We've come to the end of the third quarter, so we at MobiHealthNews have looked into our archives and rounded up the major stories of the quarter for the hospital, pharma, and insurance sectors. Read on for provider, pharma, and payer news.
Provider
The third quarter of 2016 has provided a steady stream of provider news. From partnerships that blend traditional healthcare systems with digital health startups and government agencies, to telemedicine advancements, studies to improve both patient engagement and health outcomes, and a new kind of healthcare company altogether, we’ve assembled a list of some of the biggest news of Q3 2016 here.
San Francisco-based Omada Health, an online and mobile behavioral medicine company, formed a partnership with American Medical Association and a new customer, Utah-based Intermountain Healthcare system, which will offer Omada’s flagship diabetes prevention program (DPP), Prevent, to its patients. The Prevent program aims to reduce the number of adults who develop type 2 diabetes. All three organizations will collaborate to integrate Omada’s diabetes prevention program into Intermountain’s system, with the AMA acting as an advisor to Omada to help it better understand how to make Prevent better integrate into providers' workflows. The initiative will combine the AMA’s efforts to raise pre-diabetes awareness nationally and Intermountain’s population health strategies by using Omada’s Prevent program. Doctors and care teams will be able to refer patients to, and monitor their progress through the online and app-based program. More
Apple, getting deeper and deeper into health, is starting to act more as a regulator. Developers of health and medical apps will now have strict rules to abide by with Apple's new App Store Guidelines that establish a high bar for any app aimed at health and wellness. Previous iterations of the guidelines already laid out the proper protocol for human research subjects and avoiding physical harm, but the new rules carry much more detailed and specific language, ranging from privacy protection to warnings about inaccurate data that could potentially cause physical harm. With a whole section on physical harm (previously a short line in the rules) Apple’s new guidelines aren’t letting anything slide.“If your app behaves in a way that risks physical harm, we may reject it,” the guidelines state, and go on to describe in detail possible pitfalls. Apple is also snuffing out any marijuana related apps and those that encourage people to place their iPhones under a mattress or pillow while charging, such as sleep-tracking apps. More.
Ochsner Health System in New Orleans has catapulted itself into the front lines of hospital innovation in the last few years as an early Apple HealthKit adopter, with its in-house "O Bar" app store, and with an initially successful blood pressure monitoring trial. Chief Clinical Transformation Officer Richard Milani said this quarter that the trial went well enough that Ochsner is starting to design interventions for two more chronic conditions: COPD and diabetes. More
While we’ve seen growing adoption of telemedicine across the country, it’s been a tough few months for Arkansas and Texas, which both still lag behind the national curve in telehealth services.
Earlier this summer, pro-telemedicine policies were stalled in Arkansas, and groups in Texas also tried to get the needle moving in their state legislature on allowing telemedicine to operate the same way it does in every other state. At the center of both states’ delays were the companies trying to set up shop, such as Teladoc which filed a lawsuit against the Texas Board of Medicine in 2015.
In September, the Arkansas’s State Board of Medicine finally approved regulations that allow a doctor and patient to establish a relationship via telemedicine. The medical board’s approved regulations outline a “proper physician-patient relationship” to include “a face-to-face examination using real time audio and visual telemedicine technology that provides information at least equal to such information as would have been obtained by an in-person examination. More
On the subject of telemedicine, companies offering the service are expanding their repertoire. American Well added psychiatry services to a subset of its behavioral health offering, with a larger rollout planned for the rest of the year. American Well has offered a behavioral health module to some of its customers since 2004, but is debuting some new features as well as the addition of psychiatrists, meaning many patients will be able to have mental health drugs prescribed over the platform. At first, not all medications will be prescribable over the platform because of laws that govern the prescription of controlled substances, like certain stimulants and antidepressants, via telemedicine. But the company has plans to work with community sites like urgent care or pharmacy clinics to provide those prescriptions when needed. That will be up and running by the end of the year. More
NYC-based asynchronous telemedicine service Sherpaa quietly opened its doors this week to direct-to-consumer business. Previously, text message and app access to Sherpaa doctors was available only via an employer. The service, which is free to use for employees, will cost $40 per month for individual customers. Customers can use Sherpaa’s app, the web, or a phone to communicate with doctors that work exclusively for Sherpaa 24-7. Using any of these platforms, users can get in touch with the doctors who can answer questions about a medical issue and send a prescription to a local pharmacy when appropriate. More
In a blend of telehealth and private practice, a new healthcare startup is taking two approaches to improving the patient experience – by launching a web platform and app that provides telemedicine, appointment scheduling, prescription refills and more, and also opening an actual brick and mortar private primary care practice. Carbon Health announced the launch of their app and opening of their clinic in San Francisco. The goal is to have a comprehensive platform for electronic health records and billing for small, independent practices that will ultimately create a giant network, all accessible via the app. “As crazy as it may sound, we are building a healthcare system from scratch,” said Eren Bali, cofounder of Carbon Health. “The important thing is, since you control your experience all the way from physician application to patient application to the integration with third parties, we are able to design an experience that would be impossible for the traditional health care providers." More
We also saw providers to vulnerable populations get an infusion of digital health technologies the pairing of a Medi-Cal (California’s Medicaid) community health network and a communication platform company. The product of an initiative from Health 2.0’s Technology for Healthy Communities, San Leandro-based Community Health Center Networkis partnering with San Francisco-based Welkin Health, which specializes in patient relationship management through messaging services and workflow organization. The partnership will work to develop a case management platform to leverage the success of CHCN’s Care Neighborhood Program, a comprehensive outreach program supporting the at-risk populations in the East Bay Area. More
Hospital systems are catching up to needs of their patients and equipping with digital tools, not just for management of their health but also using the system on a physical and administrative level, too. New York-Presbyterian health system announced the rollout of NYP OnDemand, a new set of digital health tools including telehealth services for both patients and providers available on the NYP website and via its mobile app. The offerings will rollout gradually over the next few months, and will include offerings for emergency services, digital follow-ups, second opinions and acute stroke care.The new set of tools builds on the health system’s app launch from the beginning of the year, at which time NYP told MobiHealthNews it would add video visits features soon. The new group of offerings, NYP OnDemand uses a mix of telemedicine and physician networks to deliver a variety of services. More
New York-based indoor mapping and navigation company Connexient announced the launch of its app with the National Institute of Health Clinical Center (NIHCC) in Bethesda, Maryland. The app, called Take Me There, uses Connexient’s existing MediNav digital wayfinder, providing indoor GPS to, through and around the facilities, and links up to existing apps to provide information about nearby locations. All of the NIHCC departments, clinics and 40,000 staff members are searchable in the app. Users are guided with a blue dot through the system, and can also plan out visits and meetings ahead of time with the website.More
St. Joseph’s Children’s Hospital in Tampa, Florida has a new tool for their young patients to deal with the stress and scariness of being in a hospital – UnMonsters, an app game released just for the hospital's pediatric patients. UnMonsters, developed in part by the hospital and interactive design firm Haneke Design, features four different types of monsters that patients must find and capture. Made specifically for St. Joseph’s, UnMonsters is a combination of distraction and exposure – the game is set in the hospital, with animated versions of places like the x-ray room, lab and waiting room. More
Kognito, the New York City-based patient engagement company that provides simulations with virtual humans, has partnered with the Robert Wood Johnson Foundation to launch a new series of conversation simulations aimed at getting people better at being, well, people, when it comes to talking about health. “We’re growing up in a world where we see technology really solving a lot of problems, but the benchmark of healthcare is the human touch,” Lois Drapin, senior vice president of Kognito’s New Health Markets told MobiHealthNews. “So we have this human intervention with an enabling technology that scales.” More
Providers are increasingly looking into ways to better engage their patients with their health. Cincinnati-based MedaCheck, which makes a medication reminder platform that can be used on a smartphone or tablet, recently finished a medication adherence study with the Cincinnati Children’s Hospital Medical Center, finding that the digital tool significantly improved medication use among adolescents. More
DeepMind, a UK-based subsidiary of Google, began a new research project with National Health Service specialist Moorfields Hospital to use artificial intelligence to detect and treat blindness-causing eye diseases. The project is DeepMind’s second collaboration with NHS, although earlier projects did not use AI. Using a million anonymous eye scans, the research partnership will investigate how machine learning could help analyze eye scans known as Optical Coherence Tomography (OCT) images, creating algorithms that can detect early warning signs of two particular eye diseases: wet age-related macular degeneration and diabetic retinopathy. The goal of the project is that eventually the AI will be able to recognize such conditions with just a digital scan. More
Proteus Digital Health is working with Children's Health in Dallas, Texas in one of the first trials of its ingestible sensor technology in pediatric patients. The trial involves patients recovering from an organ transplant, a group that typically needs to take a lot of medications on a fairly strict schedule. Fifteen patients are using the Proteus platform now and Children's Dallas ultimately intends to enroll 75. The Proteus digital medicine platform, called Proteus Discover, is a medication management and adherence system that includes measurement tools like sensor-enabled pills, a peel-and-stick biometric sensor patch worn on the body, and a companion tablet app. More
Payer
A number of health insurers made news during the quarter, showing that payers are engaging with some of the innovation in the digital health world. Even CMS made some big strides toward covering digital therapies. Read on for our roundup of Q3 payer news.
In July, The Centers for Medicare and Medicaid Services proposed rule changes that would expand the Diabetes Prevention Program effective January 1, 2018. In March, CMS certified that the expansion of the program, including digital versions of the program, would reduce net Medicare spending. These new rules changes, announced last week, are the next concrete steps CMS needs to take to make the DPP reimburseable.
CMS also announced the 14 regions and states that will participate in its new primary care model, Comprehensive Primary Care Plus (CPC+). The initiative, which was announced in April, is a multi-payer, five-year medical home model that will begin January 2017, enabling primary care practices to care for patients in the ways they deem best to improve care. The regions selected can apply to participate until September 15.
Aetna made perhaps the largest digital health announcement of the private payers. Beginning this fall, Aetna will combine Apple’s consumer tech offerings with its analytics-based wellness and care management programs by integrating several iOS-exclusive health initiatives. First off, the company will make the Apple Watch available to some of its large employers and individual members during open enrollment season, and will be subsidizing part of the cost. Aetna will also be providing, free of charge, Apple Watches to its own nearly 50,000 employees who will participate in the company’s wellness reimbursement program, demonstrating the gradual if not widespread shift of payers subsidizing consumer digital health offerings, such as video visits or even cell phones.
Humana, possibly soon to be an Aetna subsidiary, began to offer live, online mindfulness training programs to employers via wellness provider eMindful. The partnership will enable Humana to provide eMindful’s evidence-based mindfulness programs that aim to improve well-being for employees and reduce preventable risk factors that contribute to chronic health conditions.
At the end of the quarter, Cigna announced a significant upgrade to its telemedicine offerings. While the health insurer has been offering MDLive's service to members since 2013, they will now add AmWell, branded "AmWell for Cigna" both as a standard telehealth benefit for most of its employee health plans and many of its individual plans as well. In addition to expanding telehealth for its medical plans, Cigna is also remimbursing its contracted behavioral health care professionals for telehealth visits.
Several Blues made moves in digital health this quarter. Health engagement platform Sharecare formed a joint venture with Guidewell, parent company to several health plans including Florida Blue, Florida’s largest health insurer. The as-yet-unnamed JV will combine member data and expertise from Guidewell with Sharecare’s digital health tools to create an all-in-one app for health plans, starting with Florida Blue, to provide to members.
Additionally, New York health insurer Excellus BlueCross BlueShield partnered with Boston-based Wellframe to make Wellframe's mobile platform a part of its Health Care Improvement team and California residents under Anthem Blue Cross gained the ability to have video visits with a Spanish-speaking doctor for non-emergency needs through a partnership with LiveHealth Online, a telemedicine company that offers its service, Cuidado Medico, to both members and non-members of Anthem.
A few smaller moves from UnitedHealthcare this quarter: The company made some updates to its Health4Me app to help make wading through health services a little less like a chore and more like spending time on any other mobile app, and published data from a promising partnership with health coaching startup Vida.
Finally, Oscar, a relative newcomer in the payer space known for its tech saavy, pulled out of two markets. The firm will no longer offer individual market plans through the Affordable Care Act in Dallas-Fort Worth, Texas and in New Jersey beginning January 1, 2017.
Pharma
This was a big quarter for the diabetes connected device space, though that action came from the medical device sector as well as pharma. Other pharma news spanned different therapeutic areas including COPD, rheumatoid arthritis, and behavioral health. Read on for a roundup of some of the major news from the pharma and medical device spaces.
Medtronic came out with two pieces of news late in the quarter around its connected diabetes efforts: an FDA clearance for a hybrid closed loop insulin delivery system and the first test cohort of its Sugar.IQ app, created in collaboration with IBM Watson. The FDA approval of Medtronic’s MiniMed 670G hybrid closed looped system was announced by the FDA itself, as it’s the first automated insulin delivery system to get clearance by the agency.
Earlier in the quarter, Medtronic also launched its MiniMed 630G insulin pump. Ascensia Diabetes Care, a new business unit created this year when Panasonic Healthcare Holdings acquired Bayer Diabetes Care, announced the launch and FDA 510(k) clearance of its Contour Next Link blood glucose monitor, the only glucose monitor to connect to the 630G pump.
Abbott also made some steps forward on the regulatory side, getting FDA clearance to bring its more streamlined FreeStyle Libre Pro CGM system, which uses near-field communication to transmit data to a provider, to the US. In Europe, where both a prescription and an OTC version of FreeStyle Libre are already available, the company partnered with diabetes logging app company mySugr to let consumers read the sensor directly with the mySugr app.
Sanofi partnered with Google’s Verily to create a joint venture dedicated to diabetes called Onduo. The two companies together invested about $500 million in Onduo. The joint venture is based in Cambridge, Massachusetts and will combine a mix of devices, software, medicine and professional care to help people with diabetes manage their condition.
Insulet, maker of the OmniPod insulin pump, launched a new tablet app aimed at children in July. The app, called Toby's T1D Tale, is essentially a virtual story book intended for teaching young children with Type 1 diabetes about diabetes and how to manage it.
Johnson & Johnson subsidiary Animas’s insulin pump had some less sunny news: the company had to warn users about a hacking vulnerability in the wireless connection between the remote and the pump.
Animas wasn’t the only J&J subsidiary making news in the digital health world. The partnership announced in March between Johnson & Johnson subsidiary LifeScan and diabetes management company WellDoc entered a new stage with a commercial partnership agreement. Per the agreement, the companies will integrate WellDoc’s FDA-cleared BlueStar diabetes management platform and mobile application with LifeScan’s OneTouch Verio Flex smartphone-connected blood glucose monitoring system. The ultimate goal is to create a combined offering that is data-driven, comprehensive, and reimbursible by payers.
Ethicon, a medical device subsidiary of Johnson & Johnson, collaborated with healthcare technology platform developer Touch Surgery to offer professionals a simulated surgical training program in the form of a free mobile app.
Another clinical area that saw some action by pharma this quarter was COPD. Qualcomm Life and Boehringer Ingelheim announced that they would work together to develop the next generation of Boehringer's Respimat connected inhaler. Propeller Health, which developed the original connected inhaler for Boehringer, will continue to work with Boehringer to at least market the existing version of the device. And AstraZeneca began a clinical trial in collaboration with Quintiles looking at the impact of mobile medication reminders for people with chronic obstructive pulmonary disease (COPD).
AstraZeneca also expanded its Fit2Me program, which provides diet and lifestyle support for patients with diabetes, to also include patients with risks for cardiovascular disease. The program is also now available via an iOS and Android app, which has only been the case since the end of June.
GlaxoSmithKline, Pfizer, and Novartis all had some moves this quarter as well.
GSK also formed a joint venture with Verily, called Galvani Bioelectronics. Galvani, owned 55 percent by GSK and 45 percent by Verily (formerly known as Google Life Sciences) will have two research hubs, with one based north of London and one in South San Francisco. The venture will be led by Kris Famm, who was GSK’s vice president of bioelectronics R&D, and they will initially hire 30 scientists, engineers and clinicians. It will focus on implantable bioelectric medicines, a branch of medicine that works to fight diseases by targeting electrical signals in the body.
Other GSK news included the launch of the first pharma-backed ResearchKit app, to study rheumatoid arthritis, and a collaboration with The Weather Channel to create a flu forecasting app that would help the company market Theraflu.
Pfizer also did some work on rheumatoid arthritis, launching a clinical trial with Brigham and Women’s that would test an app in treating the disease. Later in the quarter, Pfizer launched a direct to consumer app called Moodivator aimed at combatting depression.
Finally, Novartis started looking into digital coaching as a tool for clinical trials. Joris Van Dam, a strategic projects leader in pharmaceutical development at Novartis, laid out some of the benefits at an event in Boston in September.
