Bill Hudenko, PhD, Global Head of Mental Health at K Health

Telehealth

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.

Remote Care

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.

Nuance’s Patient Engagement Must-Haves

Consumer demands are shifting, and they’re looking to get more out of their digital health technology. Nuance outlines the 5 must-haves for your patient engagement strategy here.

The Wire

• FDA Approved Gaming: Behavior change technology was recently featured on NPR’s 15m weekly listener Morning Edition segment, which discussed the FDA’s approval of the first prescription video game, EndeavorRX. The game, which costs $100/month, is designed to help treat ADHD in children ages 8-12 when prescribed alongside traditional medications. It requires players to navigate a character through courses while managing multiple tasks simultaneously, which sounds strikingly similar to many games targeting this age group, and its prescription status could create financial incentive for traditional developers to begin seeking FDA approval for future releases.

• WHOOP: Human performance optimization company WHOOP recently raised $200m in Series F funding ($400m total funding), bringing its valuation to $3.6b and making it the most valuable standalone wearables company. Unlike smartwatch market leaders Apple and Fitbit, Whoop provides its fitness tracker for “free” when users sign up for its $30 monthly membership, which grants access to advanced performance metrics such as heart rate variability and sleep staging, a healthy reminder that new strategies are still disrupting mature consumer tech markets.

• Skin Cancer App: A new study from the Heidelberg German Cancer Research Center investigated whether user groups below the age of 35 were willing to adopt AI-based skin cancer screening apps, as well as preferences and concerns related to the technology. A survey of 728 participants found that a majority were “positive-minded” (n=484) but preferred the apps to act mainly as an assistance system, while the “negative-minded” group (n=244) was concerned about security and privacy. Although younger digitally native populations seem willing to accept diagnostic apps, transparency and explainability of AI-based tools will likely be critical for translation to clinical practice.

• Auto-Refills: A recent editorial in JAMA Internal Medicine cast a spotlight on a problematic drawback related to the growing number of prescriptions filled automatically when entered into a patient’s EHR: many online prescription platforms lack cancellation functionality. The article tells the story of a 69-year-old seizure patient that was hospitalized after continuing to take a medication cancelled by her doctor 6 months prior, due to the fact that her pharmacy kept refilling it. Although tools exist to cancel these types of prescriptions, the authors point to financial disincentives as a possible reason for their under utilization.

• Pediatric Telehealth: The HSS awarded $10.7 million to the Pediatric Mental Healthcare Access Program to promote behavioral health integration with pediatric primary care through telehealth, broadening the service to over 40 states. The program provides training and technical assistance to care teams treating children with mental health conditions such as anxiety or ADHD, addressing the widening supply-and-demand gap for behavioral health services widened by the pandemic.

• Revenue Declines: Alvarez & Marsal’s (A&M) latest Barometer of the Post-COVID Healthcare Economy report revealed that the 25 largest nonprofit health systems saw net patient revenue drop 21% from Q4 2019 to Q2 2021. Postponed visits from virus-weary patients and climbing operating expenses led to predominantly negative margins in the first half of last year before being partially offset by the CARES Act. Over the same period, discharges decreased 18%, surgeries fell 36%, and emergency room visits declined 31%. These sharp declines are likely to prompt health systems to take action “to either ‘bring back’ or offset these deflated volumes.”

• Voice Vitals: Ellipsis Health raised a $26m Series A funding round ($31m total funding) to further develop its “voice vital sign” technology, which uses vocal biomarkers (tone / timing) to quantify and manage mental health conditions. Ellipsis Health’s software integrates with mobile apps or telehealth platforms to enable a scalable, low-cost solution aimed at early diagnosis of anxiety and depression through clinicians’ existing workflows.

• Quality Over Quantity: A new survey of 1k US healthcare consumers from PointClickCare found that 62% of respondents had never heard of value‐based care, yet 59% said they would support a healthcare system where providers are paid based on quality of work over quantity. This disconnect goes beyond terminology, with many patients unaware that value-based care is already an option. Although the model aligns incentives by encouraging providers to deliver preventive care while in theory lowering long-term costs, the information gap and third-party payer models limit consumer-like patient behavior of seeking quality care at a reasonable price.

• Medicaid Ubers: Uber recently announced that over 4 million Texas Medicaid recipients now have access to transportation to and from medical appointments through the Uber Health platform. The news comes after a sharp increase in Medicaid enrollment during the pandemic prompted legislators to begin allowing the use of ridesharing solutions for Medicare recipients in order to reduce barriers to care while reducing costs for the state government.

• Stanford’s AI Recommendations: Stanford AI leaders detailed the policy barriers that must be overcome in order for imaging AI to achieve its potential, encouraging policymakers to work with medical societies to develop stronger regulatory processes and standards. The paper suggested addressing regulatory gaps by: 1) Making sure algorithms are distinguished from their diagnostic tasks; 2) Defining algorithmic performance beyond accuracy (e.g. transparency, and auditability); 3) Expanding the AI evaluation process; and 4) Encouraging independent 3rd party testing.

• Genomic Insights: Foundation Medicine recently announced a new partnership that enables clinicians to access genomic profiling and other testing services directly through Epic’s EHR. The new integration streamlines clinical decision making at oncology practices by reducing time spent on data entry, with the goal of providing better outcomes to cancer patients by offering better visibility of the genomic insights that many oncologists already have access to.