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Yorktel Introduces Univago HE™

05 Sep 2017

Yorktel Introduces Univago HE™

 

Yorktel today introduced Univago HE described as the first and only all-inclusive telemedicine video services platform that delivers the versatility, reliability and security vital to affecting widespread telemedicine adoption.  Yorktel indicated that it designed the product from the ground up explicitly for telemedicine applications. Univago HE™ has patent-pending technologies that ensure reliability and quality in every critical connection between patient and clinician, all with “touch-of-a-button” simplicity.

Analyst View:

Univago HE represents an important breakthrough in the challenge to make Telemedicine a routine component of the provider workflow. It creates the foundation to build out a growing array of Telemedicine services that will serve the needs of providers to improve the outcomes for patients regardless of the current staffing levels and in-house capabilities.

Yorktel has presented important highlights about the produce.

Univago HE is a fully managed subscription-based service comprised of everything needed to connect patients by video with remote clinicians, healthcare experts and family members. For each workflow/use-case, deployments include any hardware, software, licensing, analytics, reporting, support and on-site spares required to execute service. The initial release of Univago HE offers subscription-based workflows specific to ICU and Acute care, but future iterations will include compatibility for emergency, stroke assessment, behavioral health, patient surveillance, and general patient assessments – and care that extends beyond the walls of the hospital (e.g. home healthcare).

With this rollout, Yorktel is now the only independently verified, HIPAA-certified service provider offering cloud-based telemedicine-as-a-service workflow subscriptions that are fully inclusive, featuring purpose built, healthcare specific video units.

Over the past few years, Yorktel’s healthcare practice has grown exponentially. The company, which works with more than 30 health systems and 250 hospitals, has deployed more than 4,000 telehealth wall units and 400 cart systems.

Security and Privacy

Every aspect of Univago HE is private, secure and adheres to the highest standards. Univago HE™ is HIPAA-compliant (independently verified by Pivot Point Security), ISO 27001-certified, and hosted in hardened, SOC2-certified data centers to provide total patient privacy and security critical to any telemedicine application.

Wall systems blend with the hospital environment to provide a non-intrusive window into patients’ wellbeing. When patients are being observed remotely, a notification and an audible bell alerts patients that a session has been initiated.

Interoperability & Integration

Univago HE includes a library of APIs and SDKs that allow for broad interoperability between Skype for Business clients, WebRTC browsers and traditional video conferencing systems, as well as integration into many different EHR/EMR platforms and clinical applications.

Support for open standards and the inclusion of APIs and SDKs extend the value of the platform. Unlike the many closed, single-use systems in the marketplace, Univago HE can support multiple inpatient workflows such as patient monitoring in intensive care units (ICU), virtual rounding in acute units, stroke assessment, behavioral health, virtual sitter, interpreter services, and more.

User (doctor/nurse) experience/ ease-of-use

User experience at every touchpoint is paramount, and Univago HE empowers clinicians, administrators, patients and technicians with resources that are intuitive, devoid of complexity, reliable, and always available. Doctors must be able to respond to a request for a call from any device, at any time and at a moment’s notice; quality and timeliness of care depends on their ability to asses and communicate without technology being intrusive.

The process of acknowledging, joining and consulting with a patient has been streamlined to match specific workflows. Included in Univago HE’s clinician-specific toolset are a number of additional assets that support ongoing activities and enhance the ability to provide care.

The ICU Patient System boasts a precision camera with HD-quality picture and 20x optical zoom, fast and quiet PTZ operation, and a 24” touch-display with hardened Linux OS and embedded video client. Adjustable settings and controls, such as night vision, enable patient assessment in low light conditions, and camera bookmarks quickly recall saved camera positions. Physicians are provided full control over the patients far end audio and video, and with ‘Snapshot’ functionality, they can easily capture room and patient information. A clinician icon bar, with up-to-date notifications and alerts, ensures that the patient’s status is accurately monitored in a timely manner.

Performance, Serviceability, Uptime and Reliability

Software, services and equipment, which are delivered across highly resilient Yorktel data centers, are proactively monitored by the company’s 24/7/365 Video Network Operations Centers to ensure operational readiness and reliability.

The focus on improving the serviceability of patient room enclosures is among the major considerations reflected in Univago HE’s design. The ICU patient wall system is modular, and QR code provisioning simplifies troubleshooting, reconfiguration and installation which, in most cases, can be completed by a single technician within one hour.

Using the foundation of streamlined design, Yorktel Univago HE allows for quick response and resolution to any service issue, minimizing the impact on patients while maintaining higher levels of reliability. Any software or hardware faults that arise are managed remotely, resolving issues quickly. Spares of each module are held on site to enable swap out and return to operational readiness within a targeted time of 15 minutes. For healthcare providers, this alleviates concerns of unexpected expenses relating to labor costs to manage failure rates, maintenance for hardware and infrastructure, as well as mitigates risk of productivity and revenue loss from “down rooms” and “work arounds.”

 

 

 

NYC Heart & Stroke Innovation Forum

25 Apr 2016

Highlights from the 2016 American Heart Association Innovation Forum, April 20, 2016

Lack of Incentive for Funding in Cardiovascular Disease Rises Challenges in the Industry

NYC Heart & Stroke Innovation event provided insight on the challenges and growth opportunities in the cardiovascular disease industry

On April 20, 2016, The American Heart Association held the NYC Heart & Stroke Innovation Forum sponsored by Biotronik and others.  The event was attended by a mix of medical, academic, financial investment and business development experts.  Although the emphasis was on innovation, the real heart of the matter (pun intended) was the fact that although Cardiovascular Disease (CVD) is the number one ranked cause of death in the U.S., the disease must vie with other serious chronic conditions for needed investment dollars.  For example, it was pointed out that there appears to be greater interest and incentives among Pharmaceutical R&D to invest on immune system based therapies along with battling liquid tumors. There were also numerous mentions of the challenges gaining traction for high-promise cardio drug ENTRESTO™ and PCSK9 drugs.  It was stated here that CVD, despite its magnitude, is not the number one area for investment by Pharma. The challenge of developing an appropriate and targeted strategy needed to garner funding was the major theme throughout the day.

Another challenge mentioned involved a concern about the roles and philosophies of government agencies as this pertains to CVD research.  For example, it takes considerable time for the FDA to approve an innovative breakthrough therapy.  This point was emphasized by Larry Chinitz, MD; Professor of Medicine and Cardiac Electrophysiology at NYU Langone.  Summarizing three alternatives to drug procedures for Atrial Fibrillation that could prevent stroke, Chinitz noted it took the FDA 11 years to approve a device used for the innovative breakthrough procedure he co-developed. He noted this 30 minute minimally invasive procedure contrasts sharply with the most prescribed and affordable anticoagulant drug therapy which he described as a “rat poison” that requires numerous blood tests and could cause severe bleeding among patients.  Chinitz also noted the latest drug alternative costs thousands of dollars.  He described three procedures capable of alleviating the need for drug-based treatments.  He noted, the majority of strokes among AFib patients develop in the Left Atrial Appendage, a portion of the heart that can simply be closed off surgically without any overall impact to heart function. This can be accomplished in a variety of ways including a very brief procedure, one he has championed. 

The day was marked by episodes of great hope and great frustration.  We heard financial experts provide views on how to best gain CVD funding while hearing how difficult it is for researchers to get grants or even locate sources of appropriate grants.  We heard of breakthroughs in 3D-printing for heart transplants and a major “moonshot project” from The American Heart Association working with Verily (formerly Google Life Sciences) and AstraZeneca.  The two companies have committed a total of $75 million over five years to support "One Brave Idea from a visionary leader" to cure coronary heart disease. Meanwhile, an investment expert told the attendees the "enemy of innovation is often size and success"  However,  the major message directly from Larry Ferguson, of AstraZeneca speaking about the “brave new idea” and echoed by others throughout the day was “a new transformative approach is what's needed for One Brave Idea to succeed.” Also notable, we were told by Esther Dyson, Chairman of EDventure Holdings, that research money may not solve America’s greatest health challenge as much as investment in wellness and prevention programs influencing daily lifestyles.

One very interesting concept that evoked some discussion was that healthcare, unlike retail or other industries, is first learning about the need for value propositions and what a value proposition actually is. 

This brief one-day conference illustrated that there is no one generally accepted investment approach to battle CVD either from the clinical or financial perspective.  The mix of traditional investors and clinical experts attending the meeting clearly included the forces needed to collaborate to achieve medical success, however they are not necessarily in sync about the best way to proceed.  Moving forward the best bet for success appears to be the need to completely redefine the meaning of “value” as applied to healthcare in a pragmatic manner rather than the checklist of requirements we often see from government agencies.

If you are interested in more information on this study, please contact Kayla Belcher, Corporate Communications, at kayla.belcher@frost.com.

Following up on Healthspot

11 Jan 2016

There are a couple of items worth mentioning since last week's surprise announcement from Healthspot.

 

Today MedCity News published a report stating that despite the demise of Healthspot, Xerox, one of the principal investors and developer of the technology powering the kiosks, remains bullish on the concept and wants to leverage the concept elsewhere.

 

Also of interest, healthcare video conferencing technology platform provider, VSee has a report on its blog providing an assessment of Healthspot's failure.

 

VSee's assessment is that the Healthspot work model was wrong because it was not an on-demand service capable of attracting a higher volume of patients. VSee based this notion off of feedback it received from the CEO of American Well, which states its Kiosk model is doing well.

 

Another interesting reason was that, although self-serving for VSee, Healthspot's business model was too costly. VSee attributed part of this to the fact that Healthspot selected VSee's major competitor Vidyo as its platform.  

 

In addition, this view states the kiosks were over-designed and essentially too extravagant for the number of patients per day, which according to VSee, Healthspot reported at 10 patients per day.

 

The third reason given by VSee is that Healthspot targeted the wrong market. This opinion asserts that Healthspot was competing with the Urgent Care provider market. This was an alleged failure because although it may have been over-designed in comparison with other kiosk models the Healthspot kiosk could not offer the range of services an urgent care center can.  Essentially, this view is a lack of cash flow, expensive technology platform and targeting the wrong market are the reasons.

 

It remains to be seen if this is correct because Healthspot itself remains silent. However, from the telemedicine perspective, it is good news that competitors and technical leaders continue to see opportunities for virtual kiosks to succeed

Healthspot: What Went Wrong?

08 Jan 2016

In a way, the events surrounding Healthspot are very similar to when Robert Bosch Health Systems Inc., exited the U.S. telehealth and remote patient monitoring (RPM) markets last year. In both cases, the move was very sudden despite notable contracts; Bosch with Veterans Affairs and Healthspot with Rite Aid, the Cleveland Clinic and others.

 

So far the demise of Healthspot has everyone scratching their heads. One of the better first assessments is on MedCity News by Neil Versel. In this piece, the head of American Well was contacted and CEO Dr. Roy Schoenberg was clear in stating this was not a happy occasion because a competitor failed. In fact, this development represents a rather visible blow to the momentum for virtual telemedicine, but more realistically another blatant example of the risks associated with telemedicine as a business. Although Healthspot was entirely focused on kiosks and this differs from virtual telemedicine services to the home that American Well provides the two markets are closely related. In fact, American Well has added kiosks to its repertoire.

 

My first thought was perhaps the patent dispute with CSI was the culprit, but the indications are that the legal actions were going nowhere. There were two initial cases with Healthspot attempting a pre-emptive strike in the U.S. District court of Ohio before CSI could file its infringement motion in Nevada. However, Ohio’s case was tossed out, the judge ruled that the case needed to be waged at the Federal Appellate level and there are no indications that the action ever really moved forward.

 

In addition, the Nevada case was paused following a motion by both parties to await the Federal Appellate decision. Based on some fast research it appears that the legal actions were not pursued and the only pending case I can find is one whereby Healthspot was attempting to recoup $830K in legal fees from CSI. Meanwhile media reports indicate Healthspot claimed CSI had admitted that it did not have solid patent infringement grounds. Therefore, the patent litigation was probably not the issue.

 

The next issue could be Healthspot's financial condition. However, from an economic perspective Healthspot was very well funded with over $43 million in recent private investment and had very promising active contracts and implementations.

 

That takes us to the next potential challenge, which could involve the cost of service. It is clear that there is no one economic model consistent across all segments of the virtual Telemedicine service providers. The prevailing perception is the cost of service is somewhere around $39 to $49 for about 10 minutes, however this varies across providers. Meanwhile, there are other reports that indicate the doctors garner about $30 of these basic fee dollars. In some cases there are subscription fees, in other cases institutional customers (employers) pay on a per-member-per-month bases; yet in some cases it's simply usage based. There are some reimbursable coverage options based on the state involved but it's very complicated and many consumers opt to pay out of pocket. The lack of a standard business model could be a challenge.

 

Additionally, the challenges in facing the adjacent virtual home services become more visible when a major player goes public, such as the situation for market leader Teladoc, a public company required to issue financial reports. This visible data reveals the stock has been on a roller coaster ride and there are public documents revealing the company is not profitable. In fact, media reports have indicated that the investment community has challenged the rate structure claiming the $49 price point (for around 10 to 15 minutes) is too low. However, when you do the math based on the time factor, this service is not cheap and raising the price could really decrease the demand.

 

A significant advantage Healthspot appeared to have over the virtual telemedicine services like Teladoc. MDLive, etc., was that the kiosks were true diagnostic centers rather than enhanced async communications or videos minus diagnostic tools. I've seen the Healthspot kiosk and it was impressive. American Well has introduced kiosks, but most of the other players are seeking partners who offer diagnostic apps to measure vital signs. This means that unless American Well ramps up its kiosks or CSI takes off, the future of the Kiosk is not promising at this point.

 

So, what else went wrong? The theories are beginning to range around the fact the management team was not experienced in healthcare, despite a very media comfortable and charismatic CEO; the systems needed for scheduling, billing and revenue cycle management are difficult and costly to implement or that this market is at this nascent stage more hype-based than fact based.

 

In addition, another challenge all virtual telemedicine vendors need to accept is that there is, as of this point, no clearly defined case law devoted to virtual telemedicine malpractice. There have not been any notable malpractice cases and most of the leading competitors brag about the positive reactions among consumers based on customer satisfaction surveys. However, as with any medical practice, there will be many lawsuits. It is unclear what the true legal risk will be.

 

Also notable, despite the technology interface we need a warm blooded human doctor at the other end of the communications link. There is ample evidence that the doctors remain unsure whether this model is competitive with their normal business, an adjunct opportunity or worthwhile. It appears to be most enticing to younger doctors, retired physicians or those close to retirement. Small practices see value but lack the scale to implement the added support systems needed to support the workflow. Some larger healthcare systems have jumped in but may have to work with doctors from the service provider networks.

 

Additionally, there is no commonly used standard agreement across the board pertaining to exclusivity of doctor provided service. Some telemedicine services have exclusive agreements, at least for full-timers while others do not.

 

The reality of starting a virtual telemedicine business that becomes visible when a participant fails is that the risks are high on all fronts: costs, pricing, legal issues, medical practice issues, workflow, marketing, revenue recognition and customer relationship management are all challenges that need strategic planning and back office systems. Also, let's not forget the various state medical boards as a factor in either positive or challenging ways as we have seen in Texas, Colorado and Mississippi (for example).

 

Healthspot appeared to have a unique product which looked much more high-tech than its prime competitor and legal opponent CSI. Actually, the pending patent issue was not about the design or features of the Kiosk, but had to do with data transmission.

 

One question remains; what went wrong?

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