 |  | | October 3, 2014 |  | | | Nine digital health acquisitions for Q3 2014
Despite the third quarter including two usually sleepy summer months, plenty of digital health news broke between July and the start of October.
1. Mergers and acquisitions
M&A activity stayed strong with eight such deals — only one less than Q2′s nine M&A deals.
 HCA buys PatientKeeper: The most recent acquisition deal — just last week — was Nashville, Tennessee-based healthcare provider HCA's purchase of PatientKeeper, one of the oldest mobile health companies still in operation. HCA's providers have been using PatientKeeper's mobile apps to organize their workflow for the past seven years. Notably, HCA aims to make PatientKeeper a subsidiary that will continue to operate from Waltham, Massachusetts and serve its 100 clients.
Google acquires tremor-canceling spoon company: Google has acquired San Francisco-based Lift Labs, a company that is developing smart utensils for people with Parkinson's and essential tremor. Lift Labs will join Google[x], which is Google's secretive innovation lab. Lift Labs has raised $1 million in funding to date. The company was also funded for two years by the NIH. The company was also part of Rock Health's accelerator in summer 2013.
Preventice and eCardio merge: Remote cardiac monitoring company eCardio has agreed to merge with wearable, remote monitoring device maker Preventice. The new company, which is called Preventice, said the merger will allow it to "drive innovation and growth in remote monitoring systems and mobile health applications". Preventice's device, the BodyGaurdian RMS detects and monitors nonlethal cardiac arrhythmias in ambulatory patients. The device uses an algorithm developed by the Mayo Clinic, sensor technology from STMicroelectronics, and wireless technology from Samsung. Patients using the system receive a number of peel-and-stick patches, two sensor units, plus a dedicated smartphone with preloaded software. BodyGuardian commercially launched in May 2013 for providers and organizations that work with providers. Its FDA clearance is for prescription use only.
Validic acquires Infometers to boost clinical device integrations: Durham, North Carolina-based health data platform company Validic announced that it had acquired its partner Mountain View, California-based Infometers for an undisclosed sum. Validic's CEO Ryan Beckland told MobiHealthNews that his company bought Infometers for its technology capabilities and for its team. All full-time Infometers employees have joined Validic, Beckland said, but the number of employees was not disclosed either. The former Infometers team will continue to work out of their Silicon Valley office, which gives Validic a strategic foothold there.
"What Infometers does is SDK integrations. What Validic has traditionally done is API integrations," Beckland explained. "The difference is API is server-side so the device, let's say an Omron Blood Pressure Cuff, would send data to a hub, which might be software on a phone, computer or Qualcomm 2net hub plugged into the wall. Then that hub, whatever it is, sends data to a server. Validic is integrated on the server side so we pull data off the server — that's the API connection. Now the SDK connection, which is what Infometers does, pulls data directly from the device itself. What Infometers actually has is a piece of software — a hub — that grabs data directly from the devices and sends it to the Validic server. That's the technology that we've added to our portfolio that will allow us to rapidly expand into more classes of medical devices and quickly broaden our horizons into the types of things we can integrate."
Higi and Stayhealthy merge in kiosk consolidation: Health kiosk startup higi has merged with Stayhealthy, another mobile health company that also has a health kiosk business. The new company will apparently still be known as higi. Stayhealthy had major deals to put kiosks in Kroger grocery stores, Supervalu supermarkets, and Albertson's drug stores, while higi was previously rolled out in 2,000 stores including Whole Foods, CVS, and Rite Aid. The newly merged company will have 6,000 kiosks, with contracts for 10,000 by the beginning of 2015.
Practice Fusion acquires Ringadoc: San Francisco-based Practice Fusion, which offers electronic health records and patient management software company, has acquired after-hours doctor calls company Ringadoc for an undisclosed sum. Los Angeles-based Ringadoc was originally incubated in Practice Fusion's San Francisco offices around the same time as another startup, 100Plus. Both startups received an angel investment from Practice Fusion CEO Ryan Howard and, now, both ended up being acquired by the company too.
Ringadoc connects patients to doctors if they want to avoid using their physicians' call system. Others who don't have a physician might also be able to use the service to help them decide whether they should go to the emergency room, the urgent care center, or whether the issue might be handled over the phone. Pricing for Ringadoc starts at $69 per month with one provider for unlimited calls and messages.
Viverae acquires OneHealth: Dallas, Texas-based employee wellness company Viverae acquired behavioral health company OneHealth for an undisclosed sum. Viverae counts 300 clients in various industries throughout the US that use its health management programs. OneHealth's offerings will bolster Viverae's by allowing users to anonymously support each others' emotional and physical health.
OneHealth offers members 24/7 structured peer support, education and tools to aide in the recovery from substance abuse and other behavioral health issues. The program uses social media and real-time tracking to monitor emotional states and to provide anonymous peer supports to help the member or their dependents stay sober.
WebMD acquires patient simulation company Therasim: "To further enhance our offering for physicians, in early July we made a small acquisition to enhance our patient simulation capabilities," WebMD's CEO David Schlanger. WebMD VP of Corporate Communication Michael Heinley told MobiHealthNews the acquired company is TheraSim:
"Medscape acquired the TheraSim business in July. TheraSim offers patient simulation technology that replicates physicians' real-world experiences in clinical decision making and drives application of learning into clinical practice. The acquisition allows Medscape to further evolve and enhance the Medscape experience for health care professionals participating in continuing education," Heinley wrote.
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Learn more about this year's mHealth Summit and register today! | | | Round-up of digital health industry metrics
Numerous research reports focused on digital health published during the third quarter of 2014.
Eighty percent of smartphone users are interested in using their smartphones to interact with health care providers, according to a FICO survey of 2,239 adult smartphone users from the UK, Australia, Brazil, China, France, Germany, India, Italy, Japan, Korea, Mexico, Russia, Turkey, and the United States. The survey analyzed how consumers prefer to interact with health care providers on mobile devices, online and in-person.
Of those that want to do more health-related tasks on their smartphones, 80 percent already receive reminders of upcoming appointments, 60 percent receive reminders to arrange appointments and health checks, 40 percent receive reminders to take medication, 34 percent use their smartphones to look for medical advice, and 32 percent receive reminders to monitor personal health risks.
 According to another survey — this one of thousands of patients in Germany, Singapore, and the United Kingdom, the adoption of digital healthcare services remains low because existing services are either low quality or not meeting patients' needs. The survey, conducted by consulting firm McKinsey, included responses from at least 1,000 patients in the three countries.
McKinsey found that more than 75 percent of respondents would like to use some kind of digital health service. Many are interested in "mundane" offerings, the firm wrote. "Surprisingly, across the globe, most people want the same thing: assistance with routine tasks and navigating the often-complex healthcare system," they noted.
In this past year about 9 percent of Americans received comparative information about doctors from a ratings website like HealthGrades.com, Yelp.com, or Angie's List, according to a survey of about 1,000 conducted by the Associated Press-NORC Center for Public Affairs Research and funded by the Robert Wood Johnson Foundation. Within the group, 905 were insured privately, publicly or had another type of insurance and 94 were not insured.
Results from a survey conducted four years ago about Baby Boomer interest in using various technologies to improve their health just published last quarter too. As a group, about 35 percent of baby boomers were interested in using their smartphone to learn about and better manage their own health, according to results analyzed by academic researchers. The survey included responses from 469 consumers, 258 of which are baby boomers.
The baby boomers said they were much more likely to use health information websites, email, automated call centers, medical video conferencing, and texting when compared to the older age group. But they said they were less likely to use podcasts, kiosks, smartphones, blogs, and wikis when compared to the younger age group.
Last year around 30 percent of patients were offered access to their online medical records by their healthcare provider or insurer, according to a survey of more than 2,100 people conducted by the ONC last year. The survey was conducted prior to the implementation of Meaningful Use Stage 2 and CLIA rules.
A similar study, this one conducted by TechnologyAdvice, focused on patient awareness of portals. While 49 percent of patients know their doctor's office offers a patient portal, 40 percent were not aware of a patient portal offering and 11 percent of patients know their doctor doesn't offer one, according to the survey of 430 patients. The research firm suggests that the number of patients who are not sure whether their physician's office offers a patient portal is high because physicians are not properly communicating what tools are offered.
Two recent surveys, one from activity tracker maker Withings and the other from research firm IDC Health Insights asked consumers about their engagement with connected health devices.
In the IDC survey, the research firm found that one out of three consumers who own fitness trackers stopped using their devices in the past 12 months. IDC adds that to maintain consumers' engagement with these devices, there needs to be more education on the benefits of health devices and activity trackers.
Withings' survey explored how much consumers know about connected health devices and vital signs in general. The company asked respondents to list off vital signs without being prompted. Almost half of the consumers in the survey could recall blood pressure as a vital sign, 28 percent recalled pulse, 22.4 percent offered BMI, 21.8 percent said blood sugar, and 20.9 percent said cholesterol level. Only 8.8 percent of users added respiratory rate to their list and 7.8 percent included blood oxygen saturation.
Another survey found that 60 percent of likely adopters of wearable technology want to use their device for health or fitness, according to the poll of 1,000 consumers conducted by ON World. The survey also found that 55 percent of respondents would prefer wearable technology on their wrists over any other part of their body. Finally, 38 percent of smartwatch adopters want to use their wearable technology for health applications.
Although one third of consumers who own wearable devices stop using them within six months, the rate of adoption of smart wearable technology has increased, according to a survey of 1,700 device owners from Cambridge, Massachusetts-based Endeavour Partners.
An estimated 330 million smartwatches will ship worldwide by 2018, up from less than 4 million in 2013, according to a recent projection from research firm ON World. ON World projected that in the next fives years an estimated 700 million wearable technology devices will ship worldwide, which will make for a $47.4 billion market. It also predicted that hardware sales will continue to dominate revenues for the next five years but monitoring services, apps, and subscriptions will have faster growth rates.
The percentage of households in the US that do not have landline phones and rely on mobile phones continues to rise. The annual CDC survey recently found that the number now stands at 41 percent. A greater percentage of respondents with only mobile phones were engaged in physical activity more, 40 percent, followed by those with landlines, 36 percent, and consumers without a phone, 32 percent.
People who had no phone were most likely to also not have insurance, 27.2 percent didn't. Just over 25 percent of mobile-only participants didn't have insurance, and 14 percent of participants with a landline didn't have insurance. Still, only a small percentage of all consumers couldn't get the medical care they needed in past year because of financial barriers — 5.4 percent of participants with a landline, 10.9 percent of consumers with only a mobile phone, and 10.7 percent of consumers without a phone.
By 2018 an estimated 75.7 million consumer health and fitness devices with integrated wireless connectivity will ship, up from 23 million such devices in 2011, according to a recent report from IHS Technology. The research firms points out that Bluetooth Smart-connected devices are the most popular, but devices that make use of the fitness and health-focused ANT standard also have a foothold.
Over the next five years, ABI Research expects 100 million wearable remote patient monitoring devices to ship. This growth, ABI said, is in part a result of providers who are more aware of the benefits remote patient monitoring wearable devices can provide to patients outside of the hospital. ABI adds that because of the growing interest in these devices, there's a bigger opportunity for platforms that collect data from several devices and apps, for example Apple's HealthKit.
In a survey of employers at companies with 1,000 employees or more, Towers Watson found that currently, 22 percent offer telemedicine consultations as a cost-saving alternative to emergency room or primary care visits. An additional 37 percent planned to offer those services by 2015, which would constitute a 68 percent increase. And by 2016 or 2017, another 34 percent of employers said they were considering telemedicine.
A somewhat similar survey found that 48 percent of employers will make telehealth services available to employees, in states where it's legal, in 2015. That's according to a National Business Group on Health survey of 136 employers representing approximately 7.5 million employees. Within this group, 33 percent of employers plan to offer these services without incentives or penalties and 15 percent plan to offer the services with incentives and penalties.
According to research firm Parks Associates the number of doctor-patient video consultations in the US will almost triple over the next year. The firm expects 5.7 million such consultations in 2014 and more than 16 million in 2015. The figure will exceed 130 million in 2018.
Parks said that 42 percent of households in the US with broadband services had used at least one online service offered to them by their physicians. The most commonly offered and used service was requesting a prescription refill online, according to the firm.
Nearly 30 percent of these US broadband households also own and use at least one connected health device, according to Parks.
Parks also predicted recently that the number of connected digital trackers sold worldwide would double again in 2014 — and top 22 million. The number sold in 2012 was 6.6 million by Parks' count and 13.6 million last year.
According to a study from Boston Children's Hospital and the University of Cologne in Germany, less than a third of health apps in the iTunes and Google Play store had any privacy policy at all in place. Researchers looked at the 300 most popular apps from each store, out of an identified pool of 24,405 health apps total. They found that only 183 of the 600, or about 30 percent, had privacy policies.
Sixty five percent of nurses use a mobile device at work for professional purposes and for at least 30 minutes every day, according to a survey of 2,498 nurses by Wolters Kluwer Health. The company recruited 1,921 practicing nurses, 386 nurse academics, 135 who are retired, and 56 other nurses.
Sixty-nine percent of physicians said patients should use tech tools to help them form a diagnosis, while 84 percent of patients said they should be able to. That's according to a recent survey from WebMD/Medscape. In a follow up, the survey asked physicians if patients should self-diagnose using technology, to which only 17 percent of physicians said they should.
Finally, a research report that published during the quarter concluded that healthcare is falling behind other industries in prioritizing and attending to security concerns. The report from security company ForeScout based on a survey conducted by IDG Connect found it's particularly true in the area of mobile device security, the report found.
IDG surveyed 1,596 IT decision makers across the healthcare, education, financial, retail, and manufacturing markets. Twenty-two percent of those surveyed, or about 350 individuals, came from the healthcare sector. Those surveyed came from the UK, the US, and the DACH region of Europe which includes Germany, Austria, and Switzerland.
The biggest problem in healthcare relative to other industries seems to be with mobile device security. Overall, mobile device usage was given low security ratings for poor policy definitions, poor technical controls and poor mitigation capabilities by 60 percent of respondents. In healthcare, however, 65 percent gave mobile device security a low rating in those categories.
| | Health insurance companies' digital health closures, launches in Q3
By far the biggest payor news this quarter came from Aetna. The insurance company, which has made a number of consumer digital health plays over the years, shut down its much-hyped CarePass platform. MobiHealthNews broke the story after reporting on the departure of two executives: Martha Wofford, former Vice President and Head of Consumer Products, left the company in June and Dan Conroy, Head of Business Development for the CarePass platform, left in July.
"At this time, we have decided to make no further investments in the CarePass platform," an Aetna spokesperson told MobiHealthNews in an email. "Current CarePass users will continue to have access to the CarePass platform for the time being, but we plan on closing the CarePass web and mobile experiences by the end of this year. In addition, we will not be conducting pilot programs with Aetna plan sponsors that were previously reported."
But Aetna also had some positive news in the quarter: the company announced the launch of a new mobile-based offering, called NeoCare, for members who are new parents with infants in neonatal intensive care units (NICUs). NeoCare Solutions, which is a startup that is a part of Aetna's Healthagen's subsidiary, offers a tablet-based app that keeps parents connected to a NeoCoach — a registered nurse or social worker — who supports them throughout their child's time in the NICU and during their transition home.
The quarter was also peppered with news from other major insurers, including Humana, UnitedHealthcare, HCSC and Blue Cross Blue Shield of Massachusetts, all of which launched apps of one kind or another during the quarter.
UnitedHealthcare opened up its mobile health app, Health4Me, to the general public, two years after the company first launched the app for its members. The app is available on both iOS and Android platforms. The Health4Me app allows users to access their health information and their families' health information in one place. Users can also find healthcare facilities in their area and compare prices for 520 medical services across 290 episodes of care so they can better estimate their healthcare expenses.
Humana, meanwhile, launched a new health app for users of its wellness rewards program, HumanaVitality. Humana members whose plans include HumanaVitality can use the app to keep track of their health and fitness goals. In addition to tracking health and fitness metrics, select members can use the app, available on iOS and Android devices, to take health assessments, challenge coworkers to health-related competitions, and read information on staying healthy.
Insurance company Health Care Service Corporation (HCSC), which offers insurance plans to residents of Illinois, Montana, New Mexico, Oklahoma and Texas, launched its first wellness app for its members, called Centered. The app focuses on activity tracking and meditation. Centered will display a daily summary of calories burned, miles walked, and time spent being active every day, but it also offers meditation sessions for users to complete every week that range from four to 19 minutes.
Finally, Blue Cross Blue Shield of Massachusetts added a mobile and online offering from OneHealth, to bolster its mental health and behavioral health programs. OneHealth offers members 24/7 structured peer support, education and tools to aide in the recovery from substance abuse, according to the health insurance company. The program uses social media and real-time tracking to monitor emotional states and to provide anonymous peer supports to help the member or their dependents stay sober.
Some other Blues also made news this quarter. The philanthropic arm of insurance company Florida Blue gave a $100,000 grant to Johns Hopkins-affiliated researchers to launch a study on how tracking devices and apps can help obese teenagers make healthier decisions. The researchers have begun recruiting the 50 teenagers it plans to sign up for the study, which will include the use of Fitbit tracking devices and the MyFitnessPal app. Study participants will track their activity and sleep with the Fitbit device, while MyFitnessPal will help them track what they eat.
Another, Blue Shield of California, an independent Blue and a not-for-profit health plan, signed on as a new Rock Health partner in August.
Healthfirst, a Medicaid plan, worked with HealthCrowd, a text message-focused patient engagement company, to prove that 86 percent of Healthfirst's Medicaid population was equipped to receive text messages. The pilot program secured a response rate of 30 to 60 percent.
In the area of employee wellness, a few notable developments broke to the surface. In July, San Francisco-based Appirio saved $280,000 in annual insurance payments by implementing a wellness program using Fitbit devices.
Specifically, the company convinced insurer Anthem to reduce its insurance bills by 5 percent after showing them data from a program called CloudFit, administered via Indianapolis-based Spire Wellness. With CloudFit, Appirio distributed 400 Fitbits to employees across the company. These employees could opt in to sharing some or all of their data either in a special group set up within the Fitbit app, or via Chatter, an enterprise social network connected to Salesforce.
Also in the quarter, the Department of Health and Human Service's Idea Lab and the Office of the National Coordinator have partnered with San Diego-based Total Communicator Solutions to develop the Idea Lab's workplace wellness initiative, called Project Boundary. Project Boundary, which was created by HHS Innovator in Residence Naganand Murty and Presidential Innovation Fellow Nayan Jain, aims to help employers engage their employees with proximity sensors and messages that are sent to the user's smartphone.
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