Buoy Health CEO Andrew Le, MD, on a recent episode of the Big Unlock podcast.

Telehealth

Teladoc and Amazon Partner on Echo Voice Visits

Yesterday’s competitors are today’s collaborators, with Teladoc and Amazon inking a new partnership to bring voice-activated virtual visits to Alexa-equipped Echo devices.

• “Alexa, I want to talk to a doctor” will now connect Echo users to a Teladoc call center to verify a patient’s medical history and health plan information ($0 if covered, or $75 direct-to-consumer). Within roughly 15 minutes, the patient will then get a call back from a Teladoc physician to treat mild needs such as colds, flus, or allergies.

• The new service will initially be available in an audio-only format for supported devices such as the Echo Dot and Echo Show, but will add video functionality “soon” to make it easier to diagnose certain conditions.

• The partnership greatly expands Teladoc’s consumer reach as part of its ongoing strategy to meet patients where they are. Amazon reports over 40M Alexa users in the US alone, and has delivered more than 200M Alexa-equipped devices globally.

• This is the latest in a string of health-focused improvements to Amazon’s Alexa ecosystem, which have included capabilities for elder care coordination through Alexa Together, as well as medication management through the Care Hub… and those are happening outside of even bigger moves with Amazon Care.

Industry Impact

Despite the recent launch of Amazon’s own Amazon Care telehealth service, Teladoc’s virtual physician network is significantly larger, and this scale will be absolutely essential to keep up with what could be an insanely high call volume for the new service.

The Teladoc partnership marks Amazon’s first attempt at providing truly on-demand healthcare with Alexa devices, and if well executed, could go a long way towards breaking down barriers to care for many patients. Even though Amazon and Teladoc are now competing in the same arena, the collaboration shows that coordinated efforts are still on the table when there’s a clear benefit for both patients and the companies.

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

• Cancer Disparities: Recent analysis from Komodo Health and BLKHLTH highlighted the extent of racial disparities in colorectal cancer (CRC) care, as well as the exact moments where care journeys deviated for different groups. Among patients newly diagnosed with CRC, 20.9% of Black patients were diagnosed after their cancer had already metastasized (vs. 18.6% of White patients), while Black patients had to wait an average of eight days longer for treatment following initial diagnosis. The full report also indicates that more late-stage diagnoses could be on the horizon, with CRC diagnoses for all patients lagging 7% to 27% behind prepandemic averages due to delayed screenings.

• Ro Acquires Dadi: Direct-to-consumer healthcare company Ro is acquiring sperm storage startup Dadi, confirming the acquisition rumors originally reported last November. Dadi provides an at-home fertility test / collection kit that 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. The acquisition is Ro’s fourth in just over a year as it looks to move beyond its roots in men’s health by acquiring companies to create a more cohesive at-home care platform, including Workpath (at-home health software), Kit (at-home diagnostic tools), and Modern Fertility (female fertility).

• Risk Factors in EHRs: New research published in JAMIA documented hospitalization risk factors available in the EHR that home healthcare clinicians (HHC) associate with patient deterioration. Across the 79 total identified risk factors, 15 surveyed HHCs most frequently cited environmental factors such as lack of caregiver support (73.3%) and no primary care provider (73.3%), as well as physiological factors such as delayed incisional healing (60%). These results could support the development of a patient deterioration warning system by providing a comprehensive list of risk factors mapped to standardized terminologies.

• Story Health Series A: It’s been a good year for Story Health. Shortly after launching with $4M in seed funding, the virtual specialty care startup secured $22.6M in Series A funding to expand its cardiology telehealth services that use AI and connected devices to help treat patients at home. Story Health has spent the last year focusing on patients with heart failure, and will use the new round of funding to expand into other areas of cardiology by using its remote monitoring platform to give specialists “unprecedented scale” to treat more patients.

• The Nurse Shortage Caveat: The number of licensed RNs in Massachusetts is up 24% from June 2019, leaving Boston-based public radio station WBUR to question why so many hospitals have job vacancies. In an interview with the president of the Massachusetts Nurses Association, Katie Murphy, RN, WBUR found that the issue doesn’t come down to an actual shortage of nurses, but a shortage of nurses “willing to work under these conditions.” An RN on the show recently left the field after 25 years to pursue her dream of opening a cafe where she can look people in the eye to “ask about their lives and offer comfort,” things she loved in her past life as a nurse.

• Different ZIP Codes, Different Outcomes: Patients from socially vulnerable areas faced significantly worse health outcomes for COVID-19. A new study published in the Annals of Internal Medicine suggests that COVID patients from vulnerable ZIP codes (lower income, less education, higher household density) were more frequently treated in the intensive care unit (29.0% vs. 24.5%) and more frequently received mechanical ventilation (19.3% vs. 14.2%), although once hospitalized they did not experience differences in mortality or discharge disposition.

• XRHealth Expansion: Virtual reality startup XRHealth recently raised a $10M venture round (total funding now $34.7M) to “expand virtual healthcare treatment in the Metaverse.” Unlike other mixed reality healthcare companies focusing on digital therapeutics for specific conditions (see MindMaze’s neurorehab treatments), XRHealth’s VR platform immerses patients and providers in “Virtual Clinics” where care can be delivered for a variety of conditions, including anxiety and autism spectrum disorder.

• Telehealth for PTSD: A recent University of Michigan study investigated the effectiveness of two telehealth treatment methods for PTSD and bipolar patients: Telepsychiatry Collaborative Care (n=506, psychiatrist makes the initial telediagnosis while an in-person care team provides ongoing psychotherapy) and Telepsychiatry Enhanced Referral (n=498, psychiatrist makes the initial diagnosis while a remote psychologist provides ongoing tele-psychotherapy). While patients were highly engaged with both treatments, the TCC group completed 50% more sessions than TER (9.6 vs. 6.4 sessions), suggesting that in-person psychotherapy positively impacts treatment adherence.

• Mindstep Funding: London-based app developer Mindstep just received £2.5M in seed funding to help develop tools for the early diagnosis of brain health conditions. The app leverages software that’s already embedded in most smartphones to track eye movement, the same tech used by Snapchat filters, but instead of using it to see what you’d look like with dog ears, Mindstep detects pupil flickers and facial expressions that could be indicative of Alzheimer’s or depression.

• Remote Wound Care: An AI-enabled app appeared to improve wound assessment and management for remote patients in a new Australian study. Data from 290 wound patients was collected (166 standard care, 124 intervention), with the intervention group using the Tissue Analytics app to measure their wounds’ dimensions and tissue composition in order to support clinical decision-making. Clinician interviews following the 5-month intervention revealed that the automated documentation helped eliminate bias from wound notes, while saving travel time for patients and facilitating care during the pandemic.