Fortnightly Healthtech Update #28

How telehealth fits into value-based care – especially when your community is a 75 mile boat trip from the mainland.

Somatix scores a win in senior living, monitoring residents at the Garden Spot retirement community in Pennsylvania.

Vital sign monitoring wearable company Current Health adds continuous glucose monitoring into the mix by partnering with Dexcom. With diabetes on the rise, and COVID-19 being more perilous for those with comorbidities, this looks like a smart play. The more relevant data you can bring into a single view for overworked nurses, the better.

Wildly controversial I’m sure: Uber offers to help out with contract tracing. So many perspectives….Many American’s would see this as an invasion of privacy no doubt. Although no doubt this data sharing is covered by the broad data sharing agreement that people just blindly swiped through when they signed up. In practice, this will cover a tiny fraction of the population – especially as Uber’s business is down by 80%. But also arguably, the sort of contact tracing action that will be necessary on a massive scale to beat the virus. Individual privacy versus public good, discuss. Personally, having lived in both Europe and the US, I can see the US struggling with the virus for longer than many European countries. The balance between individualism and the public good tilts toward public good in Western Europe.

In update #22, I noted that LifeSignals had gained the CE mark for its vital sign monitoring patch. Now, it has FDA clearance too.

New to me, Transformative gets a seed round for machine learning to predict cardiac arrest form existing monitoring technology.

Pandemic or not, digital health funding is still on a tear, with H1 funding being a record breaker. Two noteworthy trends for me. First, on-demand healthcare services are the most heavily funded. In case you needed to know why, InfiniteMD has a 200% growth in virtual consults. Disease monitoring – which would include remote patient monitoring – has the second highest funding. The fitness and wellness segment drops to fourth, having been one of the most funded segments for five years. I think that’s a fair reflection of how priorities have shifted over the last few months. Second, the emergence of healthcare systems as a source of funding is becoming stronger. Is that a good thing or a bad thing? Too early to tell I think. My concern is healthcare systems might be aiming to monopolize emerging technologies for their own profits, and that might ultimately slow broader adoption of new solutions. In other words, health systems could become even more vertically integrated than they already are.

CB Insights has a chunky report on digital health funding too. Taking more of a global perspective, this report highlights explosive growth in Asia. And, there are 46 healthcare unicorns, and only about half of them in the US – which is maybe not what we would assume.

Expected from Google perhaps, but not a company that’s been around for almost 200 years, Wolters Kluwer uses clinicians searches and other social media data to predict coronavirus hot spots.

Cutely named Sema4 raises $121m to push genomics and clinical data into practice – in areas such as precision oncology.

How long can this go on…? Employers aren’t happy with payers lack of transparency and foot-dragging on value-based care. The short answer is, as long as there are no viable alternatives. Direct primary care (DPC) is in its infancy, covering about 0.1% of the US population. Growing DPC is going to be really slow, as it’s very dependent on doctors making the change. And when docs do switch, they support far few patients by definition. Then there are startups like Oscar and Clover, that promise a different, more personal, but tech enabled experience. And opposing all that innovation, there’s lobbying by BCBS to maintain business as usual.

A proposal for really cheap biosensors from the University of Missouri: Pencil–paper on-skin electronics.

Solutions to the ills of healthcare don’t have to be complicated or expensive: Virtua Health cuts no-shows for oncology by 75% and improves inpatient bed availability by improving ED throughput.

Squarely focused on value-based care, Nutrimedy is kicking off a clinical trial to help people get in shape prior to total knee or hip replacement (TKA/THA). This would be attractive to providers taking financial risk, either as an Accountable Care Organization, or through a bundled payment for an episode of care. Medicare’s latest bundled payment experiment runs through 2023. I don’t have the numbers handy, but in Medicare’s prior bundled payment program hip and knee replacements were by far the most popular bundled taken on by providers. That’s because it was a relatively low risk way to dip a toe in the water of bundled payments. So, long story short: If Nutrimedy can cut the cost of rehab and complications by getting people in shape before surgery (pre-hab) that’s a cost saving for those taking financial risk. So, the provider will keep more money in its pocket.

A longer read: How to fine tune Medicare’s alternative payment model (eg. ACO’s and bundled payments) to grow participation.