Hippocrates on medicine in 400 BC… and a16z on investing in Memora yesterday.

Digital Health Wire will return on Tuesday, February 22nd after a Monday hiatus for President’s Day. Enjoy the long weekend, and if you’ll miss having us in your inbox on Monday, consider forwarding this to your friends and colleagues to help them get up to speed on digital health news when we get back next week.

Patient Engagement

Memora Raises $40M to Simplify Care Delivery

Although sky-high private valuations made a slowdown in healthcare venture activity a popular prediction for 2022, it sure doesn’t feel like that’s the case six weeks into the new year. Care automation platform Memora Health recently raised a $40M growth round to help more health systems provide proactive care from any setting.

• Memora Health builds the technology infrastructure behind “learning health systems,” with an AI-enabled platform that automates complex care workflows and improves them over time by learning from the ongoing behavior of patients and providers.

• The platform includes SMS-based patient messaging, reminders, and scheduling to create continuous patient touchpoints that allow providers to collaboratively manage care journeys and monitor progress.

• Data from questionnaires and EHR integrations help triage concerns to appropriate care team members while providing patients with proactive communication about their conditions, ideally improving the efficiency of all parties involved.

• The funding will help Memora meet commercial demand and drive new partnerships with health systems beyond the organizations it already works with, which include Mayo Clinic, Edward Elmhurst Health, and Penn Medicine.

The Takeaway

Memora is solving one of the most pressing challenges facing health systems by automating components of the care journey and allowing time-constrained providers to practice at the top of their license. In doing so, the company is simultaneously pushing the transition from episodic to continuous and always-on care, which seems like a pretty solid combination of goals to build around in the current healthcare landscape.

Telehealth

Online CBT Improves Depression Symptoms

Amid a recent flurry of reports calling into question the effectiveness of virtual cognitive behavioral therapy, a new study published in JAMA Network Open found that computer-assisted CBT (CCBT) does in fact improve depressive symptoms in primary care patients.

• Methodology – The study included 175 adult primary care patients at the University of Louisville who had scored 10 or higher on the Patient Health Questionnaire-9 (27 point scale), indicating at least a moderate case of clinical depression. Nearly 62% of participants made less than $30k/year, while 74% did not graduate from college.

• Interventions – Participants were randomly assigned to CCBT or treatment-as-usual groups (TAU) for 12 weeks of active treatment, as well as 3- and 6-month follow ups. CCBT included 9 online CBT lessons and weekly 20-minute teletherapy visits, in addition to TAU, which included in-office treatment at the primary care practices. 

• Results – CCBT led to significantly greater improvement in PHQ-9 scores than TAU (mean difference: -2.5), with the positive results maintained at 3-month (-2.3) and 6-month follow-ups (-3.2). CCBT remission rates were more than double TAU at all time points.

Conclusions and Relevance

This study was particularly interesting because of the treatment’s sustained results and because its participants largely came from groups that are often underrepresented in CCBT research. Although the study had some limitations (treatment-as-usual as a control can’t compare CCBT to regular CBT), the results suggest that CCBT has the potential to be particularly valuable for patients in diverse primary care settings.

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

• VillageMD Acquires Healthy Interactions: Value-based care provider VillageMD announced plans to acquire Healthy Interactions as it looks to add services such as in-person group sessions and a digital engagement platform for patients managing chronic conditions. The news comes within months of Walgreens increasing its majority stake in VillageMD to 63% through a $5.2B investment that will now see Healthy Interaction’s programs delivered through all co-located Village Medical at Walgreens locations by the end of the year.

• Telehealth Use Down, But Still Up: A recent Kaiser Family Foundation analysis of data from 41M outpatient visits between March 2019 and August 2021 found that telehealth use has declined from 13% to 8% of all visits since the first 6 months of the pandemic, but remains well-elevated above its 1% pre-pandemic average. The authors stated that it isn’t clear if and where telehealth will continue to be useful in the future, but judging from the number of giant funding rounds we’re covering on a weekly basis it seems like investors don’t think this genie is going back in the bottle.

• Sweating the Small Stuff: A smartwatch developed at UCLA is able to accurately measure the stress hormone cortisol from the wearer’s sweat, which opens the door to identifying conditions such as depression and post-traumatic stress disorder with a wrist-worn device. Cortisol is well-suited for measurement through wearables because its concentration levels in sweat are “similar to its circulating levels,” and a smartwatch that can detect it could have major health benefits for patients if manufacturers can successfully commercialize the product.

• Timely Care: Telemedicine could increase timely access to primary care according to a new study published in Telemedicine and e-Health. The average number of days between scheduling and appointment for 2.2M primary care visits at an Oakland, CA Kaiser Permanente location was 1.8 for telephone visits, 2.3 for video visits, and 3.5 for in-person visits. The study indicates that audio-only calls offer the quickest route to a primary care visit, or at least that was the case between 2016 and 2018 when the patients in the data set received care.

• Ro Funding: Direct-to-consumer virtual care company Ro raised $150M in fresh capital from its existing investors, bringing its total funding to an even $1B. Since its last funding round in March 2021, Ro has quickly expanded beyond its roots in male health by launching Ro Mind (digital mental health clinic) and fertility care, services that it is now adding to thanks to the help from its new funding and the debut of Ro Derm (virtual skincare clinic).

• Longer PTSD Treatments: A new review of 70 studies from the RAND Corporation found that longer PTSD treatment is highly correlated to a beneficial response for veterans, increasing the likelihood that patients experience remission. The evidence suggests that certain patient characteristics such as depression and service-connected disability are associated with worse retention, but the authors are optimistic that identifying such patients at admission and focusing on efforts to retain them will lead to better outcomes.

• AndHealth Raises $57M: Help could be on the way for migraine-sufferers after AndHealth announced the completion of its $57M funding round, which will be used to launch its Virtual Center of Excellence for the reversal of migraines. AndHealth’s digital therapeutic will provide “root cause medical care” for migraines, a condition that is difficult to treat but is often comorbid, sharing root causes with other chronic conditions including diabetes that often prove to be more addressable.

• Worsening Cancer Outcomes: The American Association for Cancer Research estimates that 10M cancer screenings were missed during the first year of the pandemic, and their latest report confirmed worsening outcomes. There was an 11% increase in metastatic or inoperable cancer diagnoses between March and December 2020, compared to the same period in 2019. Delays in cancer screening appear to have led to even more late-stage cancer diagnoses than initially predicted, a situation that the AACR urges be carefully monitored as the pandemic draws on.

• Koneska Series C: Koneksa raised a $45M Series C round (total funding now $65M) to accelerate the expansion of its digital biomarker platform designed to collect patient data remotely and analyze it in real time. The platform uses data from wearables such as vital signs, gait, and sleep to help with clinical trials, delivering nearly instantaneous insights that could help bring therapies to patients faster.

• Data Accuracy Concerns: Health systems are concerned about patient data inaccuracies that have been negatively impacting care, according to a Sage Growth Partners and Verato survey of 100 health execs. Only 14% of respondents were satisfied with the level of accuracy that could be achieved with patient identity data, while 72% were worried that inaccurate patient data is negatively impacting their bottom line. According to Verato, integrating data from across siloed sources (EHRs, finance systems, workflow software) is the key to enabling greater data accuracy and reducing duplicate records.