Friday, November 20, 2015

Survey Shows Consumers Unlikely to Share Data with Tech Companies



The American public does not trust technology companies with personal health data, according to a survey from Rock Health, a venture capital firm focused on digital health. The survey, of 4,017 people, found that only 8 percent said they would share health data like medical records and lab results with “a technology company.” There was a huge gap between that figure and the number who said they would hand their health history over to a research institution (36 percent) or to their own doctor (86 percent). When asked whom they would share their DNA data with, the responses were similar.

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Friday, October 23, 2015

Female Unicorn Poop Gets Mixed Reviews From FDA



Elizabeth Holmes (photo above) and her startup Theranos are getting heavy heat from just about everybody, most crucially the FDA, which sprang a surprise inspection on the company. It is certainly worth checking out a great collection of articles on the Thernos controversy curated at ReDef.

Apparently there has been some misuse of “nanotainers” — possibly the douchiest thing ever invented by a woman — which are only supposed to be used for a Herpes test but seem to be used much more often. I was recently having lunch with two pathology industry executives and they were brutal in their assessment of the startup and its “joke” of a business model and while I couldn’t follow their gargon-laden conversation I was intrigued so I started doing some research.
The best commentary I have read so far on Theranos and the controversy surrounding its testing methods and materials is a piece Dan Munro of Forbes published on Medium emphatically titled Why I Believe My Theranos Blood Test Was Inaccurate and Useless. First of all, I found it weird that Munro would publish such a piece on Medium when it seems like it would get much greater attention under his Forbes by-line, but considering the inflammatory nature of the title perhaps it was prudent for Munro’s Forbes editor to hold off judgement and leave WSJ alone behind the 8-ball as Theranos fires back with full cannons blazing. But I digress…
In the piece Munro presents a brief and compelling vignette about his own personal user-experience at a Theranos clinic in Phoenix which he thoroughly reviewed in a post published on Forbes while simultaneously dissecting publicly available information from both Theranos and the FDA. Upon reflection Munro seems to be convinced he was hoodwinked, and while he appears to be basing his opinion on mostly speculation based on limited information, the questions he posed must be answered by the company or they will suffer irreparable harm to their reputation IMO.
Elizabeth Holmes has responded to her most vocal critics at the WSJ by attempting to shame the paper as “a tabloid”. It will be very difficult for the company to be so dismissive of Munro considering he is one of the best health care journalists and commentators who has actually written favorably of the company to date, concluding his piece in Forbes with the following assessment:
All in all ‒ the Theranos experience is well thought out as a retail experience and about as frictionless as possible…
I will hold off final judgement until I have a better understanding of the situation, but at first whiff it sure does smell to me like a huge load of female unicorn poop.
Meanwhile, 23andMe has been granted permission from the FDA to resume marketing limited version of its clinical risk reports suspended two years ago at the agencies request. The company was little phased by the temporary injunction, using it as an opportunity to shore up its scientific team and shift its business model to unlock the unknown value of its biobank and 1 million+ user-base.
The moniker chosen by CBS Morning News to place under 23andMe CEO Anne Wojocicki of “Most Daring CEO” (photo below) is apt as her pivot to focusing on drug development is logical, bold and not unthinkable to execute to some degree. However, they lack the phenotypic data to complement the very limited genotypic data they have accumulated, specifically the diagnoses and outcomes captured in electronic medical records. Without this information it is very difficult to determine what diseases one should be targeting based on purely genomic data.
It’s hard to imagine how one could possibly make investments in R&D while essentially flying blind and using data from subjects that is indecipherable without some deeper, complementary knowledge on what actually happened to each each individual longitudinally. I suspect the company’s strategy for filling the holes in the information will focus on attempting to replicate the EMR data using Q&A features on their website or via email surveys or something along these lines but does the use of unvalidated questionnaires designed by under-qualified 23andMe staff meet the standard of scientifically actionable phenotypic data?!? I think not…
In sorta related news, it was both saddening and slightly terrifying to learn from the new HBO documentary San Francisco 2.0 that the unicorn poop left in the wake of the Silicon Valley “tech bros” is systematically destroying the culture of San Francisco with its douchey stench. It is mind-boggling to think that the sudden appearance of unicorn poop on the sidewalk was all it took to cause property values and rent in the Bay area to get totally out of control. The film shows the tragic dichotomy of a city scrambling to cash in on the boom, renting 1400 sq/ft one bedroom houses for $10,000/month to 25 year-old Google and Facebook employees without the slightest consideration for the impact on longtime tenants who are basically left homeless, really city-less in a sense and with very little hope that the city they have loved still has a place for them.





Thursday, September 17, 2015

The DodoNA Project is collecting sushi-grade data and genomics from thousands of patients to unlock the mysteries of brain disease





The DodoNA Project  

“DodoNA” is a metaphor. The oldest oracle of ancient Greece was at Dodona. Priestesses would interpret the rustling of leaves of an oak tree to predict the future and to advise the correct actions to be taken. Just as at DodoNA, we can interpret subtle variations in DNA, the “tree of life”, to predict outcomes and to advise our patients the correct actions to be taken. Through DNA predictions, we will improve neurological health.  Specifically, we are developing medical informatics tools to capture standardized data via routine office visits that measure the progression and outcomes of patients with 11 well-defined neurological disorders (one per Neurology program; Parkinson’s, migraine, MS, restless legs syndrome, mild traumatic brain injury, stroke, epilepsy, Alzheimer’s, ALS, brain tumors, to be named). DodoNA is a clinical practice initiative (note writing and workflow efficiencies) and a quality initiative (Best Practices). It is also a research initiative. Namely, we will invite up to 1,000 subjects for each of the 11 disorders (11,000 subjects total) to provide via informed consent a blood sample for DNA extraction and storage, and permission to associate information in their blood with information in their medical records (for the purposes of developing molecular prognostics and therapeutics).
Principal Investigator: Demetrius M. Maraganore, MD
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Sunday, August 16, 2015

This Week in Links


The Dept. of Health and Human Services Idea Lab (HHS IDEA Lab) is seeking applicants for a new West Health Innovator in Residence which is a two year appointment focused on developing a strategy for addressing problems related to aging. See full job description here.

Outcome-Oriented Metrics and Goals Needed to Gauge DOD’s and VA’s Progress in Achieving Interoperability (GAO Report - pdf)

uBiome has started aggressively courting research partners with their new Clinical Consortium, which offers researchers at member institutions early access to clinical tests, speaking opportunities at conferences, opportunity to apply for grants to fund research projects, early access to publications from others in the consortium, as well as a network of microbiome-focused academics. (uBiome Blog)

Adam Wright and Dean Sittig attempt to articulate an EXTREME definition for EMR interoperability; EXtract, TRansmit, Exchange, Move, Embed. (JAMIA - pdf)

“We believe that the technical rules adopted today by the FCC, which would allow unlicensed devices to operate in relatively close geographic proximity on the same frequency as hospitals’ Wireless Medical Telemetry System (WMTS), is [sic] not in the best interest of patients.” Rick Pollack, Executive Vice President of the American Hospital Association, in a sloppy response to the FCC decision to allow unlicensed devices use dedicated health care spectrum.

Robi Sen of IBM outlines why we need smarter wearables if we expect to use them to generate medical-grade data. (IBM Research Blog)

DEALS

IBM gives Watson eyes with announcement of $1B acquisition of Merge Healthcare. (HIStalk)

Practice Fusion Founder Ryan Howard thinks the time is now for his freemium EMR to enter the public markets and has hired interim CEO Tom Langan from Symphony Health Solutions to lead his troops through the process. (WSJ Blogs)

The FDA has awarded DNANexus a contract to build its new precisionFDA platform for managing next generation sequencing data. (FDA Blog)

Google announced it will be reorganizing its corporate structure to separate its core search and advertising businesses from the so-called “moonshot” projects the company has become (arguably) preoccupied by in recent years to the detriment of their existing products. Larry Page will step down as CEO of Google to assume leadership of the new moonshot holding company called Alphabet.

Wednesday, February 4, 2015

Recapping 101 Digital Health Acquisitions in 2014

Below is a complete list of 2014 M&A activity in digital health. If there are deals missing from this list please add them in the comments with a source. 

1.1.14

(1) ISirona retires its name following its January 2014 acquisition by NantHealth. (Press Release)

1.3.14

(2) HealthcareData Solutions acquires StratCenter, a provider of healthcare provider data. (HDS Press Release)
(3) Stryker Corporation will acquire surgical sponge counting technology vendor Patient Safety Technologies, Inc. for $2.20 per share. The company's market cap is $85 million. (Press Release)

1.8.14

(4) PressGaney acquires On The Spot Systems, developer of a real-time data capture system for patient feedback, and launches Point of Care, a solution that allows providers to capture patient feedback via tablets and mobile devices. (Press Release)

1.10.14

(5) EndoHealth Solutions will sell its HealthTronics business to Altaris Capital Partners for total consideration of up to $130 million, including $85 million in cash upfront. HealthTronics is a provider of urological products and services, including the UroChart EHR and meridianEMR systems. (Press Release)

1.15.14

(6) Surgical Information Systems acquires ambulatory surgery EMR and management software vendor AmkaiSolutions. (Press Release)
(7) Online employee health shopping systems vendor HealthSparq acquires ClarusHealth Solutions, which offers a provider search function for consumers. HealthSparq's president is Scott Decker, formerly of NextGen and Healthvision. (HealthSparq Press Release)
(8) Post-acute care software provider Brightree acquires Strategic AR, a provider of private-pay billing and collection services. (Press Release)

1.17.14

(9) Streamline Health will acquire St. Louis-based patient scheduling and surgery systems vendor Unibased Systems Architecture. (MarketWatch)

1.22.14

(10) GE will acquire API Healthcare, a provider of healthcare workforce management software and analytics solutions. (HISTalk)
(11) Etransmedia Technology acquires Medigistics, a Columbus-OH based provider of RCM and AR management services for the healthcare industry (Press Release)
(12) Myriad Genetics will acquire Crescendo Bioscience for $245mm in cash. (Myriad Press Release)

2.5.14

(13) Streamline Health completes its acquisition of Unibased Systems Architecture. (WSJ Online)
(14) BlueStep Systems, a clinical platform provider for the long-term and post-acute care market, merges with  BridgeGate Health, a system integration provider. (GE Press Release)

2.7.14

(15) Bottomline Technologies will pay $8 million for Rationalwave Analytics, an early-stage predictive analytics company. (Press Release)

2.21.14

(16) UnitedHealth's Optum division acquires a majority stake in Audax Health, the developer of a consumer health management platform that was founded four years ago by the now 24-year-old Grant Verstandig. (Press Release)

(17) Healthwise and the Informed Medical Decisions Foundation announce their pending merger. (Press Release)

3.3.14

(18) TelusHealth acquires Med Access, a British Columbia-based vendor that claims its EMR is #1 in Canada with 4,000 users. (MarketWatch)

3.12.14

(19) CompuGroup Medical acquires three European HIT providers: lab software provider vision4health Laufenberg & Co and office-based physician software vendors Imagine Editions and Imagine Assistance. (Press Release)
(20) QuestDiagnostics completes its acquisition of Solstas Lab Partners Group and raises its full-year 2014 financial guidance. (Press Release)

3.19.14

(21) Varian Medical Systems will acquire the oncology team imaging collaboration software product of Atlanta-based Velocity Medical Solutions.

3.21.14

(22) Social health management vendor Welltok acquires wellness game developer Mindbloom. (MobiHealth News) Welltok has raised $48mm to change consumer patient behavior at the population scale.
(23) Defense contractor ManTech International will acquire 7Delta, which provides healthcare IT contracting to the VA, DoD, and HHS. ManTech wants a piece of the VA's Transformation Twenty-One Total Technology program, for which 7Delta has won more task orders than any other vendor.

3.25.14

(24) AirStrip acquires Sense4Baby assets from West Health (MobiHealth)

3.31.14

(25) Icon acquires US clinical trial designer Aptiv Solutions for $143.5 million. (Irish Times)

4.5.14

(26) 3DSystems will acquire Medical Modeling, the leading provider of individualized 3D printed anatomy for use in surgical simulation and planning. (Motley Fool)

4.7.14

(27) IQuum acquired by Roche Holding for $450MM. (Roche Press Release)
(28) Pharmacy benefits-management company Magellan Health Services Inc. said Tuesday it will pay as much as $370 million in cash and stock to acquire CDMI LLC, a clinical consulting company based in Newport. (Press Release)
(29) Perficient acquires BioPharm for $17.6mm. (STLToday)

4.17.14

(30) Pharma company Opko acquires smart inhaler startup for at least $10mm. (MobiHealth)
(31) Following weeks of speculation, Nuance has formally acquired mobile-focused image-sharing company Accelerad. (MobiHealth)
(32) Facebook acquires ProtoGeo, maker of activity tracking app Moves (MobiHealth)
(33) Intel confirms acquisition of health wearable company Basis Science at a value of between $100-150mm. (MobiHealth and TechCrunch)
(34) Radiology outsourcer Alliance HealthCare Services acquires the assets of OnPoint Medical Diagnostics, which offers a cloud-based scanner quality control system used by 81 hospitals, for $1 million in cash and two years of royalties. (WSJ Online)

4.23.14

(35) Kaufman Hall, a provider of financial consulting services and software for healthcare, acquires Axiom EPM, a provider of financial performance management software for healthcare and other industries. (Press Release)

4.24.14

(36) NexJ Systems acquires Liberate Ideas, developer of a point-of-care patient education solution. (MarketWatch)
(37) Heart Corporation expands its Hearst Health group and Zynx Health division with the acquisition of CareInSync, the developer of a mobile platform for provider-patient communications. (MobiHealth)
(38) TruvenHealth Analytics acquires Simpler Consulting, a provider of Lean enterprise transformation services to healthcare, government, and other commercial organizations.
(39) ZirMed acquires the payment processing, patient eligibility, and patient estimation business owned by TransEngen. (Source)
(40) GE Healthcare will acquire CHCA Computer Systems, the Canada-based developer of the Opera software application for OR management and analytics, of which GEHC Is a distributor.
(41) Practice software vendor edgeMED acquires revenue cycle management company Physician's Billing Alternative.

4.28.14

(42) TruvenHealth Analytics acquires Fortel Analytics' predictive healthcare fraud technology, which will be integrated into Truven's payment integrity solutions. (PE Hub)
(43) PressGaney acquires Dynamic Clinical Systems, a patient-reported outcomes services and solutions provider. (Press Release)
(44) Infor completes its acquisition of substantially all the assets of GRASP Systems International, a provider of automated patient acuity, workload management, patient assignment, and consulting services. (Press Release)
(45) Consumer engagement provider Accolade acquires konciergeMD, which offers a platform for care plan adherence. (Press Release)

4.30.14

(46) Etransmedia Technology acquires Medical Billing Solutions, expanding its geographic presence placing it in the top 10 large scale RCM services business. (Press Release)

5.5.14

(47) Huron Consulting Group closes its acquisition of Epic consulting firm Vonlay of Madison, WI. (Nasdaq)
(48) Covidien acquires BioHarness-maker Zephyr Technology. (MobiHealth)

5.6.14

(49) Weight Watchers confirms Wello acquisition, plans API-enabled fitness platform. (MobiHealth)
(50) Xerox will acquire ISG Holdings, which offers workers' compensation software systems under the StrataCare and Bunch CareSolutions brands, for $225 million. (IFA WebNews)

5.7.14

(51) Streamline Health will acquire the assets of cost and spend management solutions vendor CentraMed. (MarketWatch)
(52) GoogleVentures invests $130 million in oncology data platform vendor Flatiron Health, which will use some of the money to acquire oncology EMR vendor AltosSolutions. (Flatiron Health Press Release)

5.12.14

(53) TheAdvisory Board Company says in its earnings call that it paid $25 million to acquire HealthPost, a physician finder and appointment scheduling site that will be rolled into the company's Crimson analytics offerings that are used by 1,400 hospitals. HealthPost has seven employees, seven customers, $1 million in annual revenue, and is break-even on the P&L side.

5.13.14

(54) Pharma commercialization services vendor Quintiles will acquire consulting firm EncoreHealth Resources, hoping to use real-time EHR information to give drug companies outcomes data. Houston-based Encore has 250 consultants (Quintiles Press Release)
(55) Bankrate acquired Caring.com, a senior care resource for those seeking information and support as caregivers, for $54 million. Caring generates revenue primarily through referral fees from senior housing communities, as well as subscription and display revenue. (Press Release)

5.27.14

(56) Ebix acquires Healthcare Magic and its Ask A Doctor service with an online network of approximately 15,000 doctors and will incorporate the service in its large online library of medical education tools. (Press Release)

5.29.14

(57) CardioMEMS gets FDA clearance for implanted artery pressure sensor, St. Jude to acquire it. (MobiHealth)

6.2.14

(58) Net Health acquires The Rehab Documentation Company (ReDoc), leader in physical therapy electronic medical records. (Press Release)

6.3.14

(59) TrialScope acquires Deloitte Analytics LLC assets including its PharmaCM Business. (MarketWatch)

6.10.14

(60) T-System sells its ED billing business to Intermedix, saying it will focus on its clinical and coding initiatives that will continue to be offered under the RevCycle+ brand. (Press Release)

6.12.14

(61) Mediware acquires Harmony Information Systems, whose systems help state and local agencies track long-term care policies. (MarketWatch)

6.13.14

(62) Elsevier acquires Amirsys, which offers clinical decision support and learning tools for radiology, pathology, and anatomy that will be integrated with the Elsevier Clinical Solutions suite. (Online WSJ)

6.17.14

(63) BioClinica, a provider of eClinical solutions for the pharmaceutical industry, acquired Blueprint Clinical, a company offering risk-based monitoring technology for clinical trials. The acquisition adds Compass, a cloud-based scoring tool to the BioClinica eClinical platform. (BioClinica Press Release)

6.18.14

(64) Cost management systems vendor Equian, which changed its name from Health Systems International a few weeks ago, completes its acquisition of AfterMath Claim Science, which offers data mining cost analysis solutions to payors. 
(65) Consulting firm VeritechIT acquires Health Technology Solutions, a one-employee consulting firm run by Terry Grogan, acting CTO for Temple University Hospital (PA). It appears from VeritechIT’s bio page that Michael Feld — listed as founder, president, and CEO – is also acting CTO of Lancaster General Health System (PA).
(66) Medical device maker Medtronic acquires competitor Covidien for $42.9 billion in cash and stock, giving Medtronic a convenient excuse to move its headquarters out of US tax jurisdiction to Ireland even though the company’s name will continue as Medtronic and its “operational headquarters” will remain in Minneapolis. 

6.25.14

(67) Emdeon will acquire Capario for $115 million in cash from its private equity owner Marlin Equity Partners, with Emdeon announcing plans to incorporate the CaparioOne revenue cycle management product into its Intelligent Health Network.
(68) KPMG acquires Cincinnati-based Zanett Commercial Solutions, an Oracle partner and health IT consulting firm.
(69) IMSHealth will acquire some product lines of Cegedim, which sell life sciences marketing solutions, for $520 million in cash. Cegedim’s Pulse Systems products for medical practices (PM/EHR, RCM, patient portal, patient kiosk) weren’t mentioned as being part of the deal.
(70) Quintiles completes the acquisition of Encore Health Resources (MedCity News)

7.8.14

(71) Mobile health startup Validic has acquired Silicon Valley-based competitor Infometers in a deal that expands the sensor data aggregation company's ecosystem by 44 percent and gives them a presence outside of their Research Triangle home. 

7.14.14

7.30.14

(74) 3D Systems acquires Simbionix Surgical Simulation for $120mm in cash. (3DPrint.com)

8.5.14

(75) Cerner has announced $1.3 Billion acquisition of Seimen's health care services business, making it the undisputed largest Health IT company in the world in terms of workforce (and possibly total revenue as well). (Cerner Press Release

8.6.14

(77) Practice Fusion has acquired after-hours house call startup Ringadoc. (MobiHealth News & Practice Fusion Press Release)
(78) Clinical surveillance software developer Theradoc was acquired by Premier for $117mm in cash. (Premier Press Release)
(79) WedMD acquires TheraSim. (MobiHealth News

9.17.14

(80) Viverae acquires mobile-enabled, behavioral health startup OneHealth. (MobiHealth News)

9.22.14

(81) MedAssets completes acquisition of Sg2 for $142mm. (Press Release)

9.23.14

(82) HCA, the largest hospital system in the US, announced it will acquire PatientKeeper, developer of mobile apps for physicians that merge data from multiple systems inside one institution. (Healthcare IT News)

10.2.14

(83) Nextech will acquire MDIntelleSys, maker of cloud-based EHR software for Eye Care. (Press Release)

10.9.14

(84) Box will acquire medical image sharing startup MedXT to boost the growing cloud-services company's healthcare offering in the run-up to their IPO. (MedCity News)
(85) NetPulse acquires Club Apps for an undisclosed sum. (MobiHealth News)

10.28.14

(86) Vitals has acquired price transparency service Compass Health Advisors. (MobiHealth News

11.3.14

(87) PDR Network has merged with LDM Group, provider of medication adherence and behavioral health information solutions. (Press Release
(88) Aetna has acquired Chicago-based maker of insurance exchange software bswift for $400mm. (MobiHealth News)

11.4.14

(89) Physical Therapy EHR provider WebPT acquires WebOutcomes, which has developed a web-based outcomes tracking tool for physical therapy patients. (Press Release)
(90) Truven Health Analytics has bought JWA Consulting. (Press Release)

11.20.14

(91) ShareCare will acquire Quality Health and its 50 million members. (MobiHealth News)

11.21.14

(92) Emdeon will acquire Change Healthcare in a deal valuing the Nashville-based startup at nearly $185mm. (MobiHealth News

12.9.14

(93) Welch Allen has completed the purchase of remote patient monitoring startup HealthInterlink. 

12.5.14

(94) ALPHAEON has acquired 3D imaging startup Claron Medical Technologies for $55mm. (Press Release

12.10.14

(95) Happtique has been snapped up by Las Vegas-based Social Wellth. (MedCity News)

12.11.14

(96) Meridian Medical Management acquires Origin Healthcare Solutions. (Press Release)

12.15.14

(97) Neos Technologies has acquired AFrame Digital, one of the original smartwatch companies with a medical-grade quantified self device which has largely been distributed through licensing deals with third parties such as Sprint. (Press Release)

12.22.14

(98) HTC Global Services has acquired CareTech Solutions, which develops health IT and web products for health systems. (MedCity News

12.24.14

(99) AMN Healthcare Services acquires Avantas in a deal for $16.5mm cash and a potential for $8.5mm in additional earn-out based on future performance. (MedCity News)

12.31.14

(100) In the final deal of 2014 Modernizing Medicine snaps up Aesyntix Health for an undisclosed sum. (MedCity News

RECENTLY ADDED

2.11.14

(101) MyFitnessPal acquires Rock Health portfolio company Sessions for an undisclosed sum, (HISTalk)