Q3 2016 Healthcare Provider Industry Highlights: Digital Health Innovations and Strategic Partnerships

As the third quarter of 2016 came to a close, foreign media outlet MobiHealthNews summarized the major news concerning healthcare providers, health insurance payers, and pharmaceutical companies during this period. The quarter saw a steady stream of developments in the healthcare provider sector, ranging from partnerships among traditional healthcare systems, digital health startups, and government agencies, to advances in telemedicine that enhanced patient engagement and therapeutic outcomes, as well as the emergence of new types of healthcare companies. VCBeat (WeChat ID: vcbeat) has compiled a detailed overview for you. Let us first review the major events involving healthcare providers over the past few months. Due to the extensive length of the content, it will be presented in three parts, with Part One focusing on healthcare providers.

Omada Health, a San Francisco-based online and mobile behavioral medicine company, has launched its flagship diabetes prevention program (DPP), called Prevent, which aims to reduce the number of adults developing type 2 diabetes. Omada has currently partnered with the American Medical Association (AMA) and a new client, Intermountain Healthcare, a Utah-based healthcare provider, to deliver the Prevent program to patients through the latter’s system.

These three organizations will collaborate to integrate Omada’s DPP into Intermountain’s system. In this process, the AMA will serve as a consultant to help Omada better understand how to seamlessly incorporate its Prevent program into provider workflows. This initiative will combine the AMA’s efforts to raise national awareness of prediabetes with Intermountain’s population health strategy by leveraging Omada’s Prevent program; physicians and care teams will also be able to enhance patient engagement and monitor disease progression through the program’s online and app-based features.

Tech giant Apple is increasingly extending its reach into the realm of medical regulation. Its newly released “App Store Guidelines” impose stricter regulations and higher standards on developers of health and medical applications. While previous versions of the guidelines had already established an appropriate protocol foundation to prevent physical harm to human research subjects, the new rules employ more detailed and specific language to mitigate potential physical harm, covering aspects ranging from privacy protection to warnings about inaccurate data. In the updated guidelines, the section addressing physical harm has expanded to a full chapter (previously only a single line), underscoring Apple’s zero-tolerance stance. The guidelines state that “if an app presents any potential for physical harm, it may be rejected from the App Store,” and subsequently elaborate on common pitfalls. Furthermore, Apple has rejected all cannabis-related applications, as well as apps that encourage users to place their iPhones under mattresses or pillows while charging, such as sleep-tracking applications.

In recent years, the New Orleans-based Ochsner Health System has emerged as a pioneer in hospital innovation through its early adoption of Apple’s HealthKit, including the launch of an in-hospital “O Bar” app store and initially successful blood pressure monitoring trials. Richard Milani, the system’s Chief Clinical Transformation Officer, stated that the third-quarter trials proceeded smoothly, prompting Ochsner to initiate interventions for two chronic conditions: chronic obstructive pulmonary disease (COPD) and diabetes.

Although the adoption of telemedicine institutions has been increasing across China this quarter, the situation in Arkansas and Texas remains bleak. In terms of telemedicine services, these two states still lag significantly behind the national trend.

Earlier this summer, policies favorable to telemedicine failed to pass in Arkansas. Telemedicine-related groups in Texas also attempted to persuade the state legislature to permit mobile telemedicine operations, as other states have done. At the heart of the legal struggles in both states were companies seeking to conduct business there, such as Teladoc, which filed a lawsuit against the Texas Medical Board in 2015.

Teladoc, a telemedicine company headquartered in Louisville, Texas, completed its acquisition of HealthiestYou, based in Scottsdale, Arizona, earlier this quarter. HealthiestYou has developed an app designed for employee health services. According to MobiHealth News, the total value of the acquisition reached $125 million, involving a combination of cash and stock. Teladoc’s management considers this acquisition an excellent opportunity for deep collaboration between Teladoc and HealthiestYou. Both companies are industry pioneers committed to advancing telemedicine and empowering users to make autonomous decisions regarding their healthcare. Their partnership will provide users with richer choices, drive higher levels of user engagement, and improve return on investment for partners.

In September, the Arkansas State Medical Board finally approved regulations permitting physicians and patients to establish telemedicine relationships. The approved regulations allow the use of real-time audio and video technologies in telemedicine to facilitate an “appropriate physician-patient relationship,” meaning that the information obtained via telemedicine should be no less than what would be available during an in-person outpatient visit.

As the primary entities in telemedicine, companies providing telemedicine services are expanding their business scopes. Since 2004, American Well has offered a behavioral health module to select clients. This year, the company has integrated psychiatric services into its behavioral health product suite and plans to scale up deployment over the remaining months of the year. The introduction of new features and the inclusion of psychiatrists mean that many patients will be able to obtain prescribed medications for mental health conditions through the platform. Initially, however, due to legal restrictions on controlled substances, the telemedicine platform cannot prescribe all medications, such as certain stimulants and antidepressants. To address this, the company plans to partner with community-based providers, including emergency medical services and pharmacy clinics, to facilitate the issuance of necessary prescriptions, with these collaborations scheduled to become operational by the end of the year.

Sherpaa, headquartered in New York City, provides asynchronous telemedicine services. In early October, the company quietly launched a direct-to-consumer business line. Previously, Sherpaa’s text messaging and app-based consultation services were available exclusively through employer-sponsored plans, allowing employees to use them at no cost. Now, individual consumers can access Sherpaa’s dedicated physicians around the clock via its app, website, or mobile phone for a monthly fee of $40. Consumers can conveniently contact Sherpaa doctors through any of these platforms to have their medical questions answered and, when appropriate, receive prescriptions sent directly to their local pharmacies.

Amid the convergence of telemedicine and private practice, a new breed of healthcare startups is adopting two approaches to enhance patient experience: one involves launching online platforms and applications that offer services such as telemedicine consultations, outpatient appointment scheduling, and prescription refills; the other entails establishing physical private primary care practices. Carbon Health has announced the launch of its proprietary application and the opening of clinics in San Francisco. Its goal is to create an integrated platform that manages electronic health records (EHR) and billing for small, independent medical practices, ultimately building a vast network accessible via its application. Eren Bali, co-founder of Carbon Health, noted that while the concept may sound ambitious, the company is pragmatically building a healthcare system from the ground up. More importantly, whereas traditional healthcare providers control every aspect of the user experience—from physician-facing apps to patient-facing apps and third-party integrations—Carbon Health is able to design an experience that traditional providers struggle to deliver.

We also observed in the third quarter that healthcare providers serving vulnerable populations have adopted digital health technologies from community health service networks and communication platform companies through Medi-Cal (California’s Medicaid program). As part of the “Healthy Community Healthcare 2.0 Technology” initiative, the San Leandro, California-based Community Health Center Network (CHCN) is partnering with San Francisco-headquartered Welkin Health, which specializes in patient relationship management through information services and workflow organization. This collaboration will jointly develop a case management platform to support the success of CHCN’s “Care for Neighbors Program,” an initiative aimed at supporting high-risk populations in the East Bay region.

Hospital systems are also closely aligning with patient needs by gradually equipping themselves with digital tools. This is not only for patients’ own health management but also applicable to the clinical and administrative levels of hospital systems. NewYork-Presbyterian (NYP) Healthcare System has announced the launch of a new suite of digital health tools, NYP OnDemand, which includes telemedicine services provided to patients and providers through the NYP website and mobile application. The product will be rolled out gradually over the coming months, offering services such as emergency care, digital follow-ups, second opinions, and acute stroke care. This suite builds on the applications that NYP Healthcare System has been progressively introducing since the beginning of this year and will shortly add features such as video consultations. As a new product portfolio, NYP OnDemand will integrate telemedicine and physician networks to deliver a range of services.

New York-based indoor mapping and navigation company Connexient has announced the joint launch of an application called “Take Me There” with the National Institutes of Health Clinical Center (NIHCC) in Bethesda, Maryland. The app leverages Connexient’s existing MediNav digital search system to provide users with indoor GPS services for nearby locations by integrating surrounding facilities and linking with existing applications. All NIHCC departments, clinics, and its 40,000 staff members are searchable within the app. Users can pinpoint their location via a blue dot on the system’s map and can also schedule outpatient visits and meetings in advance through the web interface.

St. Joseph’s Children’s Hospital in Tampa, Florida, has just launched UnMonsters, a novel tool designed to alleviate the stress and fear associated with hospitalization among pediatric patients. Developed collaboratively by the hospital and interactive design firm Haneke Design, this game-based application is specifically tailored for St. Joseph’s Children’s Hospital. It features four distinct types of monsters, rendered in an anime-inspired style and hidden throughout various areas of the hospital, such as the X-ray room, laboratory, and waiting areas. Pediatric patients are tasked with finding and capturing these creatures, a process that helps them gradually forget the discomfort of hospitalization and become more familiar with the hospital environment.

It is a patient engagement company headquartered in New York that offers virtual human simulation programs. The company previously collaborated with the Robert Wood Johnson Foundation to launch a series of new simulated conversations designed to infuse greater humanity into health-related discussions. Lois Drapin, Senior Vice President of Kognito’s Health Market, stated that while modern technology has resolved many issues for people, the cornerstone of healthcare remains human connection; therefore, Kognito has introduced this enabling technology that quantifies human intervention.

Healthcare providers are seeking an increasing number of ways to better stimulate patient engagement. Headquartered in Cincinnati, MedaCheck is a medication reminder platform that can be used on smartphones or tablets. The company recently completed a study on medication adherence with Cincinnati Children's Hospital Medical Center, and the results found that digital tools can significantly improve adolescents' medication-taking behavior.

DeepMind, a UK-based subsidiary of Google, announced on July 5 a collaborative research project with Moorfields Eye Hospital, a specialist institution within the UK’s National Health Service (NHS). The initiative leverages artificial intelligence (AI) technologies to detect and treat blinding eye diseases. This marks DeepMind’s second collaboration with the NHS, although AI was not employed in their initial joint project. The study utilized one million anonymized retinal scans to investigate how machine learning can assist in analyzing optical coherence tomography (OCT) images, resulting in the development of algorithms capable of detecting early signs of two specific eye conditions: wet age-related macular degeneration and diabetic retinopathy. The ultimate goal of the project is to enable AI to identify specific disease conditions solely through digital scans.

Furthermore, on August 30 this year, DeepMind announced a research collaboration with the NHS to leverage deep learning for designing radiotherapy treatment plans for patients with head and neck cancer. DeepMind and the NHS will jointly conduct research by analyzing anonymized data from over 700 head and neck cancer patients, in compliance with the data privacy policies of University College London Hospitals (UCLH). The study aims to explore the potential of deep machine learning to reduce radiotherapy planning time. By introducing AI-driven intelligent algorithms for designing radiotherapy regimens for head and neck cancer patients, the goal is to shorten the current four-hour segmentation design process to just one hour. This would free up physicians’ time, allowing them to devote more resources to patient care, education, and research. Moreover, if the algorithms for head and neck cancer radiotherapy planning successfully pass clinical validation, this big-data algorithm could be extended to other types of cancer.

Proteus Digital Health is collaborating with Children’s Health in Dallas, Texas, to conduct a pilot trial of ingestible sensor technology in pediatric patients. The trial focuses on patients recovering from organ transplantation, who typically need to adhere to strict schedules for taking multiple medications. Currently, 15 enrolled patients are using the Proteus Discover medication management and adherence platform, and Children’s Health in Dallas plans to eventually expand enrollment to 75 participants. The platform comprises various measurement tools, including sensor-equipped pills, wearable biosensor patches that adhere to the skin, and a companion tablet application.