Better’s fast fail, ending health assistance service 30 Oct

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/10/Better.png” thumb_width=”150″ /]Better is sadly not. This two-year old service that provided personal health assistance, including a real, live health assistant, to guide members through health questions, the thickets of insurance claims, finding doctors and specialists, apps and more, announced earlier this week that it was ending operations as of 30 October. While it was announced via their Twitter feed on Tuesday, most of the industry learned of it through Stephanie Baum’s article in MedCityNews today. Better formally debuted only 16 months ago [TTA 23 Apr 14] and at the time this Editor felt that it was a service in the right direction, a kind of ‘concierge medicine for the masses’ needed when individuals have to direct more and more of their own care.

A solid start, as our Readers have seen, does not guarantee success, but this fast fail is still fairly shocking. A concern at the time was the pricing for the full service model at $49/month, which later became the family price (individuals were $19.99/month). CEO/co-founder Geoff Clapp was among the most Grizzled of Health Tech Pioneers; he had been a co-founder of Health Hero/Health Buddy from 1998 to its sale to Bosch Healthcare, a very long pull in telehealth, and he had spent much of his post-Health Hero time generously advising other startups. Yet despite the involvement of blue chip Mayo Clinic as a service provider, its financial backing from their investment arm and socially-oriented VC Social+Capital Partnership, it managed to raise only its initial seed funding of $5 million (CrunchBase).

So what happened? (more…)

What a big VC thinks of digital health

Bessemer Venture Partners has been a major investor in healthcare tech for over 30 years, not only with Rock Health and their eponymous fund, but also with WellTok, MindBody, Health Essentials, DocuTap and others. Observations from one of their VPs include that the IPO window for digital health has been only open a short time–six months; B2C and B2B2C sectors have been resilient, with ‘Uber for healthcare’ concepts like PillPack [TTA 14 July] gaining traction; and that they like a third-party administrator concept for employee population health called Collective Health. Rock Health blog.

Rock Health’s mid-year report: 2015 investment leveling off

Rock Health‘s 2015 report is revealing in one aspect–that the authors try to put a game face on what is a flat situation in digital health investment for first half. Not even the most optimistic of the digerati expected a lift of 16 percent as we saw in 2014 versus 2013 [TTA 2 July 14], but the 8.7 percent fall off from 2014’s blistering $2.3 billion to $2.1 billion in 2015 year-to-date was unexpected. StartUp Health’s report indicated a slower start to 2015, though slightly less, so the reports correspond. Digital health still is growing faster than software, biotech and medical device.

Other highlights:

* The top six categories accounted for 50 percent of investment funding: wearables, analytics, consumer engagement, telemedicine, enterprise wellness, EHR/clinical workflow

*  In M&A action, this year’s first half has almost matched 2014’s full year total, but with only 13 percent of the investment. Most are digital health companies acquiring others for small amounts. (more…)

Do startups truly threaten the ‘healthcare establishment’?

Or are successful startups fitting into their game? Chris Seper in MedCityNews paints the picture of one side of a quandary. The ‘healthcare establishment’ fundamentally and to its detriment does not understand and is threatened by the startup and innovation process. A startup may begin with an idea which is, in his words, ‘almost always flawed, sometimes deeply’. If the founders are smart, they will test their ideas, validate them and change them appropriately. If not, they will fail. But it is easier for the Establishment to point at the most egregious of the bad ideas and use them to rationalize the status quo.

But being congenital contrarians, we paint the house on the other side of the street. Has the Establishment caught up with–or in some cases, co-opted startups, making them and their funders ‘do their diligence’ and be more cautious before emerging? This Editor would argue yes, and largely for the better.

**The ‘Wild West’ days are over. A few years ago, a truly bad or deeply flawed health tech idea or could easily find funding, because it was all blank slate, new and ‘transformative’.The sexiest hooks were Quantified Self, sleep, employer health incentives, interactive coaching, genomics, app prescribing and (last) wearables. A lot of founders imagined themselves as the Steve Jobs of Healthcare, down to the black turtleneck. Now there is a history of success and failure. The railroads reached the dusty frontier towns.

**There’s now a ‘Startup Establishment’. National accelerators (more…)

Looking back over Telehealth & Telecare Aware’s predictions for 2014, part II

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/01/magic-8-ball.jpg” thumb_width=”150″ /]Editor Charles has treated you to a look back on his 2014 predictions, daring Editor Donna to look back on hers. Were they ‘Decidedly so’, ‘Yes’, ‘Reply hazy, try again’ or ‘My sources say no’? Read on…

On New Year’s Day 2014, it looked like “the year of reckoning for the ‘better mousetraps’”? But the reckoning wasn’t quite as dramatic as this Editor thought.

We are whipping past the 2012-13 Peak of Inflated Expectations in health tech, diving into the Trough of Disillusionment in 2014.

There surely were companies which turned up ‘Insolvent with a great idea’ in Joe Hage’s (LinkedIn’s huge Medical Devices Group) terms, but it was more a year of Big Ideas Going Sideways than Crash and Burns.

Some formerly Great Ideas may have a future, just not the one originally envisioned. (more…)

Digital health accelerators, anatomized (US)

A phenomenon in both the US and the UK is the digital health accelerator that ‘enrolls’ promising startups and nurtures their entrepreneurial founders with business coaching and limited funding. In the UK, accelerators cluster around universities such as Sheffield, Edinburgh, Ulster, Bristol and Bath. In the US, startup accelerators clustered bicoastally–Boston/New York-Silicon Valley/San Diego–and were dominated by Blueprint Health, StartUp Health and later Rock Health. In the past three years, they have dispersed to places like Minneapolis, Dallas, Phoenix and Philadelphia. Lisa Suennen, no stranger to the scene as a managing partner of advisory service Venture Valkyrie, has written ‘Survival of the Fittest: Health Care Accelerators Evolve Toward Specialization’, published by the California Health Care Foundation. She notes that accelerators, once meant for entrepreneurs/developers to help them bridge the gap from the kitchen table (more…)

Is digital health neglecting The Big Preventable–medical errors?

 

Preventable medical errors persist as the No. 3 killer in the US – third only to heart disease and cancer – claiming the lives of some 400,000 people each year.

(US Senate hearing, cited in HealthcareITNews 18 July 2014)

At the end of last month, this Editor questioned the efficacy of our current state of ‘consumer engagement’ in Patients should be less engaged, not more. The ‘less engaged’ was a call for simplification: regimens and devices which were easier to use, less complicated and far easier to fit in everyday life. (Aesthetics helps too.) Back in 2013, HeartSister/Ethical Nag (and Canadian) Carolyn Thomas called for health app (and by inference consumer engagement) designers to ‘skate to where the puck is going’–as in “For Pete’s sake, go find some Real Live Patients to talk (and listen) to first before you decide where you’re going!” Often it seems like these apps and platforms are designed in a vacuum of the entrepreneur’s making. The proof is the low uptake (Pew, Parks, IMS) and the apps’/programs’ lack of stickiness after all this time (Kvedar 8 Sep blog post).

Now Laurie Orlov tells us we were looking at the wrong puck, as analysts do. First, all that ‘nudging’ and all those apps haven’t moved the needle on diabetes and obesity. Second, why are app developers neglecting that third largest killer, preventable medical errors? Add to that 400,000 yearly–over 1,000 per day–the 10,000 estimated patients every day who suffer serious complications. (more…)

Health IT funding bubble seen by veteran investor

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2012/12/crystal-ball.jpg” thumb_width=”120″ /] How is health tech like the 1990s ‘dot-com’-ers? Veteran Silicon Valley investor (HealthTech Capital) and former entrepreneur Anne DeGheest projects a ‘Series B crunch‘ in funding health tech and IT in an interview with The Wall Street Journal’s Venture Capital Dispatch. The key factors: angels and ‘unsophisticated investors’ are pouring money into all sorts of devices, apps and related services in seed and Series A stages just to get on board in a hot sector. When the founders of these companies get to Series B and present to more demanding investors, the lack of a true value proposition and a detailed business plan that answers basic questions leave them standing on, as aptly put, ‘a pier to nowhere’ or as Joe Hage termed it last month, ‘insolvent with a great idea.’

Ms. DeGheest’s view that we are reprising the elements of the ‘dot-com’ bubble is confirmed by the numbers in Rock Health‘s and PwC‘s funding reports throughout 2013:   (more…)

HealthSpot Station kiosks add telepharmacy

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/booth-with_new_attendant.jpg” thumb_width=”180″ /]’Virtual consult’/staffed kiosk HealthSpot Station [TTA 29 Oct], most recently adding behavioral health EHR Netsmart and telemedicine provider Teladoc [TTA 5 Sept], as well as several health system providers, is expanding into telepharmacy through a strategic alliance with Canada-based MedAvail. MedAvail’s kiosks fill prescriptions in clinics, hospitals and office locations, including live assistance from a pharmacist, though the website video doesn’t explain how drugs not in stock in the kiosk are handled. What’s notable? Large kiosks are moving towards full-scope onsite clinics. HealthSpot in its three years of existence has quietly accumulated over $15 million in funding, $10 million in 2013 alone–a fact that is not included in Rock Health’s Digital Health 2013 report, unless this Editor overlooked it. Is this not digital health delivered? Correct me if I’m wrong. HealthSpot/MedAvail press release. Also see Editor Charles’ post on ‘The Future of Doctors’ below for more on this trend and its consequences.

Rock Health opens new HQ to wonder, sums up 2013

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/RockHealth_Photo©BruceDamonte_02.jpg” thumb_width=”175″ /]As seems to be the way in the West Coast Digital Health scene, the opening of accelerator/funder Rock Health’s new HQ in the Mission Bay district of San Francisco gained more heavy-breathing hype than its mostly positive 2013 digital health investment report. The soireé during last week’s JP Morgan Healthcare Conference, glowingly reported in Xconomy with plenty of pics of the achingly trendy interior design and Health Digerati/D3Hers (Digital Health Hypester/Hipster Horde) at play also was a demo of a different type–how insular interests interlock and circle in Fog City. Star guest San Francisco Mayor Ed Lee spearheaded the remaking of the district into a life sciences/tech center; the Xconomy-moderated panel discussion paired him with Rock Health founder/CEO Halle Tecco and Alexandria Real Estate CEO Joel Marcus;  Alexandria underwrites Xconomy and has a huge investment in life sciences real estate; the new Rock Health HQ is on the ground floor of an Alexandria-owned building. Of course Mission Bay is now hyped as the ‘US Digital Health Hub’ for all those Rock Health-accelerated, funded startups. It does give one pause: how much of this is substance, or is it the peak of style before tipping into The Trough of Disillusionment? The tartest takedown on this is courtesy of Neil Versel’s Meaningful HIT News column. Pointed pokes abound: at Silicon Valley for its health tech failures (Google Health among them), the odd duplications (Google-funded telemedicine provider Doctor On Demand sounds like American Well, Ameridoc, etc.) and the even odder lack of considering integration with payer/provider systems and workflows.  Keep wasting your money, Silicon Valley venture capitalists (Note to Neil: the circular swings seem to be a feature of Alexandria’s properties–they’re present at Alexandria Center NYC too. Image © Bruce Damonte/Studios Architecture)

With that aside, the highlights of the Rock Health Digital Health Funding Year In Review were generally positive, but some of them, looked at critically, weren’t, even when depicted in attractive charts and graphs: (more…)

First M&A roundup for 3rd quarter: more action, less value, whither digital health?

VC/research firm TripleTree is first out of the gate with its roundup of merger and acquisition activity in healthcare, July through September. The news and directions are mixed. Deals are up 28 percent from the two previous quarters but down 12 percent in total deal value. Most are in the healthcare facilities area with home care giant Gentiva acquiring Harden Healthcare and insurance giant Humana adding to its LTC, Medicaid/Medicare portfolio with American Eldercare. 19 healthcare companies had successful IPOs totaling ~$3 billion of transaction value. Two highlighted here are Envision Healthcare Holdings (ambulance and outsourced physician services) and Benefitfocus (benefit administration software and tracking). Given that they are the creator of the iAwards at the annual Wireless-Life Sciences Alliance in May which focuses on digital health, the decidedly non-buzzy companies getting the action here are perhaps another indicator of the funding cooling preceding M&A as projected by Rock Health back in July [TTA 9 July], with their 3rd Quarter report due out shortly.

Breathing monitoring, Google Glassing, AngelListing at Rock Health’s Demo Day

The Rock Health accelerator premiered its fifth class of startup/early stage companies last week. The most interesting are the assistive technologies developed by Lift Labs in devices for everyday use–a spoon that counteracts the effect of active tremors; the Spire clip-on breathing monitoring device that takes an additional step into biofeedback and stress management (the similar BreathResearch was in TTA 24 Sept); the Google Glass-powered Augmedix service for doctors that serves up patient information during exams; ThriveOn which creates an on-demand 8-12 week custom-built programs for mental health issues. Rock Health also announced its alliance with AngelList  (more…)

Another diagnostic for Alzheimers with impact on telehealth gains $2MM funding

Will a market of hundreds of millions be able to access these needed technologies?

Neurotrack, a computer-based cognitive program designed to pick up changes three to six years in advance of an official diagnosis of Alzheimer’s or dementia, gained Series A funding led by Founders’ Fund (Peter Thiel) and joined by Social+Capital Partnership plus several angel investors. Developed initially at Emory University with the technology part of a five year National Institutes of Health (NIH) study, it tests subjects on preference for repeat images versus novel images; a preference for repeat images may indicate a disturbance in the hippocampus area of the brain in completely asymptomatic subjects. However, you will not find it at a doctor’s office or a pharmacy kiosk near you soon. Its initial use will be in clinical trials for pharma companies developing drugs targeting early-stage dementias. The meaning for telehealth and telecare (more…)

Rock Health’s guide to FDA for the health tech entrepreneur (US)

In 26 slides, Rock Health has neatly summarized for those unfamiliar with the FDA approval thickets (99% of us) on what is a regulated health tech product and is not. Instead of a MEGO (my eyes glaze over) experience (familiar to all those who’ve sledded through the FDA website), there are simple examples in how to determine what class your device falls into (I, II, III) and what you need to do to gain approval. It also clearly defines the substantial difference between 510(k) premarket submission and the far more complicated PMA premarket approval–and the fact that after approval, FDA will forever be in your life. It also notes that other approvals such as FCC may be required and many other tips on how to make the process easier and less garment-rending for your organization. Features comments from Chris Bergstrom of WellDoc and Geoff Clapp, who co-founded Health Hero which is now Bosch Health Buddy. SlideShare link