3.08.21
7 min. read

Big Tech in Healthcare. Trivia answer.

Welcome back to E&O Mondays, the free newsletter from Exits & Outcomes that (usually) features the world’s most complete weekly health tech funding round-up. I mixed it up this week to recap recent healthcare moves by Amazon and Google for this edition of Big Tech in Health.

 E&O Mondays.

In this issue:

  • I mixed it up this week with an edition of Big Tech in Health instead of the usual health tech funding round-up. Read on for recaps of what Amazon and Google have been up to in recent months.
  • Next week E&O Mondays will be back with a double-whammy (two weeks’ worth!) of health tech funding.
  • Also: The long-awaited answer to last week’s health tech trivia question along with the names of three E&O readers who got it right.

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Recapping Amazon’s recent healthcare moves

Haven harvested for spare parts

The news you certainly know: After a long slog, high-profile departures, and little progress, the Amazon-JPMorgan-Berkshire Hathway joint venture, Haven, officially shut down. It’s hard for me to believe the dateline but CNBC broke the story on January 4, 2021 — even though it feels like much longer, thanks to the endless stream of analyses that followed. So, enough about Haven. Perhaps more remarkable is how quickly Amazon seems to be moving in the wake of Haven’s implosion.

Amazon Care hits the road

Don’t forget: Amazon Care first made headlines in September 2019. No doubt the service’s early publicity was a clear signal that Haven was, indeed, doomed. But again, it’s surprising to me how long Amazon Care has been around in pilot form. Is it really 18 months now?

STAT just broke big news about Amazon Care last week: Care Medical PC, the medical practice that underpins the still-Amazon-employees-only service, has registered new corporate entities in 17 states beyond its original Seattle, Washington pilot site. Taking a cue from STAT, The Seattle Times wrote a follow-up piece that added four more states that Amazon Care had registered to do business in over the past few days. (No doubt other reporters will build on this until we hit 50 states, which I suspect will happen within weeks.)

(By the way, “Care Medical” is such a devious name for a business entity that hopes to remain hidden. Many, many medical practices include those two words. Is there such a thing as anti-SEO consultants?)

Meanwhile, Amazon’s devices evolve

Just a few days ago Amazon’s voice tone-monitoring wearable Halo got an upgrade that allowed it to integrate with the company’s voice-based smart home assistant, Alexa. (The connectivity just allows Halo wearers to ask Alexa to read out their Halo stats.)

And rumors swirled that Alexa’s hardware counterpart, Echo, might soon offer advanced health monitoring capabilities. Business Insider reported (the day after the Haven implosion news broke) that Amazon was developing a version of the device that could monitor your sleep and detect medical conditions including sleep apnea. The project is called Brahms internally. It’s supposedly a device that sits on your nightstand and passively monitors the sleeper via millimeter-wave radar.

Updates on Google’s health initiatives

A Google Nest device for sleep apnea? While it’s not the most important development out of Google, like Amazon, the company is rumored to be developing a bedside device that passively monitors sleep and might diagnose conditions like sleep apnea. (Paying subscribers to E&O first read about this project in 2019, but the rest of the world just found out about it in January when 9to5Mac reported on it.)

Finally: Google acquired Fitbit Sticking with the hardware developments for a minute, Google finally, officially acquired Fitbit in January. The company made clear in its announcement that the deal had always been about “devices not data” — after almost two years of making that case to privacy-minded regulators around the world. Fitbit also added new glucose tracking capabilities to its app and announced other diabetes-related partnerships. As Apple began to roll out its own fitness subscription service, Fitbit added Deepak Chopra as a mental health-focused content partner for its Fitbit Premium offering.

Google Fit gets more medical too Just as Fitbit added glucose tracking, Google Fit generated headlines by adding new features that use the smartphone’s camera — and no other hardware — to read heart rate and respiratory rate.

Google Health’s EHR front-end: Care Studio The big news out of Google Health in 2021 is probably Care Studio’s expansion. Care Studio is a frontend piece of software that sits on top of a clinician’s EHR and gives them more tools to view and search through complex patient information. Google has piloted it with a small group of clinicians at Ascension facilities in Jacksonville, Florida and Nashville, Tennessee, but it is now bringing it to a larger group.

(As someone who started writing about digital health back when the original Google Health PHR was around, it is a little surreal that a group at Google is back in action using the same name. It is striking how much more focused Google Health is on clinicians this time around. They were often criticized for not understanding healthcare and healthcare providers’ workflows a decade ago with their consumer-focused attempt.)

Verily/Onduo: More conditions, more partners, still impacting Sanofi’s bottom line

Verily and Onduo have had a productive few months, but it is worth noting that the one-time 50-50 joint venture is still impacting the pharma company’s books. In a recent government filing, Sanofi shared:

“Following the restructuring of Onduo LLC, finalized November 11, 2019, Sanofi received from Onduo a dividend in the form of DexCom shares valued at $122 million. As of December 31, 2020, those shares had a carrying amount of [$106] million, versus [$123] million as of December 31, 2019.”

The big Onduo news this quarter, however, was its move to officially broaden its offerings out from its original diabetes-focus to multiple chronic conditions. This strategy began to take shape right around the time of the Sanofi divestment (and likely helped drive that restructuring), but Onduo’s official relaunch occurred in early 2021:

“The expanded platform is designed to support members managing one or more chronic health conditions including type 2 diabetes, pre-diabetes, weight loss, hypertension, and mental wellness, with plans for further expansion into behavioral health.”

Recently, Verily and Onduo announced a big customer win in the form of a six-year agreement with Highmark Health. (Six years is an unusually long term for an agreement like this, no?) As part of the deal, Verily and Onduo will provide:

“Digitally-enabled care solutions to manage chronic conditions, with potential initial areas of focus to include congestive heart failure and chronic obstructive pulmonary disease (COPD), as well as a clinical insights platform that will allow Highmark Health to use data to guide patients through personalized pathways for care.”

In other Verily news: Liftware and OneFifteen

One Verily acquisition that had slipped my mind was Liftware, which the company acquired way back in 2014. Liftware now offers two products, Steady and Level, but they both make use of motion-stabilizing technology in handles for utensils (spoon, fork, or spork) to help people with hand tremors eat more easily. No real update, but Verily did file a trademark for the term Liftware in 2021, which suggests the product line is still in the mix and not going anywhere.

Another Verily initiative that has been relatively quiet recently is OneFifteen, the “not-for-profit healthcare ecosystem” that Verily runs to people with substance use disorders. Verily continues to build out the offering, which includes both an in-person clinic (Dayton, Ohio) and digital health offerings. This month it made a few improvements to the OneFifteen Android app, including in-app telemedicine, pre-appointment surveys, and SMS autofill for easier sign-in. Uptake for the app is still low, apparently, as the Google Play store shows only 100+ installs so far.

A current job opening at Verily makes clear that OneFifteen is hoping to build out its remote mental health offerings:

“We are looking for an experienced and passionate software engineer to join our mental health efforts including an opportunity to directly combat the opioid epidemic. In this role, you will have the responsibility to design and build patient- [and] clinician-facing mobile applications. With our partners, we founded OneFifteen, a tech-enabled recovery ecosystem where your work will be deployed to patients in need.”

A few new details about Coefficient (AKA Granular Insurance Company)

Of all the Verily-led initiatives, the one I’ve read the least about is Coefficient, AKA Granular Insurance Company. This is Verily’s “precision risk solution to provide self-funded employers with more predictable benefit plan protection.” A recent job ad for this business unit kept things pretty vague:

“Granular is an enterprise business with a long-term ability to drive new values through [the] application of technology to insurance and employer benefits, and ultimately build linkages to consumers (workers and dependents) in BtoBtoC models. In this role, you will have the opportunity to build technology solutions that transform a set of low-technology enabled business features and facilitate new commercial features and functions.”

Finally: Verily’s smart diaper offering with P&G’s Pampers, Lumi

Verily has so many projects. This one for a smart diaper and baby monitor that it developed with P&G’s Pampers brand appears to be still of interest to the company as it recently filed a patent to advance the sensing capabilities of diapers:

“Disclosed solutions detect a presence of a substance by transmitting light through an article and measuring the returned light. Examples of articles are common disposable diapers, reusable cloth diapers, pantiliners, and adult diapers. Detectable substances include substances that fluoresce, for example, biological structures such as chlorophyll, bilirubin, and porphyrin.”

While the original iteration of Lumi smart diapers was focused on feeding and sleep schedules, this patent suggests the smart diaper might evolve into a medical product that tracks the excretion of bilirubin into the diaper of babies overcoming jaundice.

Health Tech Trivia Answer

In case you missed it, this was last week’s Health Tech Trivia Question.

Question: In September 2011 the FTC famously fined two app developers for falsely claiming that their apps could cure which medical condition? Extra bonus point(s) if you remember one or both of the names of the apps.

Answer: The medical condition was acne. The names of the two apps were “AcneApp” and — incredibly — “Acne Pwner”. The apps displayed colors and instructed users to hold the screen of their phones up to their skin to treat their acne. Android app Acne Pwner managed 3,300 downloads at 99 cents a pop, while Acne App received 11,600 downloads at $1.99 in the iTunes AppStore. The FTC fined them accordingly.

This week’s winners:

  • Julie Yoo, General Partner, Andreessen Horrowitz (Bio)
  • Alex Liu, PM, Verily (Twitter)
  • Andrew J. Rosenthal, Sr. Director of PM, eHealth Inc. (LinkedIn)

E&O Mondays will be back next week with two-weeks’ worth of funding news and yet another Health Tech Trivia q.

What did you think of Issue 018 of E&O Mondays?
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