SWORD Raises $163M for Virtual MSK Platform

Digital musculoskeletal (MSK) care provider SWORD Health raised a $189m Series D round, making the startup the latest digital health “unicorn” by lifting its valuation to $1.8b.

Based on SWORD’s fundraising pace, it’s safe to say the pandemic has been a boom for virtual MSK solutions. The company closed a $25m Series B in January, followed by an $85m Series C in June, and the recent funding pushed its outside capital total to over $324m.

SWORD offers a suite of personalized MSK solutions that includes:

  • ASK a PT – 24/7 remote access to physical therapists for general questions
  • Digital Guardian – Applies wearables and video monitors to guide safe workouts
  • The Academy – Customized educational content

The virtual-first approach is designed to reduce preventable surgeries for patients while driving value for risk-taking customers such as payors, employers, and health systems.

SWORD CEO Virgilio Bento founded the company in 2015 after seeing first-hand the “challenges that families face when they have to recover a loved one.” The WHO estimates that close to 2 billion people suffer from MSK conditions globally, creating a lot of room for multiple companies to emerge as leaders.

Digital MSK startups have attracted significant investor attention in recent months, with Hinge Health securing $600m to expand its online MSK platform, and Kaia Health raising $75m for its no-hardware-needed rehabilitation programs.

The Takeaway

SWORD prides itself on being “the industry’s only end-to-end digital MSK solution” (but then again, so does Hinge), and it will need to demonstrate that its hybrid approach offers a superior return on investment than competing strategies. If it can accomplish this, then the new funding should give it strong positioning within an MSK market that is quickly establishing itself as one of the top telehealth use cases.

DHW Q&A: The Future of Telehealth With BlueJeans

With Krish Ramakrishnan
BlueJeans by Verizon, Co-Founder and Chief of Innovation

Virtual health continues to be one of the most rapidly evolving landscapes in all of healthcare, with the second year of the pandemic bringing a new set of opportunities and challenges for patients and providers alike.

In this Digital Health Wire Q&A we sat down with the co-founder and chief of innovation at BlueJeans by Verizon, Krish Ramakrishnan, to discuss the changing role of telehealth and the areas where the technology offers the most potential going forward.

BlueJeans was early to the video software space, what led you to found the company?

It’s fair to say that the idea began over ten years ago when we started seeing video overtaking telephony as the future of communication. We saw cloud-based software as a way to democratize video communications back in 2010, allowing us to provide access to anybody, anywhere, at any time.

This was the principle reason behind founding the company and naming it BlueJeans. It’s a universal fabric. Anyone can use it and feel comfortable.

Can you tell us a little bit about BlueJeans and its value proposition?

BlueJeans is a collaboration platform. It enables users to have engaging and secure conversations remotely. Anything you would need from a collaboration platform you can find in BlueJeans: note taking, recording, messaging, and so forth.

The telehealth platform is built on the same BlueJeans architecture. It’s in the cloud, secure, and has all the same fundamentals – but it is purpose built for healthcare. 

What are some features of the telehealth platform that set it apart from a general meetings solution?

Videoconferencing was designed for general meetings, not telehealth specifically, so the original experience was not great in that situation. One of the issues was that you had to download an app. Another was that there was no concept of a virtual “waiting room.” 

When you go to a doctor’s office there’s a waiting room with a check-in and an intake form that allows you to share information and notify the medical staff. All of these things make the experience great, and none of these things are in a “meetings” product.

We saw this as an opportunity. After we eliminated the need to download an app and made sure everything was secure and HIPAA compliant, the next thing we did was build a virtual waiting room.

BlueJeans waiting rooms have all of the features I mentioned that make a good experience. They allow hospitals to customize the look and feel to make sure it’s how they want it, with the right patient education resources readily available.

After that, patients have access to interpreter services, closed captioning, and transcription, all integrated directly into the call.

What are some of the constraints currently holding back telehealth adoption?

One of the biggest constraints is that it’s a new experience, and I’ll give you an example: the introduction of ATM machines.

Banks introduced ATM machines to save time for tellers and provide access to withdrawals 24/7. Now fast forward to today, people rarely go to the bank. Nearly all of the banking that you want to do you can do remotely. This would have been inconceivable back then.

People did not trust ATM machines originally. They wanted to go into the bank and talk to a teller, and to see their withdrawals in person. There was more comfort in the old way of doing things. These days, you only go to the bank if you’re forced to go to the bank. The pendulum has swung the other way.

That’s the journey we’re on with telehealth. Some people will adapt quickly, but some will long for the brick-and-mortar visit. But over time, as technology improves, and more remote patient monitoring gets integrated into care, the need to go to the hospital will diminish. Similar to how the need to go to the bank diminished.

Everything is building towards a telehealth future, and it is going to be the norm, not the exception. 

BlueJeans was acquired by Verizon in 2020, can you share a little about the acquisition? 

We saw an opportunity by partnering with Verizon to make video permeate through more applications outside of meetings. Telehealth was one, education was another, but you need scale to make these use cases a reality.

Verizon brings something that no other partner does: the network. Video requires a network that’s high speed, high capacity, and low latency. With Verizon investing so much in 5G, we thought that a marriage between a video provider, BlueJeans, and a network provider, Verizon, would be a great combination that would enable a better experience.

5G also has certain characteristics that make it useful for telehealth and medical care more broadly. It enables very low latency between action and reaction, and also has very high bandwidth.

I’m really excited to see where this can have an impact in rural health. In these areas, access to expertise isn’t easily available. If we can provide both telehealth and a secure broadband connection, patients will be able to access not only generalists, but also specialists. 5G helps with scarcity, and will help level the playing field between the medical care available in urban areas and rural locations.

How do you see the telehealth space evolving over the next few years?

One area that I think is going to get a lot of attention is elder care and assisted living. The senior demographic is already very large, and is only going to continue growing. Telehealth is going to make it more convenient to provide quality healthcare to seniors, many of whom lack mobility or transportation. It will also help to keep them healthier, because if seniors have to visit a clinic in-person, then their chances of getting an infection are higher.

Our priority at BlueJeans and Verizon is to expand the reach of telehealth. Whether that’s to rural areas or senior communities, many people stand to benefit, and the technology is still in its early stages.

Five years from now, we won’t even call it telehealth, we’ll just call it a doctor’s appointment.

CHIME: Patient Engagement on the Rise in 2021

CHIME’s recently released 2021 Digital Health Most Wired Survey explores how the pandemic and regulatory changes have fueled a surge in adoption for patient engagement technology over the past year.

The survey of nearly 750 healthcare organizations offering acute, ambulatory, and long-term post-acute care (LTPAC) assesses the progress these providers are making on their digital transformations, offering insight into the adoption of several new technologies.

Patient Telehealth Use Stabilizes

  • Telehealth use has stabilized as a hybrid care option for most organizations
  • 77% reported that >10% of patients used telehealth in 2021 (up from 67% in 2020)
  • 26% reported that >25% of patients used telehealth in 2021 (down from 32% in 2020)

Patient Portals Expand Capabilities

  • 88% of ambulatory care organizations report that >25% of patients accessed their portal in the last year, vs. 83% for acute and 82% for LTPAC
  • Many portal capabilities are now considered standard, with test results and secure messaging all adopted by >90% of organizations
  • OpenNotes access saw the most dramatic growth, up to 89% adoption in 2021 (vs. 65% in 2020)

Mobile Apps Gain Functionality

  • Most common mobile app capabilities are text reminders (86%), EHR access (84%), prescription renewal (84%), and visit scheduling (80%)
  • Service pricing lists saw the most growth in 2021, up 22% in 2021 (50% adoption)
  • LTPAC organization apps have a wide feature gap, with text appointment reminders and wayfinding functionality each 18% less common than in acute and ambulatory care apps

The Takeaway

The rising adoption of new patient portal and mobile app features underscores the fact that most healthcare organizations have been fairly agile in their response to the pandemic, aiming to provide patients with greater transparency into their own care.

Telehealth’s continued climb in utilization is balanced by the fact that fewer providers are using it as their only way to offer care like during the pandemic, and instead viewing it as a core component of a modern patient experience.

CVS Shifts Store Strategy to Omnichannel Healthcare

Consumers’ growing preference for omnichannel services has put a lot of pressure on brick-and-mortar retailers to adjust to the times or risk losing business, a message that CVS has clearly received as it looks to move beyond its corner drugstore image.

CVS Health announced that it will close 900 stores over the next three years, equaling roughly 9% of the company’s US footprint. The closures are part of a broader strategy overhaul to focus more attention on digital growth while reimaging its stores as healthcare destinations.

The foundation of CVS’ future retail strategy involves three new store formats:

  • Sites dedicated to offering primary care services
  • HealthHUBs designed for everyday health and wellness needs
  • Traditional CVS Pharmacies with prescription services and personal care products 

The move into primary care is particularly interesting. CVS’ current Minute Clinics use RNs for services such as physicals or flu shots, while generating referrals for nearby primary care providers. Although it’s unclear whether CVS will staff physicians in its new formats, the move suggests it is attempting to keep these patients in its ecosystem.

Other synergies are possible with CVS’ payor arm Aetna, which already provides plans nudging members to visit MinuteClinics by charging lower copays. The local density of people with Aetna coverage will factor into the decision of which stores to close, and CVS hopes to capture the downstream benefits resulting from preventative screenings.

The Takeaway

At a time when digitally-native competitors like Amazon are flooding into the healthcare space, CVS is aiming to leverage its biggest advantage over these new entrants: its physical presence.

If CVS can successfully transition its stores into healthcare destinations, its scale would allow it to serve thousands of patients per day, expanding access to primary care while driving in-store volume of wellness products and long-term gains for Aetna members.

Ro Rumored to Be Acquiring Dadi

Direct-to-consumer health company Ro is rumored to be in talks to acquire at-home sperm storage startup Dadi, according to recent reporting from TechCrunch. 

Ro, which was valued at $5b when it raised a $500m Series D in March, is reportedly pursuing a $100m transaction for the men’s fertility startup, a healthy multiple for a seed-stage company (no pun intended) with $10m in total funding.

  • Dadi provides an at-home fertility test / sperm collection kit, designed to encourage men to become more aware of their reproductive health and contribute to family planning conversations. The company allows men to go from testing to sample storage without stepping foot in a clinic, an approach that could improve the patient experience for a stigmatized issue.
  • Ro has roots in male health, focusing on erectile dysfunction products that still account for half of the company’s revenue. The search for growth beyond its flagship product has led to three acquisitions over the past year, including Workpath (at-home health software), Kit (at-home diagnostic tools), and Modern Fertility (female fertility).
  • While the home-care theme is apparent in the Dadi rumors and Ro’s overall strategy, TechCrunch reports that the rapid pursuit of acquired revenue is leading Ro employees to feel like many of the moves “came out of nowhere” with little integration into the company’s broader business.

Industry Impact

For Ro to overcome its growing pains, it’s aiming to create a more cohesive at-home care platform through acquisitions aligned with that goal, making the Dadi rumors seem more probable than not.

Ro is one of the most valuable privately-owned health tech startups, a title many suspect will change to “publicly-owned health tech startup” through an IPO in the not-too-distant future.

It’s closest competitor, Hims & Hers, recently unveiled a new mobile app to serve as a unified hub for the brand’s telehealth offerings and treatments, and Ro’s fast-paced acquisitions are seemingly positioning the company to pursue a similar long-term care model as it prepares to go public.

Lightbeam Health Solutions Acquires CareSignal

There’s been a lot of talk in the digital health space about the potential of wearables to improve remote patient monitoring. However, with most companies focusing their attention on introducing new devices to the home, Lightbeam Health Solutions is setting itself apart by adding a “Deviceless RPM” service through the acquisition of CareSignal.

  • Lightbeam offers end-to-end population health solutions for payors and providers looking to manage risk. The company generates patient cohorts for over 42m lives to bring health data “into the light” and provides proactive insights that ensure patients receive the right care at the right time.
  • CareSignal’s Deviceless RPM service uses a combination of automated text messages and IVR calls to gather self-reported patient data for over 30 conditions, identifying actionable moments for care delivery while allowing value-based organizations to sustainably scale care teams without sacrificing engagement.
  • The acquisition makes sense for Lightbeam on many levels. Integrating scalable patient monitoring and engagement into the company’s core population health offering improves the cohort creation at the center of the service, while also allowing risk-bearing partners to manage chronic conditions in a cost-effective manner.

The Takeaway

The success of chronic condition management solutions involves not only the improvement of patient outcomes, but also the ability to demonstrate a meaningful return on investment within a reasonable time horizon.

Lightbeam is addressing both of these metrics by acquiring CareSignal, and doing so at a time when healthcare personnel bandwidth is in great need of relief.

Can Wearables Help Measure Patient Outcomes?

Researchers from the University of Edinburgh published a systematic review in Nature that aimed to determine the current evidence base and reporting quality for mobile digital health interventions (DHI) in the postoperative period following surgery.

Methodology – After screening 6,969 articles for patients undergoing surgeries where postoperative outcomes were measured using DHIs (defined as mobile technologies to improve health system efficiency and health outcomes), 44 studies were included in the final review.

Results – The review indicated that several types of mobile phone- or wearables-generated data can improve the assessment of postoperative recovery:

  • patient-reported outcome data (from validated self-report tools)
  • continuous activity data (from wearables)
  • combining remote assessment with active clinical prompts or patient advice

DHI Shortcomings – Studies included in the analysis demonstrated that DHIs may facilitate patient recovery following major operations and reduce inappropriate service use, although they also revealed issues with the current evidence base that should be addressed:

  • patients are rarely engaged in the development of DHIs
  • only one study was designed to engage patients in reviewing their own data
  • high levels of exclusion exist for patients without relevant mobile technology

Discussion

The increasing availability of high quality mobile technologies provides a new bridge between clinical services and patients’ homes, and while the authors of the study are optimistic about the technology, they stress the importance of improving reporting standards if its potential is to be fulfilled.

Going forward, the researchers suggest that studies of DHIs in postoperative settings seek to provide meaningful comparisons to non-DHI care in order to demonstrate clinical value, with particular attention paid to reporting quality so that equitable comparisons can be made to existing research.

AppliedVR Raises $36M for VR Pain Management

Virtual reality (VR) therapeutics developer AppliedVR raised a $36m Series B round ($71m total funding) to fuel growth as it awaits a decision from the FDA on its first de-novo submission for pain management.

  • AppliedVR combines VR-based cognitive-behavioral therapies with mindfulness exercises to help manage chronic pain, with patients reporting reductions in the daily life interference caused by their pain for up to several months after treatment.
  • EaseVRx is the company’s flagship product awaiting FDA approval, standing out as the first VR prescription therapeutic to receive breakthrough device designation for treatment-resistant fibromyalgia and chronic intractable lower back pain.
  • Research published in JMIR found that EaseVRx produced “clinically meaningful” improvement in pain outcomes, and AppliedVR is investing heavily in building evidence demonstrating its therapeutics as effective for patients, scalable for providers, and viable for reimbursement.
  • The latest funding will be used to prepare for EaseVRx’s full market launch after FDA approval, as well as to build out its product pipeline that includes RelieVRx (for acute postoperative pain) and AnxietyVRx (for generalized anxiety treatment).

Industry Impact

Although other startups such as XRHealth are pursuing the therapeutic VR space, none have AppliedVR’s established client roster (AppliedVR partners with over 200 health systems) or supporting body of research.

Following its Series B, AppliedVR has a lot of momentum in a chronic pain market estimated to negatively impact the economy to the tune of $635b annually. EaseVRx’s FDA approval would provide another tailwind to help the company be among the first to make VR pain management a reality.

Truveta Launches Deidentified Clinical Data Platform

Healthcare data analytics startup Truveta announced the launch of its deidentified clinical data platform designed to provide insights on rare medical conditions and COVID-19.

Truveta was formed earlier this year by 14 health systems with a mission of “saving lives with data.” The announcement revealed that it has raised $195m to develop its platform and expand its partner base.

  • The “Truveta Platform” promises real-time answers to public health questions by aggregating partners’ deidentified patient data and communicating it in an interactive dashboard. Data inputs include all EHR data, physician notes, images, and genomics, which can then be studied based on demographics, comorbidities, and vaccine manufacturers.
  • The addition of three new health system members (Ochsner Health, Saint Luke’s, UnityPoint) pushes Truveta’s total partner count to 20, representing over 16% of US patient care from clinical sites in 42 states.
  • Preliminary insights shared in the press release found that Moderna recipients experience the most adverse events and J&J recipients have the most hospitalizations. Truveta also found that people with high-risk conditions like cancer or HIV are no more likely than the general population to have a breakthrough case, which the authors believe could be a result of risk averse behaviors.

Industry Impact

Truveta is aiming to expand its member base as quickly as possible, taking the “moral imperative” route by calling for new health systems to join its platform to improve care during the pandemic.

Although Truveta states that its data is “licensed for ethical medical research, not to target advertising to patients or physicians,” the company isn’t registered as a charity, creating tension between its mission and the path to revenue.

That said, the Truveta Platform has the potential to have a positive impact on public health by making fresh insights available from existing data, and the new funding provides significant resources to find the balance between successful health and business outcomes.

Papa Raises $150M for “Family-on-Demand”

“Family-on-demand” platform Papa recently raised a $150m Series D round ($241m total funding) to extend the reach of its solution that provides companionship to older adults and other vulnerable populations. 

This funding pushes Papa into “unicorn” status with a $1.4b valuation, highlighting the continued investor enthusiasm for products that address social determinants of health such as loneliness and isolation. 

  • Papa connects seniors with “Papa Pals” to provide companionship or assistance with daily tasks such as transportation and housework, with the backend of the platform handling everything from logistics to compensation.
  • Standard visits last an average of three hours, enough time to not only drive someone to a grocery store or doctor’s office, but also enough to help them unload bags or keep them company in a waiting room.
  • Papa Pals are matched to requests through the Papa app and serve as a friendly middleground between an on-demand service worker, such as an Uber driver, and a traditional caregiver, which usually focus on functions such as mobility and hygiene.
  • Papa’s services are offered as a covered benefit through employers and health plans rather than as a direct-to-consumer offering. According to Papa, lonely people have been shown to use the hospital 60% more due to mental health and behavioral stressors.

The Takeaway

Against a backdrop of pandemic-related isolation, Papa is addressing the care gap for seniors who don’t require a full-time caregiver but still need companionship or assistance, and its climbing valuation shows that VCs see big potential for this type of care.

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-- The Digital Health Wire team