Month: October 2024

Oracle Announces AI-Powered EHR, QHIN

Posted on by Jason Barry

This week’s Oracle Health Summit in Nashville was a rodeo of announcements, and by this time next year it sounds like we could see both an entirely new AI-powered EHR and a freshly minted QHIN.

The biggest headline from the event was the unveiling of a next-generation EHR powered by AI, which will allow clinicians to use voice for conversational search and interactions.

  • The EHR is being developed from scratch rather than built on the Cerner Millennium architecture, which Oracle itself reported had a “crumbling infrastructure” that wasn’t a proper foundation for its roadmap.
  • The new platform will also embed Oracle’s AI agent and data analysis suite across all clinical workflows, while integrating with Oracle Health Command Center to provide better visibility into patient flow and staffing insights.

Not content with just a fancy new EHR, Oracle also announced that it’s pursuing a Qualified Health Information Network designation, making it the latest EHR to jump from CommonWell to the TEFCA bandwagon.

  • TEFCA sets technical requirements and exchange policies for clinical information sharing, and Oracle will now undergo robust technology and security testing before receiving its designation.
  • Oracle said that its guiding goal is to help streamline information exchange between payors and providers, simplify regulatory compliance, and help accelerate the adoption of VBC.

The news arrives as Oracle recorded its largest net hospital loss on record 2023. The only competitor to gain ground was long-time rival and current QHIN Epic, which welcomed Oracle’s QHIN application with a hilariously backhanded press release.

  • “Interoperability is a team sport, and Epic looks forward to Oracle Health getting off the sidelines and joining the game.” Fighting words for a company with information blocking lawsuits piling up.

The Takeaway

Regardless of how these moves play out, Oracle is undoubtedly taking some big shots that are refreshing to see. Only time will tell whether doctors who have spent years clicking through their EHR will be able to make the shift to voice, or if Oracle’s QHIN tech audit will go better than it’s VA roll out.

CopilotIQ and Biofourmis Merge to Build Single Pane Home Care

Posted on by Jason Barry

One of the biggest stories to come out of last week’s HLTH meetup was the surprise merger between Biofourmis and its under-the-radar remote care competitor CopilotIQ.

CopilotIQ launched a few short years ago in 2021 to provide remote patient monitoring for seniors managing chronic conditions through its High-Frequency Connected Care platform.

  • The platform combines clinical automation software with biomarker data, behavioral analytics, and nursing visits to better manage conditions like diabetes and hypertension.
  • The company has raised just $30M to-date, and was mostly operating in stealth as it grew its footprint to 11 states and “tens of thousands” of patients.

Biofourmis on the other hand is a Softbank-backed giant that reached unicorn status in 2022 as it closed its $300M Series D round, although we haven’t seen an update on that peak-pandemic valuation.

  • The focus for Biofourmis has centered on supporting health systems, payors, and pharma companies with in-home delivery of complex care using wearables, FDA-cleared algorithms, and a virtual specialty care ecosystem.
  • Its founder-CEO Kuldeep Rajput departed last year and recently transferred his shares to existing investors while launching a multimodal clinical AI startup called OutcomesAI.

The combined company will be helmed by CopilotIQ CEO David Koretz, who will oversee its transformation into an end-to-end home care solution across the full spectrum from pre-surgical optimization to acute, post-acute, and chronic care.

  • The announcement highlights the power of combining CopilotIQ’s consumer-facing business with Biofourmis’s enterprise customer expertise within a “single pane of glass” to view patients across the entire care continuum.
  • Tough to argue with the logic behind one integration, one security audit, simplified procurement, and a better user experience.

Outside of that, the only other info on the merger is that it’s an all-stock transaction that’ll see existing investors – including General Atlantic and Bessemer Venture Partners – pile in another $100M to attempt to bridge the gap to the public markets.

The Takeaway

At a time when valuations are quickly heading back to earth and exits are hard to come by, Biofourmis and CopilotIQ’s merger has all the tell-tale signs of an investor-driven union, and the smaller company’s CEO will now get a shot at proving platforms beat point solutions for in-home care.

HLTH 2024 Recap and Major Announcements

Posted on by Jason Barry

That’s a wrap on HLTH 2024, and the showfloor was every bit as electric as outside on the Vegas strip.

Over 12k attendees made the trip out to Sin City, and they all had the same two things on their minds: Busta Rhymes and artificial intelligence.

The blind excitement of 2022 and the hallucination trepidation of 2023 gave way to calculated strategies on using AI to deliver results for patients, platforms, and everyone in between.

It was also refreshing to see the good ol’ fashioned innovation happening outside of the Cirque du Chatbots, and we rounded up the biggest announcements from the exhibit hall to help keep them all straight:

  • Artera overhauled its Harmony platform with a string of new features and an AI agent dynamic duo for Staff (translation, predictive text for patient comms, message shortening, EHR-integrated conversation summaries) and Insights (no-show reports and engagement analysis).
  • Blue Shield of California partnered with Salesforce to streamline the prior authorization process by co-developing a tool that’ll allow physicians and patients to receive PA answers in near-real-time during visits. 
  • Caregility is doubling Lee Health’s virtual acute care infrastructure to nearly 1,000 patient rooms by building on its existing fleet of telehealth wall systems and carts with additional APS200 Duo dual-camera devices.
  • CHAI – The Coalition for Health AI – published its draft frameworks for certifying independent Health AI Assurance Labs and standardizing the output of these labs with CHAI Model Cards, which are pretty much a “nutrition label” for AI solutions.
  • CirrusMD is making physician-first, on-demand healthcare available to over 55k for-hire-vehicle drivers in New York State through a new collaboration with The Black Car Fund.
  • Clarify Health joined forces with Prealize Health to help payors and providers anticipate utilization trends and proactively allocate resources. The fresh faces in Clarify’s C-suite also send a pretty clear signal that it sees market consolidation on the horizon and wants in on the M&A action.
  • CopilotIQ merged with Biofourmis to create “the first end-to-end platform” for delivering in-home care from pre-surgery to acute, post-acute, and chronic condition management. Massive news that we’ll be circling back on next week.
  • GE HealthCare launched an AI Innovation Lab to accelerate progress across areas like clinical decision-making, cancer recurrence predictions, and model training for medical imaging.
  • Healthie and Zocdoc are now able to access and update each other’s calendars using all the latest availability and booking information.
  • HealthSnap unveiled its new Principal Care Management program that delivers disease-specific pathways to patients with complex chronic conditions, enabling providers to comply with CMS requirements for PCM through automated eligibility reporting, care coordination, and tailored treatment plans.
  • Luma debuted the next iteration of its Patient Success Platform with the introduction of its LLM-powered Spark solution, which unlocks new capabilities like automated fax processing and “patient-facing omnichannel concierge” (AKA conversational phone chat).
  • Oracle Health debuted an end-to-end payments solution that handles gateway routing, processing, and acquiring under a single agreement, as well as a separate medical claims processing product dubbed Oracle Health Clinical Data Exchange.
  • Solera Health shared key findings from its new report showing that strategically supplementing in-person care with a multi-condition virtual care network could lead to a 2.3%-3.1% reduction in total cost of care. It was great kicking off the show with Solera diving into the details.
  • Spring Health took the lid off its Specialty Care solution that provides rapid access to intensive treatment for acute behavioral needs, addressing the harsh fragmentation within the mental health system by supporting 50+ conditions through a single platform.
  • Suki is bringing its AI documentation capabilities to Zoom’s telehealth platform, marking the startup’s second partnership along the same vein after teaming up with Amwell earlier this year.
  • Upfront is now live on the athenahealth Marketplace, bringing its suite of patient engagement solutions within closer reach of more providers.
  • Withings Health Solutions announced the launch of the BPM Pro 2, the first cellular blood pressure monitor to collect patient-reported outcomes and empower remote care programs to scale. Easily one of the best demos we’ve ever seen.
  • Wolters Kluwer Health showcased the integration of UpToDate within Abridge’s ambient AI platform that allows draft clinical documentation to include direct links to the latest, evidence-based recommendations.

We had a blast catching up with everyone at HLTH, and want to give a warm welcome to all of our new readers we met at the show! Stay tuned for deeper dives into many of these in next week’s Digital Health Wire.

Oshi Lands $60M Series C for Virtual GI Care

Posted on by Jason Barry

Oshi Health just found 60 million reasons why becoming the first virtual gastrointestinal center of excellence in the U.S. was a great decision.

Since launching in 2020, Oshi has raised nearly $120M (half from its just-closed $60M Series C) to help the ~70M Americans suffering from GI conditions control their symptoms while decreasing their total cost of care.

  • It accomplishes this by supporting patients with a gastroenterologist-led care team of advanced practice providers, dietitians, behavioral health specialists, and care coordinators.
  • These multidisciplinary teams collaborate with local PCPs and GI clinics to treat conditions ranging from acid reflux to Crohn’s Disease, enabling a high-touch point approach that would be difficult to achieve without the extra bandwidth.

The fact that Oshi is already available in all 50 states and to 40M+ people as an in-network benefit is a testament to both the size of the market as well as its model, which differentiates itself with its deep behavioral health integration.

  • Many symptoms can be caused by the connection between the patient’s gut and brain, with trauma often marking the onset of new GI issues, and can be corrected through CBT or gut-directed hypnotherapy. Oshi has the research to back that up.

A study done in conjunction with a large national health plan found that Oshi generated $10,292 per patient in avoidable testing, procedures, and ED visits, with 92% of patients reporting symptom improvement within six months.

  • Publishing this data was instrumental to Oshi securing health plan coverage, which made it easier for the employers they work with to integrate that care into their benefits offerings, and in turn helped drive awareness among employees with access to the service.

Although payors and employers continue to shift away from specialty point solutions toward broader digital health platforms, the GI market is large enough to justify standalone companies like we see in cardiology or MSK.

The Takeaway

Oshi has quickly emerged as a leader in the virtual GI space, and it’s now armed with $60M to push its lead even further by expanding its payor coverage, provider group partnerships, and employer programs – not to mention a push into Medicare slated for 2025.

IT Leaders Are Ready For New Solutions

Posted on by Jason Barry

The future’s looking bright for digital health after the Peterson Health Technology Institute’s 2024 State of Digital Health Purchasing Survey found that decision-makers across the industry are ramping up their tech investments.

  • The headlining stat: 97% of employers, 86% of health systems, and 84% of health plans intend to maintain or increase digital health spending in the coming year.

Three quarters of purchasers have already grown their budget for new solutions, motivated primarily by consumer demand (83%) and improved outcomes (62%).

  • Cost advantages were cited as a top investment driver for 60% of health plans and 49% of health systems, versus just 34% of employers.
  • Across all three groups, 43% have acquired enough solutions to address 6+ conditions, and it was interesting to see how their clinical priorities varied.

Purchasers are more hawk-eyed than ever when it comes to their contracts and vetting processes.

  • 59% of contracts have a duration under two years, leaving a short window for solutions to demonstrate clinical improvements and illustrate their value.
  • When comparing vendors, a proven track record was usually the deciding factor, beating out both ROI and ease-of-use for every group.

Looking ahead to next year, value-based care is top of mind, with 100% of employers expressing interest in risk-based contracts for new solutions, as well as 60% of health plans and 50% of health systems. Other top goals include:

  • 72% of health plans are looking to reduce costs and improve member experience
  • 74% of employers are looking to improve productivity
  • 80% of health systems are looking to improve patient experience

The Takeaway

Health plans, employers, and health systems all seem to be embracing the transformative magic of digital health, and this report gave vendors a way stack their decks with data on the unique priorities of each group.

Maven Clinic, Suki, Glooko Start Q4 in Style

Posted on by Jason Barry

It isn’t every week we see digital health startups score a hat trick of massive funding rounds – let alone one that rakes in a combined $295M – but Maven Clinic, Suki, and Glooko clearly came to play.

Maven Clinic kicked off the action by closing $125M of Series F funding and vaulting its valuation to $1.7B. The women’s and family health startup also gave us a behind-the-scenes peek at its 10-year roadmap:

  • Fertility Benefits – Maven’s fertility benefits administration product has brought millions of lives under management since launching last year, and it’s leaning in on forming more clinic partnerships to create a seamless experience between Maven’s virtual care model, financial platform, and in-person treatments. 
  • VBC – The maternity program that serves as the bedrock of Maven’s platform is moving past “phase one” by using real-time data to engage members with a broader ecosystem of services, enabling Maven to take on full-risk and align incentives with outcomes.
  • Engagement – Soon-to-be-announced AI capabilities will bolster Maven’s engagement engine with more insights into fertility, maternity, and family building, as well as often-overlooked areas like return-to-work, parenting, and menopause.

Next up we saw ambient AI startup Suki land $70M of Series D financing on the heels of  adding over a dozen new health systems in the past few months.

  • The release highlighted an expanded partnership with MedStar Health that’ll make Suki Assistant available to thousands of clinicians across specialties including primary care, cardiology, and gastroenterology.
  • Suki also teased plans to expand beyond its existing Suki Assistant and Suki Platform offerings, although details were sparse on what that might entail.

Glooko rounded out last week’s top scorers with a $100M Series F round and the appointment of a new CEO to guide the digital diabetes developer through its next chapter.

  • Freshly appointed chief Mike Alvarez will accelerate the global expansion of Glooko’s solution suite that helps diabetics take control of their condition and equips care teams with a unified platform for managing devices, data, and engagement.

The Takeaway

Digital health startups are off to a hot start in Q4, and Maven Clinic, Suki, and Glooko are the ones cranking up the heat. All signs are pointing to more late-stage mega-rounds as companies look to shore up their balance sheets and bridge the gap to a quickly thawing IPO market, unless of course they’re already eager to diveright in.

Rock Health Q3 Update: Tapestry Weaving

Posted on by Jason Barry

Rock Health’s Q3 Digital Health Market Update showed that investors have found comfort strolling down a path of “focused funding,” with last quarter’s innovation story shifting from transaction volume to market positioning.

The U.S. digital health sector logged $2.4B in venture funding across 110 rounds in Q3 2024, bringing year-to-date funding to $8.2B. 

  • While Q3’s 110 rounds marked a slowdown from 136 in Q1 and 133 in Q2, average investment size held steady at $22M quarter-over-quarter, indicating that investors are honing their focus while continuing to make sharp plays.
  • The analysis also noted that investments are overlapping with partnerships, with companies keen to support startups they’ve already worked with in crowded spaces like healthcare AI – as seen with NVIDIA and Hippocratic AI.

The real narrative behind last quarter’s activity was what Rock Health referred to as “tapestry weaving,” or digital health players building up their offerings to compete with legacy leaders and market incumbents. The related graphic was easy on the eyes.

  • While Q3 mergers and acquisitions were also low at just 21 moves – versus a quarterly average of 37 last year – companies like Dario and Fabric are using M&A to integrate new capabilities and expand their footprint.
  • Like weaving a tapestry, both Dario’s addition of Twill and Fabric’s acquisition of TeamHealth VirtualCare stitched together different solutions to create a more robust platform and address a broader range of customer needs. 

Tapestry weaving isn’t exactly an easy hobby. It involves integrating different products, teams, and go-to-market strategies that all have a chance of backfiring along the way.

  • Big acquisitions help compete for big contracts, but they can also strain the acquirer’s balance sheet.
  • CVS is an easy example. In the last six years, CVS used $88B to add a major payor, a clinic operator, and a home-care provider to its flagship pharmacies. The entire company is now valued at less than the cost of those three moves ($83B current market cap).

The Takeaway

Although the raw count of digital health investments continues to drop off, activity volume isn’t the same as activity quality. The tapestry weaving trend is a reminder that the “true impact of digital health innovation is shaped in the details,” through its investment structures, targeted partnerships, and post-M&A playbooks.

Huma Acquires eConsult, Launches Huma Workspace for Health Systems

Posted on by Jason Barry

Huma isn’t wasting any time putting its $60M of Series D funding to work, acquiring digital triage and consultation platform eConsult less than a few months after closing the round.

The move aligns with Huma’s vision of becoming the “Shopify for Digital Health” by equipping provider orgs and pharma companies with modular platforms / software development kits for a wide range of use cases.

  • The Huma Cloud Platform is a no-code app builder that enables companies to spin up their own solutions using a combination of GenAI prompts and pre-built templates.
  • The platform includes a library of modules and device connectivity tools for any therapeutic area, APIs and integration capabilities, and a marketplace that creates a flywheel of new features from existing users.

eConsult’s intelligent triage platform adds an entrypoint to Huma’s ecosystem by guiding patients through a series of medical questions before determining an appropriate pathway.

  • From there, eConsult gives physicians a summary of any flags or considerations to review, then connects them to a “comprehensive array of digital health solutions” such as appointment booking, screening tools, or virtual consults.

Those capabilities strengthen the foundation of Huma Workspace for Health Systems, which was announced alongside the acquisition to provide seamless access to Huma’s library of pre-built modules and solution marketplace. Those support:

  • Check-in and Triage: Captures patient symptoms and clinical history to prioritize patients with immediate needs and optimize intake.
  • Communication Suite: Equips clinicians with tools to manage patients remotely, such as a full messaging suite, video, scheduling, and EHR integration.
  • Remote Patient Monitoring: Allows hospitals to quickly scale applications for diabetes, hypertension, CKD, and other conditions.
  • Proactive Engagement: Automates direct patient communication for screening, education, and engagement campaigns across entire populations.

Put it all together, and Huma is assembling the pieces to an end-to-end platform for delivering virtual care at scale, with over 3,000 hospitals and clinics already using it to power projects for nearly two million active users.

The Takeaway

End-to-end digital health platforms aren’t built in a day, and the acquisition of eConsult confirms that Huma isn’t afraid of using M&A to speed up the process. Huma is full-speed-ahead with adding new capabilities and growing its footprint, so it wouldn’t be surprising if more acquisitions were right around the corner.

2024 Trends Shaping the Health Economy

Posted on by Jason Barry

Trilliant Health just released its 2024 Trends Shaping the Health Economy Report, delivering a unique perspective on the healthcare market through the lens of supply and demand.

The fourth edition of the report builds on the core findings from the previous three:

  • 2021: Healthcare is a negative-sum game.
  • 2022: Every part of the health economy will be impacted by reduced yield.
  • 2023: The victors in healthcare’s negative-sum game will be those who deliver value.

This year’s 164 page analysis is organized into eight sections, each examining a significant macro trend and supported by a wide collection of data-driven stories:

  • 1) The healthcare system is disproportionately expensive. Despite spending nearly 2X more on healthcare than peer countries, utilization has remained largely unchanged, while increasing 7% in peer countries since 2000. U.S. outcomes are also far worse. (Page 11 Chart)
  • 2) Health status continues to decline. We’re seeing higher volumes of early onset cancers in patients under age 45 for breast (+6.6%), colon (+10.0%), and kidney (+2.1%) between 2018 and 2023. (Page 22 Chart)
  • 3) Government regulation is failing to produce value. This one’s a mixed bag. Regulating cigarettes decreased usage by 30%, but mandated reporting of quality measures hasn’t yielded enough improvement to offset the cost of reporting. (Page 46 Chart)
  • 4) The value of tech advancements is uncertain. Since 2018, multiple AI CPT codes have been introduced, but utilization remains infrequent and concentrated among cardiac conditions such as coronary artery disease and ECG cardiac dysfunction. (Page 77 Chart)
  • 5) Supply constraints are correlated with inadequate yield. The decrease in practicing physicians from 2019 to 2023 resulted in a -0.9% workforce reduction. Notably, 31.3% of physicians changed practice location over that time period. (Page 89 Chart)
  • 6) Forced consumerism has fostered fragmentation. Over 14% of patients with commercial coverage go out-of-network for behavioral health services, versus just 2% for physical care. (Page 111 Chart)
  • 7) Lower-cost care settings can offer better value. New treatment paradigms often start in the hospital but shift to new settings over time (due to new tools, reimbursement reform). How long will that continue? (Page 125 Chart)
  • 8) Employers are better equipped to demand value. Employers have historically been relatively passive in managing healthcare costs., but new transparency requirements compel them to change that. (Page 148 Chart)

The Takeaway

Trilliant’s report showcases the fact that the inputs of the U.S. healthcare system, as measured by cost, exceed the outputs, as measured by the actual value received by Americans. As Trilliant’s Head of Research Sanjula Jain puts it, “every stakeholder can – and must – deliver more value to their customers.”

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