Study of medication adherence with AI-supported selfies highlights potential for clinical trials

AiCure’s tool uses a form of artificial intelligence for facial recognition to confirm that patients have taken the correct medication.

Intermountain Healthcare Innovation Fund gives some more love to Redox

Redox Engine, the Madison, Wisconsin health IT startup that’s helping healthcare facilities overcome interoperability challenges has received $1 million in follow-on investment from Intermountain Healthcare Innovation Fund, according to a company release. The funding is part of Redox’s Series B round.

Redox will work with Intermountain in the Salt Lake City-based health system’s push to adopt digital health solutions that fit into their electronic health record. The company will also support applications Intermountain has developed, such as the Rehab Outcomes Management System, as part of Redox’s API platform.

Healthbox has previously run an accelerator for healthcare startups called Healthbox Studio but with the management change last year, Healthbox repositioned itself as a venture capital investment manager with an innovation platform that functions as a consultant to and collaborator with healthcare partners.

Healthbox has managed Intermountain Healthcare’s Innovation Fund since the fund’s launch in 2015. The fund is intended to source, evaluate, and invest in companies that align with Intermountain’s mission. So far the fund has made a handful of investments in healthcare startups, in addition to Redox:

Zebra Medical Vision, an Israel-based health IT business, developed a clinical decision support teaching computers to read and diagnose medical images through machine learning. Last year, Zebra closed a Series B round as it launched a consumer-facing product called Profound. The service allows individuals to upload their medical imaging scans such as computerized tomography scans and mammograms to Zebra Medical Vision’s online service, and receive an automated analysis of key clinical conditions.

Syapse is a precision medicine software meets clinical decision support startup. It seeks to improve care coordination for hospitals by extracting clinical, genomic and other molecular data from medical records, labs and pharmacies and integrating that data to offer more detailed patient profiles. By doing this, the company wants to guide doctors to find the right diagnostic test and therapeutic approach. The Intermountain fund took part in its Series C round.

The fund also invested in Utah-based genomics software developer Tute Genomics, which was later acquired by PierianDx. PierianDx seeks to enable personalized medicine for clinical labs.

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Oncora Medical and MD Anderson embark on personalized radiation oncology study


Philadelphia-based clinical decision support startup Oncora Medical is collaborating with University of Texas MD Anderson Cancer Center in Houston in a study to help radiation oncologists develop personalized treatment plans with the goal of improving outcomes, according to a news release. The Phase 1 study will focus on data from 2,000 breast cancer patients and last three to nine months.

Oncora’s Precision Radiation Oncology Platform will analyze data from MD Anderson’s electronic medical record system, tumor registry, radiation therapy planning system, and Brocade — a Web-based clinical documentation tool for medical records developed by MD Anderson Associate Professor of Radiation Oncology, Dr. Benjamin Smith.

Oncora will be tasked with creating interoperability between its Precision Radiation Oncology Platform and Brocade to explore the potential value of a combined product, the release said.

“Through this alliance, we hope to improve workflows and processes for radiation oncologists and simultaneously give radiation oncologists access to better information to support real-time, precision medical decision making,” Smith said in the release.

Although most people think of precision medicine as targeted therapy, Lindsay noted that the company defines precision medicine as the “right treatment for the right patient at the right time” and wants to expand the conventionally accepted definition beyond drugs and diagnostics.

The study was a year in the making and will be Oncora’s biggest endeavor to date, Lindsay said.

“Our software needs to access data across multiple software systems at a center that treats nearly 10,000 patients per year. That is part of the reason why we spent so long planning for the partnership. We want everything to go smoothly and we want to deliver MD Anderson a seamlessly integrated product.”

The study will also assess physician utilization and quality of the company’s predictive modeling efforts. But the ultimate criteria for success will be the deployment of a “functioning product” at MD Anderson, noted Lindsay.

The second phase of the of the collaboration with MD Anderson will expand the study to all cancer types treated with radiation.

One of the challenges in healthcare is de-siloing data, particularly for clinical decision support. When it comes to cancer treatment, radiation oncology data risks being siloed in different hospital software systems, which makes it tough to collect and analyze. Oncora Medical views its approach as a way to make predictive analytics and precision radiation oncology succeed.

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Rock Health highlights geographic diversity of digital health M&A deals

By Rock Health’s count, there were 20 digital health mergers and acquisitions in the first quarter of 2017. Although Castlight Health’s acquisition of Jiff was interesting, it’s not the size of the deals that’s a head turner so much as the fact that many took place beyond the usual locales of Silicon Valley, Boston, and New York.

It’s also worth noting that Rock Health generally takes a more conservative approach to assessing deal flow on a quarterly basis than, say, StartUp Health. Rock Health counted 71 digital health deals totaling more than $1 billion (but a lot less than the $2.5 billion StartUp Health counted).

The biggest deal for the quarter was unquestionably McKesson’s $1.1 billion acquisition of CoverMyMeds, a Columbus, Ohio-based technology developer to automate medication prior authorizations for pharmacies, prescribers, payers and pharmacy benefits managers.

Who were the investors? JumpStart and Charles Hallberg were among the first investors in CoverMyMeds. Francisco Partners, Medical Growth Fund, and SaaS Capital also backed the business.

Retail health kiosk businesses higi, based in Chicago raised $40 million in 2016 for the development of retail partner support tools. Last month, it acquired a Seattle, Washington-based company that developed a rewards system to encourage healthy behavior — EveryMove.

Who were the investors? EveryMove investors included Premera Blue Cross in Washington state, Blue Cross and Blue Shield of Nebraska, BlueCross BlueShield Venture Partners and Seattle angel investors.

RxWiki and TeleManager’s merger gave birth to Digital Pharmacist, an Austin, Texas-based company that developed a marketing platform to support community pharmacists to give them the kind of engaging digital resources that big box drugstores have at their disposal. Digital Pharmacist acquired PocketRx, a mobile app for prescription refills based in Shreveport, Louisiana.

Telemedicine technology group GlobalMed in Scottsdale, Arizona acquired TreatMD, a Miami, Florida-based, bootstrapped telemedicine company.

Birmingham, Alabama based DAXKO acquired Denver-based Zen Planner, a member management software company for gyms and sports clubs in Colorado, Mainsail Partners is a Zen Planner investor.

Rock Health’s report notes that with 20 digital health companies that have raised more than $100 million since 2011, there are more M&A deals to come this year.

The report also spotlights new funds targeting digital health. Veteran digital health investors Oak HC/FT are raising a $500 million fund. Venrock, which is a major digital health investor, closed a $450 million fund — its eighth. The fund invested in both Castlight Health and Jiff.  New York-based Lux Capital raised a $400 million fund.

Among the brand-spanking new funds in the first quarter include Biomatics Capital’s $150 million fund launched by two Gates Foundation executives that will target genomics and data-driven healthcare.

The $100 million Section 32 fund in San Diego is being launched by Bill Maris, former CEO of Google Ventures.

Spectrum Health in Grand Rapids, Michigan is launching a corporate venture capital arm to invest in health technologies that lower the cost of healthcare and improve the patient experience. Spectrum Health is a not-for-profit, integrated, managed care health care organization.

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Insurance navigator Wellthie looks beyond healthcare with $5M Series A round

Wellthie, a health insurance navigation startup launched by a former Anthem Blue Cross Bue Shield product development executive, has raised $5 million in a Series A round, according to a company blog post. The new funding will be used to bolster the New York-based company’s sales and marketing muscle as it prepares to expand into vision, dental and life insurance in the second quarter, Sally Poblete, Wellthie Founder and CEO, told MedCity News in a phone interview.

IA Capital Group led the investment round with participation from Aflac Corporate Ventures. Last month, Aflac announced plans to set up a $100 million fund to invest in early stage companies relevant to Aflac’s core business. Some of the angel investors from the insurance industry that have backed Wellthie include Mike Battaglia, former chief consumer officer at Humana, Dr. Bill Winkenwerder, a former co-CEO of Highmark Blue Cross Blue Shield, and Sam Havens, a former CEO of Prudential Healthcare.

“What’s unique and exciting about this round is insurance industry luminaries are putting in their own money,” Poblete said. “It shows that the support we’re getting is from people deep within the industry.”

Poblete said she sees the business as a way to support insurance brokers that work with small businesses and carriers with technology by improving decision support and providing other robust features.  For brokers, Wellthie can do scenario planning, provide a virtual storefront and give medical and ancillary quotes through a shopping and enrollment platform. For insurers, it can help them manage small group and individual members and drive growth. Wellthie’s platform also helps payers do market analysis based on members’ purchasing behavior. 

Wellthie and other technology companies have developed customer relationship management products to help insurance companies become more consumer-focused and their plans easier to understand.  As the insurance industry waits for the GOP to put their own legislative stamp on insurance reform, it will be interesting to see whether insurance companies will rely more on health tech companies like Wellthie.

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With $25M fundraise, Amino launches price transparency services for employers, providers

About 16 months ago, Amino became the first for-profit company to gain access to the Centers for Medicare and Medicaid Services‘ vast database of Medicare claims. Now it’s not only expanding its price transparency services to self-insured employers and healthcare providers but also giving these groups access to this data.

The company raised a $25 million Series C round to support the launch of Amino Plus for EmployersAmino for Providers, and make its data platform available, according to a blog post about the fundraise. The physician search and appointment booking service allows consumers to search for physicians and gain information on prices based on individual conditions, service needs, health insurance coverage and personal preferences. One goal is to help hospitals improve their consumer/patient experience, particularly to find physicians in their network and make more informed decisions about their care. Another is to help self-insured employers reduce their healthcare costs.

Highland Capital Management led the round. Other investors that took included Accel, Aspect Ventures, Charles River Ventures, Northwestern Mutual Future Ventures, and Pilot Wall Group, among others.

“This phase of financing is about building the full ecosystem around Amino,” said David Vivero, Amino CEO, in a phone interview. “Through these services. we can make sure users get access to realtime deductibles, view their plan designs and [contact details].”

Vivero and his team have taken a number of steps to try to set Amino’s approach apart from other companies. Aside from the Medicare database access, it doesn’t allow physicians to pay for exclusion. Users can see whether a doctor’s rate for a given procedure is higher than, lower than, or similar to other doctors nearby. The search engine uses statistical adjustments to account for differences in the types of people doctors treat, so a doctor with healthy patients isn’t unfairly compared to a doctor who treats sicker patients. Last year, it became a Medicare consensus-based entity, a status that means Amino gets support from CMS to create healthcare quality measures that become available to other groups with the same status.

“This is a very big next step for us,” Vivero said. “In the history of American healthcare, everyone has had their own facts and that’s left consumers with conflicting data.”

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Report: Digital health startups raise $2.5B in Q1 even as deal volume declines to six-year low

This post has been updated with data from Rock Health’s Q1 report

Digital health startups raised $2.5 billion across 124 deals in the first quarter of the year — a record high amount for the first quarter but lowest deal volume since 2011, according to a report from StartUp Health. Big data analytics business Grail’s supersized $914 million Series B fundraise accounted for a big chunk of the funding raised for the first quarter.

“Even though [venture capital firms] are betting less, they’re betting bigger,” the report noted.

Like Ping An Good Doctor’s $500 million round last year, Grail was also a spinout — in this case from Illumina. Although Grail is considered a cancer diagnostics company, it also has biotech software component, with high-intensity sequencing tools to detect signs of cancer in the blood, including ctDNA.

Interestingly, Grail is somewhat similar to Freenome, a company that raised $65 million in March. Freenome uses machine learning and big data analytics to spot signatures from immunological and metabolic changes towards early cancer detection.

For the first time, population health startups attracted more investment than other digital health subsectors, raising $392 million in 25 deals. Alignment Healthcare alone raised $115 million from private equity investor Warburg Pincus. Livongo, which focuses on diabetes management and prevention, raised $52 million from General Catalyst Partners is also listed in the population health category.

Venrock topped other investors with four investments in the quarter. Among them were Virta Health — a health IT startup that claims it can help people reverse Type 2 diabetes.

At this time last year, StartUp Health noted that startups in digital health had raised $1 billion in 100 deals, dominated by health insurance startup Oscar with a $400 million fundraise. Although big data analytics companies raised the most — $286 million — the patient/consumer experience category accounted for the highest volume of deals at 20.

Source: StartUp Health Insights Report Q1 2017

Source: StartUp Health Insights Report Q1 2017

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Will cancer research atrophy under Trump administration?

Chatter at an early morning session on the third day of the  43rd annual meeting in Washington, D.C., was largely focused on the state of healthcare — and the survival, or repeal, of the Affordable Care Act — under the new President Trump administration.

A conversation about the state of healthcare at the Association of Community Cancer Centers’ annual meeting mostly focused on speculation over the Affordable Care Act’s future under the Trump administration. But the discussion shifted to the standing of the Cancer Moonshot Task Force, put in place during the final year of President Obama’s tenure.

Dr. Kavita Patel of the D.C.-based think tank The Brookings Institution and Dan Todd of Todd Strategy, both former Capitol Hill staffers, said any push for increasing the funding for cancer research will most likely come from agency heads, at the Food and Drug Administration, the Centers for Disease Control and Prevention, and the National Institutes of Health.

“There’s a commitment on Capitol Hill,” Todd said. “But the moonshot folks all went to work with former Vice President Biden. If there’s nobody [in the White House], it’s going to atrophy.”

The task force, helmed by former Vice President Joe Biden whose son, Beau, died of brain cancer in 2015, left D.C. the same day as the rest of the White House staff when President Obama left on Jan. 20. Today, it lives on as the nonprofit Biden Cancer Initiative, and the former vice president said the nonprofit’s work will focus on bringing down the cost of cancer treatments, enabling wider access to clinical trials, and supporting community oncology efforts.

Even before Obama and Biden left the White House, national cancer research received a boost. In December, the 21st Century Cures bill was passed into law. Through the law — the Capitol Hill commitment to which Todd referred — Congress appropriated $1.8 billion in new funding for cancer research.

Whether President Trump’s White House will take up the mantle of moonshot cancer research is an uncertainty. Although former members of the Cancer Moonshot Task Force had spoken with the incoming administration about the research — which includes a conversation between Biden and his successor, Vice President Mike Pence, about continuing the work — the new White House’s proposed budget removes $6 billion in funding from the National Institutes of Health.

“Trump’s [administration] agreed to help continue some of those efforts,” Patel said. “Doing that but releasing a budget where you’re cutting the NIH by billions of dollars does not make sense to me.”

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Digital health companies merge to launch patient engagement business serving Medicaid patients

Voxiva and Sense Health have merged to form Wellpass, a patient engagement business designed to help providers and payers send timely messages and alerts to their patient population, according to a news release. The digital health startup is led by Voxiva Cofounder Paul Meyer. The new business is the latest in a series of mergers and acquisitions that reflect the steady drumbeat of consolidation in digital health.

Wellpass includes mobile health and wellness programs Voxiva developed with a patient engagement platform developed by Sense Health. Some of those include Voxiva’s best-known programs Text4Baby for infant care and Text2Quit for smoking cessation.Those programs have resonated with the Medicaid patient population that provider and payer customers serve, with a 44 percent increase in dental visits and 40 percent boost in appointment attendance.

The company’s combined resources give it a client base of more than 30 healthcare providers, more than 70 state Medicaid health plans, and 10 state government agencies, the release said. Although Voxivia has been around since 2001, Sense Health launched in 2012 and took part in the New York Digital Health Accelerator’s 2014 cohort.

Text messaging is viewed as a more effective way to reach Medicaid patients because research indicates they are more likely to have access to email through a mobile phone rather than a computer.

Meyer said in the release that Wellpass is intended to surmount the challenges of deploying fragmented engagement and population health solutions by enlisting Sense Health’s platform for Voxiva’s messaging programs.

Several digital health groups have harnessed text messaging to boost patient engagement, such as HealthCrowd and Babyscripts, a company that seeks to prevent pregnancy complications. Digital health initiative coactionHealth, created by Centerstone Research Institute (CRI), and Verizon, seeks to improve patient quality of life and hospital utilization through a combination of case management, wellness coaching and smartphones.

The Wellpass deal underscores the consolidation trend in digital health, which saw a flurry of deals last month. This year Castlight Health acquired Jiff Health — a deal that closed today. By Rock Health’s reckoning, there were at least 112 digital health acquisitions in 2016, a figure that could well be outstripped in 2017.

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Beltway insiders struggle to predict what will happen to health insurance exchanges, essential benefits

From left: Leah Ralph of ACCC, Dan Todd of Todd Strategy, and Dr. Kavita Patel of The Brookings Institution at Cancerscape conference by the Association of Cancer Care Centers in Washington, D.C.  Photo: Andrew Zaleski

Mix concern for the future well-being of the insurance exchange market along with a healthy dose of ¯_(”/)_/¯ and you’ll have a decent analysis of healthcare in the U.S. circa 2017.

At the Association of Community Cancer Center’s 43rd annual meeting this week in Washington, D.C., there was a discussion about the state of healthcare under President Trump’s administration — a timely subject, given the recent failure of House Republicans to pass the American Health Care Act (AHCA), their repeal and replace version of the Affordable Care Act, or what’s commonly known as Obamacare.

Moderated by the ACCC’s director of health policy Leah Ralph, the discussion included Dr. Kavita Patel of the Washington, D.C.-based think tank The Brookings Institution and Dan Todd of Todd Strategy. As former Capitol Hill staffers, both offered instructive comments on congressional Republicans’ failure to pass the AHCA.

“The House is always this kind of chaotic, welcome-to-the-jungle kind of mess,” Patel said. “Bottom line: They didn’t have the votes.”

Todd echoed the sentiment, also noting that a dose of political miscalculation led House Republicans to believe all their members would vote for an Obamacare repeal bill. In recent days, members of the GOP have blamed the Freedom Caucus, the more conservative wing of the Republican Party in the House, for scuttling the AHCA. (Notably, President Trump tweeted this admonishment: “The Freedom Caucus will hurt the entire Republican agenda if they don’t get on the team, & fast.”). This happened about eight minutes before the discussion on Thursday.

Political dynamics aside, what does any of this mean for cancer treatment in the U.S., and the general state of healthcare? That was the question both Patel and Todd tried to make sense of for conference attendees.

The insurance exchange marketplace is where about 10 million people currently get their insurance, and how it fares in the year ahead is what Todd tackled head-on. Since passage of the ACA seven years ago, it’s now apparent that the small group market doesn’t look like the large group market — it looks much like the Medicaid market, made up of people who are sicker and older, and is highly cost-sensitive. The fix employed by President Obama’s administration, which wasn’t contemplated in the original healthcare law, was a risk adjustment payment paid to plans.

“Will the Trump administration make those payments like the Obama administration did? My gut tells me no,” Todd said. “If no, you don’t have a healthy market.”

Patel responded in kind, noting that if the Trump administration does away with cost-sharing subsidies, the result will be “people who have cancer who can’t afford insurance.” The reason? The financial stability of the federal healthcare marketplace will begin to falter. So far, the Trump Administration hasn’t said one way or the other whether it will continue providing those subsidies for insurers who participate in the federal marketplace, although House Speaker Paul Ryan said that the Trump administration should keep making those payments to insurers “to avoid destabilizing the market,” the Wall Street Journal reported Thursday.

Patel also highlighted the essential benefits component of the ACA, which required all plans sold in the marketplace to cover cancer screening, treatment, and follow-up care. The ACA tied out-of-pocket maximums paid by patients to essential benefits.

Health and Human Services Secretary Tom Price has signaled that Republicans will dismantle elements of Obamacare even without the votes in Congress. As the Chicago Tribune reported, Price described in testimony this week how “his department could make insurance plans cheaper by scaling back several federal mandates, including what the ACA currently defines as ‘essential benefits’ in coverage.”

“You get rid of [essential benefits], you actually get rid of those out-of-pocket annual maximums, which are crucial for cancer patients,” Patel said.

Although both the White House and Ryan vowed they would renew their efforts to repeal the ACA, it’s too soon to tell what will happen with healthcare this year.

Put another way: ¯_(”/)_/¯.

Featured photo: Justin Sullivan, Getty Images