Pandemic Lessons Led to Google Health Shakeup

The recent dismantling of Google Health following the departure of its chief, David Feinberg, MD, could easily have been interpreted as evidence that the company was retreating from healthcare.

To clear up any confusion, Google Chief Health Officer Karen DeSalvo, MD, spoke with Bloomberg about the search giant’s reorganization. She revealed that the changes reflect a shift in focus related to Google’s work during the pandemic, and that the company is in no way “retrenching on health.”

For Google, the pandemic was an unexpected crash course in health sector operations, expediting many of the lessons that could otherwise have taken years.

Dr. DeSalvo stated that the company’s work on services ranging from contact tracing to population mobility tracking played a large role in the decision to restructure its health unit.

  • Google’s old strategy revolved around consolidating the company’s wide ranging healthcare efforts, such as disease detection and clinical decision support, into a centralized product unit to be commercialized. Dr. Feinberg was hired in 2019 to lead the new division, Google Health, but his team members were disbanded into research and wearables units shortly after his departure.
  • Google’s new strategy is an effort to embed healthcare initiatives into its core products, such as Search and YouTube, rather than launching independent commercial services. This strategy is designed to have a wider influence on health by meeting consumers where they already are.

Industry Impact

With a majority of Google’s revenue coming from advertising, working with sensitive health data quickly attracts attention from regulators. One of Google Health’s early projects under Feinberg got particularly messy when a search tool created for the Ascension hospital network prompted a federal inquiry over data privacy concerns.

Although the Ascension search tool is still operational and secure, Dr. DeSalvo admits that the company must tread carefully when navigating the healthcare space, but believes that the reorganization will help to deliver superior medical care and human outcomes.

Invitae Acquires Ciitizen to Make Genomics Accessible

Genetic testing leader Invitae recently acquired consumer health tech company Ciitizen for $325m, split between $125m and approximately 7m shares of Invitae stock.

While a medical genetics business and a digital record compiler share few similarities at first glance, the strategy behind the deal comes into focus when looking at the driving themes behind each company.

  • Ciitizen is a patient-centric platform that enables users to organize their medical records in order to optimize their own care or contribute the data towards a different goal, such as rare disease research. CEO Anil Sethi founded Ciitizen in 2017 after having a difficult time accessing his sister’s health records while she was battling cancer. 
  • Invitae is on a mission to bring comprehensive genetic information to mainstream medicine. The company is attempting to aggregate global genetic test results into a single user-friendly service that makes the information accessible to anyone with patient consent.
  • Both companies share a common goal that might be better served by working together: data accessibility. Whether unstructured health records or disjointed genetic test results, each business is seeking to improve the utility of hard-to-reach data.

The Takeaway

As genomics transitions from a laboratory testing-based industry to an information industry, Invitae is aiming to develop a platform that allows patients to make use of their data. The acquisition of Ciitizen gives Invitae the ability to create a centralized hub for genomic and clinical information, a dynamic dataset with the potential to drive better research and health outcomes.

Amazon Care is Coming to a City Near You

Amazon is expanding its in-person medical care service to 20 cities by the end of next year, causing many digital primary care providers to begin wondering how much disruption is on the way.

  • What is Amazon Care? The service offers virtual primary care through an app, connecting users to physicians with messages and video in as little as 60 seconds. For in-person care, nurses are dispatched to patients’ homes for tests and treatment, as opposed to patients travelling to an office.

Amazon Care began as an employee-only health service for the company’s own workers, but recently opened up to other US-based employers.

In-person care was originally limited to Washington state, Washington DC, and Baltimore, but is now set to reach Philadelphia, Chicago, Dallas, and Boston in 2021 – at least according to “three people familiar with the plans” speaking to Business Insider.

  • Is Amazon Care coming to your city in 2022? Yes… as long as you live in Atlanta, Denver, Detroit, Houston, Indianapolis, Kansas City, Los Angeles, Miami, Minneapolis, Nashville, Tennessee, New York, Phoenix, Pittsburgh, San Francisco, San Jose, or St. Louis.

Although the expansion announcement might seem as innocuous as a young Jeffrey Bezos telling you he’s starting to sell books on the internet, Amazon’s success in industries ranging from e-commerce to cloud computing suggests that healthcare could be next.

The $3T US healthcare market is notoriously difficult to disrupt, and Amazon Care’s unique approach of sending clinicians to patient homes is an enormous logistical problem, but that might make the company behind 2-day free shipping the best one to solve it. 

Although Amazon’s recent healthcare ventures haven’t had an industry-altering impact, the company has a long history of experimenting, learning lessons from failures, and making a better product down the road. Amazon Care might be that product.

Lyra Expands Into New Mental Health Conditions

Mental health benefits provider Lyra Health recently announced a trio of new solutions designed to address complex conditions such as alcohol use disorder and suicidality.

Lyra is seeking to effectively support the employees often overlooked by traditional health plans, such as those with serious mental illnesses and substance use disorders.

The new offerings will launch in early 2022 and include:

  • Lyra Reset addresses problematic alcohol use through virtual therapy, group sessions, symptom assessments, peer support, and medication. Lyra Reset promotes a durable recovery by providing resources for the entire family.
  • Lyra Dialectical Behavior Therapy for Suicidality combines virtual therapy sessions with therapist-prescribed skill-building lessons to help patients decrease suicidal thoughts.
  • Lyra Concierge provides personalized support for children, adolescents, and adults who need help accessing specialized mental health support or rehabilitation facilities.

The Trend

Many new digital mental health companies are focusing primarily on patients suffering from depression and anxiety, a large market given the pandemic-fueled climb in mental health disorders. 

However, as these companies begin to mature (Lyra has raised $680m and is valued at $4.2b), many will expand into other serious conditions.

This trend has the potential to help patients find specialized care that fits their needs, while also supporting employers looking to maintain a healthy and productive workforce.

Blood Pressure Tracking Is Coming to the Apple Watch… Eventually

The Apple Watch is arguably the most successful consumer health product of all time, allowing users to track a wide range of biometric data while shipping over 33m units in 2020 alone.

That’s why when the Wall Street Journal recently reported that Apple is planning to include an on-wrist blood pressure monitor in an upcoming version of the watch, both consumers and healthcare providers took notice.

  • How It Works – Citing internal company documents, the WSJ revealed that Apple’s tool tracks blood pressure changes using pulse arrival times, which measure how long it takes for blood to reach the wrist after a heart beat.
  • Limitations – This approach would show users how their blood pressure is trending (picture your wrist vibrating to tell you that your blood pressure is spiking during an argument), but would not provide a baseline measure of systolic and diastolic blood pressure.
  • Competition – Samsung is taking a different approach with the Galaxy Watch, which is already equipped with an optical sensor that can detect changes in blood pressure but requires a traditional cuff to calibrate and lacks FDA approval.
  • Launch Date – Although the Apple Watch Series 7 is set to debut later this month, blood pressure tracking isn’t expected before 2022, due in part to the engineering challenge of making the feature compact enough to fit in an already-crowded watch.

The Takeaway

Rumors of new Apple Watch features circulate every year before the product’s refresh, but the latest leaks provide more insight than most into Apple’s strategy for measuring blood pressure.

Pulse arrival time tracking highlights the Apple Watch’s potential and limitations in healthcare, but with hypertension afflicting ~100m Americans, the feature has the chance to make a significant impact in the lives of patients.

The Proof is in the Patients, Trinity Health RPM

A recent article from HealthcareITNews explored the benefits of remote patient monitoring programs (RPM) by highlighting the success of Trinity Health’s recently deployed system.

In 2017, Trinity Health was feeling the weight of its scale, with a 16% readmission rate for its high-risk Medicare population across 94 hospitals in 24 states. The health system was beginning its transition to a value-based care model and seeking to improve patient outcomes and reduce costs by lowering its readmission rate to single digits.

To accomplish this, Trinity Health created a plan to avoid preventable hospitalizations through a dual-approach RPM program:

  • Home Care Connect – For skilled home care patients that require persistent attention, Home Care Connect utilized Vivify Health’s connected care platform to offer chronic-condition pathways and a home care kit that addresses diagnosis-specific needs. Patients were provided an LTE-equipped tablet and monitoring devices including a pulse oximeter and blood pressure cuff.
  • Virtual Care Center – Patients who did not meet skilled home care eligibility were given access to Trinity Health’s Virtual Care Center, which connects patients to remote care services through an online portal.

Results

Following the RPM program’s month-long pilot with 55 patients, only a single patient was readmitted to the hospital, giving Trinity Health the confidence to expand the program nationally. Over the next year, readmissions dropped from 16% to 6%, leading to not only lower costs, but also to an increase in CMS incentives.

Trinity Health attributes the success of its RPM program to its user-friendly interface and a strong educational component, driven by the tablet’s ability to provide voice instructions and answer condition-specific questions.

For the Home Care Connect program, the proof is in the patients, with compliance and satisfaction numbers remaining high at 85% and 96%, respectively.

K Health Acquires Trusst, Sets Sights on Mental Health

Digital primary care provider K Health announced its acquisition of text-based therapy app Trusst for an undisclosed sum, expanding its services into the rapidly growing online mental health arena.

  • Trusst offers a proprietary mobile platform that has the look and feel of regular text chats, adding a layer of familiarity to sensitive conversations with a therapist. To use the service, patients download the Trusst app and fill out a short questionnaire about their symptoms before being connected to a licensed therapist.
  • K Health provides a public symptom checker that funnels users into an AI-guided assessment of their health concerns, then allows them to connect to a physician via a telehealth call or explore treatment options through its paid service.

Both companies share a similarly lightweight digital-first approach to healthcare, providing services without the cumbersome overhead of many competitors, and expanding access to mental health professionals who would otherwise be prohibitively expensive or difficult to reach. K Health intends to fold Trusst’s services into its existing offerings, which include 24/7 access to primary care providers and prescriptions for as low as $12/month.

The Hottest Space in Digital Health

According to Rock Health’s H1 2021 digital health funding report, the virtual mental health space attracted over $1.5b during the first six months of the year, making it the leading clinical focus for new digital health capital. 

That definitely seemed true last week. The K Health acquisition took place one day before  Headspace and Ginger’s blockbuster merger, and the timing is far from a coincidence.

With so much investor attention on the space and a limited number of mental health service providers, companies are quickly staking claims through M&A activity, and K Health is betting that Trusst’s text-based therapy could be the answer to meeting the growing demand for accessible mental health services.

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