Category: Digital Health

Xealth Makes Digital Health Usable

Posted on by Jason Barry

The booming digital health sector has seen such rapid expansion that it is beginning to enter the next level of its industry life cycle: the stage where solutions have solutions.

Digital health integration platform Xealth recently closed $24m in Series B funding, bringing the Providence St. Joseph Health spinoff’s total funding to $52.6m.

Xealth aggregates and organizes digital health tools within the EHR, enabling not only easier reporting, but also centralized distribution, enrollment, and patient monitoring.

The Xealth platform has three interdependent modules:

  • Xealth Clinical Interface – Solutions are ordered, delivered, and tracked from within the EHR, with clinical decision support matching patients to relevant solutions.
  • Xealth Digital Command Center – Provides customized reporting of patient and provider engagement, which is aggregated to match demographics to solutions.
  • Xealth Integration Layer – Supports deployment of multiple solutions through a single integration with the EHR, allowing health systems to save IT resources by avoiding independent vendor integration.

The Takeaway

As health systems pursue innovation, they’re presented with an abundance of disjointed products with specialized use cases, creating the need for a platform that allows physicians to prescribe and monitor these solutions within a single cohesive workflow.

Xealth’s services are already available to over 100k physicians, and the company states that care teams are seeing improved patient engagement metrics as a result of measuring outcomes across a health system’s entire virtual solution ecosystem.

Aggregators that improve usability of existing solutions have emerged as success stories in other industries such as business collaboration software, and Xealth is looking to replicate this success within the digital health landscape.

Under the Radar Healthcare Disruptors

Posted on by Jason Barry

Digital health venture fund and advisory team Rock Health recently published an excellent blog post outlining what they call healthcare’s “middle children,” defined as large-but-not-huge companies that should be eyeing expansion into healthcare.

The authors argue that these middle children have distinct competitive advantages over the cohort of technology giants that have recently been pursuing the healthcare space, which include the likes of Amazon, Alphabet, and Apple.

  • Middle children with market capitalizations between $10b and $350b are large enough to make an impact in healthcare, but small enough to avoid the scrutiny of massive players. They are often consumer-facing, with business lines that could pivot towards a healthcare use case (picture Lululemon’s acquisition of Mirror).
  • Larger middle children have deep pockets and talents pools (Salesforce, Nike), with the capabilities to pursue large healthcare goals.
  • Smaller middle children have more specialized capabilities (Garmin, Airbnb), that could help with solving more focused problems.

Middle Children Advantages

  • Smaller healthcare goals are big enough for middle children to pursue for growth, whereas much larger companies need loftier projects to warrant market expansion.
  • Loyal customer bases can be activated by middle children to establish initial users while avoiding the regulatory attention quickly drawn by larger competitors.
  • Specialized assets from middle children, such as logistics expertise or data analytics, can provide a competitive edge in healthcare. 

Potential Middle Children Plays

  • Blizzard could passively monitor behavioral health conditions for children playing its games
  • Paypal could integrate Health Savings Accounts to help users manage healthcare spending
  • Hello Fresh could offer health insights and recommend food products for delivery

The Takeaway

Gaining share within the $3.5t US healthcare market is a powerful motivator for any company looking to pursue a strategy shift, but even consumer-favorite brands will need humility to navigate the complex and quickly evolving environment.

Although middle children don’t specialize in the sector, Rock Health makes a solid case that they might be some of the best-positioned companies for healthcare disruption, and I wouldn’t be surprised if we’re reading about some of the plays listed in this blog post in next year’s business news.

Pandemic Lessons Led to Google Health Shakeup

Posted on by Jason Barry

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

Posted on by Jason Barry

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

Posted on by Jason Barry

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.

Verily Aims to Build GPS for Patient Care

Posted on by Jason Barry

Mayo Clinic and Verily, Alphabet’s life science division, recently announced a two-year strategic partnership to develop a clinical decision support (CDS) tool that caters to a patient’s individual needs. 

Although physicians generally do not love their EHR flashing advice at them, the collaboration aims to sidestep the one-size-fits-all approach of traditional CDS tools with AI-generated recommendations relevant to the patient in the room.

  • The Partnership – Mayo Clinic will provide curated clinical content and deidentified health record data while Verily will apply advanced analytics and user-centered design to deliver insights within existing point-of-care workflows.
  • The Roadmap – The tool will initially focus on cardiovascular and cardiometabolic conditions at Mayo Clinic, but will use open standards to enable integration with multiple EHRs for possible expansion to other use cases for Verily’s health system partners.

The Takeaway

While announcing the partnership, medical director of Mayo Clinic’s Center for Digital Health Bradley Leibovich MD stated that he hopes the tool can be used as “a GPS for patient care.”

The companies cited the exponential growth in medical discovery and knowledge as making it  nearly impossible for caregivers to keep up with the latest advances in their fields, creating a need for a tool that offers clinical support. 

Verily and Mayo Clinic are betting that their combined expertise in clinical informatics and data science will be the solution to creating a patient-relevant CDS that clinicians actually want to use.

Apple Takes a Step Back From Healthcare

Posted on by Jason Barry

According to a new report from Business Insider, Apple is scaling back its internal HealthHabit app that let employees track their fitness, talk to clinicians, and manage hypertension. 

HealthHabit was one of Apple’s largest projects resulting from a partnership with AC Wellness, a primary care provider for employers and families. Unnamed sources at Apple stated that HealthHabit was intended for a consumer launch if successful internally, which… it apparently wasn’t.

Although the project was the focus of more than 50 employees, it struggled with user engagement, a problem all too familiar to those working on digital health products.

  • The Strategy – Apple’s healthcare ambitions are apparent in its products, with the company incorporating a medical-grade EKG in the Apple Watch and data-sharing for clinical trials through the iPhone Health app. HealthHabit’s roadmap likely resembled that of Amazon Care, which began as an employee-only primary care app before expanding nationwide earlier this year.
  • The Trend – Apple’s news follows just days after Alphabet reported that it was dismantling Google Health and reorganizing its healthcare projects to be closer to their team-specific specialties (e.g. Health-AI moves within AI group). Sometimes taking a step back is the best way to move forward, and Apple’s recent moves are far from the end of its healthcare strategy. 

The healthcare history books are filled with would-be disruptors who seemed to have everything they needed (excellent teams, funding, strong industry connections), but few if any have had the bottomless warchest of capital and talent commanded by Apple.

While the moat around healthcare is incredibly wide (entrenched tech/vendors, complex datasets, demanding users), the same could be said about the smartphone market circa 2008.

Despite this step back, if any industry needs a disruptor, it’s healthcare – and if any consumer brand is going to pull it off, it’s Apple.

The Mental Health Mega-Merger

Posted on by Jason Barry

At a time when mental health problems are rapidly escalating, Headspace and Ginger have a solution: mega-merger.

Meditation app Headspace is merging with teletherapy platform Ginger to create a combined company called Headspace Health. The agreement values the joint venture at $3b (10x this year’s expected revenue) and will give Headspace Health the ability to begin offering affordable mental health services to over 100 million people globally. 

  • Headspace – The company is best known as one of the first guided meditation apps and remains a leader in mindfulness training. Headspace has partnerships with many consumer-favorite brands such as Netflix and Spotify, giving many of those suffering from anxiety and depression their first exposure to accessible care.
  • Ginger – Ginger offers its members access to mobile-first mental healthcare, including behavioral health coaching and telehealth therapy. It has an on-demand, team-based care model, giving users 24/7 access to therapists.
  • Headspace Health – The newly formed company will blend Headspace’s 65m+ user base with Ginger’s evidence-based interventions, creating an easy way for patients to improve their well-being from a unified platform. Headspace Health will also have one of the world’s largest mental health data sets, which it will leverage to deliver highly personalized care.

Industry Impact

Headspace Health plays at the intersection of the mental health crisis and telemedicine, two areas that have been attracting significant investor attention. With so much capital flowing into the space, consolidation was soon to follow, and this merger could kick off a wave of similar deals involving other popular meditation apps such as Calm.

Competing acquisitions aren’t the only change foreshadowed by the merger. Headspace Health was originally the name of Headspace’s 2018 digital therapeutic product that failed to receive FDA approval, and it’s now easier to see how federal clearance, and reimbursement, could be on the horizon.

Optum Enters the Direct-to-Consumer Arena

Posted on by Jason Barry

Optum, a subsidiary of UnitedHealth, recently began selling prescription medications online directly to patients. The company also began offering telehealth services to provide prescriptions to treat depression, erectile dysfunction, and other common illnesses – directly challenging startups such as Ro and Hims that offer online access to drugs for many of the same ailments.

UnitedHealth is the most profitable US healthcare company, with net income totaling $15.8b in 2020, and Optum is its fastest growing business segment. The company has expanded far beyond its payer roots and now employs or contracts over 50k physicians.

Optum launched its online storefront in November 2020 before adding pharmacy and healthcare services in June. It’s recent redesign and cash payment options make it more friendly to digitally native consumers.

  • The Strategy – More Americans are paying directly for healthcare, and by offering cash services to either uninsured or budget-constrained patients, Optum is increasing access to healthcare.
  • The Real Strategy – Optum’s entrance into the direct-to-consumer world defends against rising competition from retail giants such as Amazon and Walmart, both of which have launched digital pharmacy options as membership incentives.

The Takeaway

UnitedHealth’s largest competitive advantage is its vertical integration. It operates the largest US commercial insurance provider, a substantial pharmacy benefits manager, and is one of the biggest employers of physicians in the country. It’s recent expansion deepens this integration, while keeping patient money in-house amid a sea of new competition.

Do Clinicians Have Faith in Health Tech’s Future?

Posted on by Jason Barry

Accenture’s Health Strategy senior manager Dr. Darryl Gibbings-Isaac took to the HIMSS21 stage to discuss clinicians’ trust in the future of healthcare technology. The keynote addressed the findings of a new Accenture survey that asked physicians a series of true or false questions relating to their trust in technology’s growing clinical role.

1. Clinicians’ digital health adoption will not revert to pre-pandemic levels.

  • 71% will continue to use digital tools to the same or greater extent
  • 61% would invest in digital health tools if it improves their bottom line
  • 76% believe that digital investments will increase in the next five years 
  • Verdict – True

2. Clinicians believe AI is a threat to their future prosperity. 

  • 80% are interested in AI for clinical uses
  • 76% believe AI is not a threat to their job security
  • 45% have received training or have upcoming training about AI and digital tools
  • Verdict – False

3. Clinicians see value in investing in AI and digital health.

  • 68% see digital health’s long-term impact as positive
  • 61% believe that the investment required for digital health tools is a barrier
  • 76% believe that digital health spending will increase in the next five years despite barriers
  • Verdict – True

4. Clinicians trust in the security of healthcare technology.

  • 76% are only somewhat confident in measures to protect patient data
  • 41% have security concerns over patient data that hinders adoption
  • 33% of those uninterested in AI-based solutions cite lack of trust
  • Verdict – False

The Takeaway

To answer Accenture’s original question of whether or not clinicians have trust in the future of healthcare technology, the response is a reserved “yes.” While clinicians believe digital health adoption is here to stay, more work is needed to ensure trust in its security – specifically work centered around improving the three T’s: tools, transparency, and training.

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