireland HSE digital head quits, Matt Hancock assaulted on Tube 
Killnet racks up 22 more healthcare cybervictims and data thefts; whitepaper on best defense practices (Cyberattacks are inevitable)
Pull the plug on Oracle Cerner in the VA! Two House Representatives urge return to VistA, send bill to Veterans’ Affairs committee (Back to the drawing board?)

A potpourri of news this week from Google’s antitrust lawsuit (and 6% layoff) to Dollar General’s clinic pilot with DocGo mobile vans. Ransomware attacks by AlphV/BlackCat fizzled and the DOJ knocked out Hive. Significant research on micro samples of blood and post-traumatic biomarkers published. Oracle has more VA/MHS problems, engineering head departs. Some funding and grants. And did Elizabeth Holmes really attempt to flee the country?

Rounding out week: Oracle Health engineering head departs; Hive ransomware KO’d by DOJ; Google sued by DOJ on antitrust, lays off another 12,000; Pearl and Precision Neuro raise, Enabled Healthcare ADAPT grant
Mid-week news roundup: CVS Health Virtual Primary Care launches, VA’s two-day Oracle Cerner EHR slowdown, and microsampling blood + wearables for multiple tests (Not quite a return for the Theranos concept)
Healthcare cyberattack latest: NextGen EHR ransomwared by AlphV/BlackCat, back to normal – 93% of healthcare orgs had 1-5 ransomware incidents (Expect more of this–it’s a movable war)
Using wearables to monitor biomarkers related to neuropsychiatric symptoms post-traumatic event (Significant research)
Theranos Holmes trial updates: did she book a one-way flight to Mexico last year, or were the prosecutors reckless and wrong? (You decide)
CVS, Walgreens, Walmart….Dollar General health clinics? (A low-risk toe in the clinic water)

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News from ATA 2023: debate over DEA in-person prescribing requirement, winners of Telehealth Innovators Challenge, 2024 board chair announced

March 15, 2023 | by | No Comments

The American Telemedicine Association’s annual conference, ATA2023, which wrapped two weekends ago, had some major debates, awards, and some board changes.

Special ‘listening’ session on DEA’s proposed changes on telemedicine prescribing of controlled substances. This would resume the in-person visit requirement for Schedule III-V non-narcotic controlled medications. A 30-day limit on a prescription would be permitted for a telehealth remote visit and prescription, but an in-person visit would be required during that period or thereafter before any renewal. The DEA proposed rule issued 24 February (draft here) includes allowing care to be delivered uninterrupted for 180 days after the end of the public health emergency (PHE) ending 11 May, but then requires an in-person physician visit. ATA opposes this new requirement for patients who were prescribed these medications solely during telehealth during the PHE (release 25 Feb). Public comment on the proposed rule is open for 30 days (27 March). A representative of the DEA was in the audience for the Monday 6 March discussion moderated by Kyle Zebley, ATA’s senior vice president of public policy. Other telehealth measures were extended for two years in last year’s passage of the 2023 Federal budget bill [TTA 4 Jan]. Healthcare Finance

Winners were announced for ATA’s Telehealth Innovators Challenge. The four categories and winners were:

Femtech and Women’s Health Winner: SimpliFed. SimpliFed is a virtual breastfeeding and baby feeding provider network that improves access to professional lactation support.

In-patient Care Solutions Winner: Great Speech. Great Speech provides speech therapy through a network of 200+ therapists and adds artificial intelligence (AI) technology and proprietary algorithms.

The Patient Experience: Clearstep Health. Clearstep guides healthcare consumers to the best next steps for care based on their symptoms, insurance, location and preferences via a virtual triage system set up for providers. 

Tools That Deliver Care: Strados Labs. The Strados Cardiopulmonary Platform, using the RESP Biosensor, captures wheezing, coughing, and other lung sounds plus respiratory dynamics, then to a clinician portal supported by machine learning algorithms.

SimpliFed also won the overall Judges’ Choice Award. Oshi Health, a virtual-first gastrointestinal care clinic integrating evidence-based medical care and behavioral health support into a convenient, high-touch, data-driven care model, received the overall People’s Choice Award. Release

Sree Chaguturu, MD, has been named Chair-elect of ATA’s Board of Directors for a two-year term starting May 2024. Dr. Chaguturu is executive vice president and chief medical officer, CVS Health. He has served on the ATA Board of Directors since December 2020. He will follow Kristi Henderson, DNP, CEO, MedExpress and senior vice president of the Center for Digital Health and Innovation for Optum Health, who is now Immediate Past Chair. Release

Congress may extend emergency telehealth flexibilities for Medicare, high-deductible plans for five months in spending bill

March 10, 2022 | by

The quaintly titled 2,741 page $1.5 trillion omnibus bill to fund the US government for the remainder of fiscal 2022, rolled out in the wee hours of Wednesday, includes an extension of telehealth flexibilities established under the COVID-19 public health emergency (PHE). The flexibilities extend full geographic coverage (versus rural only), location (home and medical facilities), and full payment for beneficiaries and providers, including some audio-only visits. This will apply, however, only to Medicare beneficiaries and providers, members of high deductible health plans (HDHP), and patients of rural health clinics (RHCs), and Federally Qualified Health Clinics (FQHCs). This is a five-month stopgap into 14 September. (The Federal fiscal year 2023 starts 1 October.)

The telehealth rule extension includes:

  • Practitioners such as physical therapists, occupational therapists, special therapists, and audiologists 
  • Originating sites can be anywhere in the US including the home and medical facilities
  • 1,400 Federally Qualified Health Centers (FQHCs) and 4,300 Rural Health Clinics (RHCs) can continue providing telehealth services including mental health visits
  • Waiving in-person initial visit requirement for mental health as well as postponing the in-person visit six months after receiving a telehealth visit
  • Audio-only allowed for Medicare
  • HDHPs have a continued ‘safe harbor’ to offer members telehealth services pre-deductible for the remainder of the 2022 plan year 

The vote is scheduled for the House today (9 March–still not finalized as of this writing), and to the Senate 11 March, with a concurrent short-term funding extension to give the Senate the usual time through 15 March. As of this time of writing, the floor wrangling continues with COVID-19 funding dropped and $13.6 billion in emergency non-defense aid to Ukraine added. The inclusion was cheered by ATA and ATA Action in their release; also Becker’s Hospital Review and Roll Call.  Update: the House passed the domestic portion of the bill 260-171 late Wednesday 9 March evening, and it moves on to the Senate.

Congress calls to extend PHE telehealth flexibilities; FCC’s $48M telehealth funding boost, telehealth’s shortcomings in pediatric asthma treatment

February 2, 2022 | by

Permanent telehealth flexibility and expanded use still being debated, and still stuck in Congress. The expansion of telehealth that came with the US public health emergency (PHE) isn’t permanent, despite some expansion plugged into the Medicare Physician Fee Schedule. That can only come with legislation passed by Congress and signed into law–and it is still being debated. A fresh group of 45 Congresscritters (this Editor can’t restrain a certain sarcasm) is now plumping for a more permanent extension for a set–but undefined– time, as part of February funding legislation. This effort is being led in the Senate by Brian Schatz, D-Hawaii, and Roger Wicker, R-Mississippi. Oh yes, the power of a letter to the House and Senate majority and minority leaders (sigh!) Meanwhile, the CONNECT for Health Act and the Telehealth Modernization Act have languished for months in the Senate Finance committee and in House Ways and Means. Healthcare IT News

Over at the Federal Communications Commission (FCC), they’re doling out the sixth and final tranche of $47.89 million to 100 provider and community health organizations that applied to the COVID-19 Telehealth Program. The total FCC funding in this round 2 was $249.95 million that built on funding that was part of the CARES Act. The full list is in the FCC release (PDF). MHealthIntelligence

A combination of in-person care with telehealth as an adjunct may be the best protocol for treating pediatric asthma, a UC Davis Health study found. The first part of the study analyzed EHR records for asthma patients aged 2-24 treated at UC Davis Health in 2020. Of 502 patients, telemedicine usage was significantly lower among:

  • Patients with a primary language other than English (OR = 0.12, 95% CI: 0.025–0.54, p = 0.006)
  • School-aged children (OR = 0.43, 95% CI: 0.24–0.77, p = 0.005),
  • Those who received asthma care from a primary care provider instead of a specialist (OR = 0.55, 95% CI: 0.34–0.91, p = 0.020).

Focus groups are qualitative and should be used for direction and to surface issues, and they did with telehealth. The 12 parents and five young adult patients who were randomly selected and participated stated that:

  • The parents felt that in-person care built better rapport, was more effective in counseling the child and young adult patients on their medication and condition, and more actively engaged their children
  • Parents did not feel confident in correctly using diagnostic tools like peak flow meters and home spirometers on a telehealth visit
  • Scheduling follow-up telehealth appointments was more difficult than in-person 
  • Where telehealth stepped up was convenience–to see their specialist without travel time. The visit also ‘cut to the chase’ by seeing one physician only, not an entire care team. And it was protective of their children during the pandemic. 

Most of the focus group participants agreed that a combination of telemedicine and in-person visits would be preferred when asthma is well-controlled. Published in the Journal of Asthma. Also MHealthIntelligence, which read the study conclusions a bit different than this Editor.