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DeciBio Weekly Digital Health Digest Volume 5 — February 19, 2020
The Chinese government launches an app using civilian location tracking and coronavirus infection status, and drones track civilians in private residences. Teladoc robot treats an isolated coronavirus patient to reduce clinicians' risk of infection. Big tech's digital phenotyping projects create a "self-fulfilling prophecy" risk no one is talking about.
The life science industry has made great strides since the SARS coronavirus outbreak in 2003, culminating in a vastly different experience from the outset. Here we reflect on these advances over the past 17 years and how current diagnostic and therapeutic innovations are rising to combat the COVID-19 crisis.
TLDR: Tech companies have begun to incorporate the majority of our digital lives — texts, search, and location history; camera and microphone-enabled video and voice data; social views, likes, and posts; wearable-enabled physical activity data — into “digital phenotypes” that feed predictive models for disease detection, symptom monitoring, and therapeutic intervention. The Google-Ascension partnership, for example, theoretically gives Google the ability to integrate clinical records, FitBit data, and digital behavior data (i.e., your Google account activity).
So what? As consumer tech blurs the line between “health” and “personal” data, patients are increasingly exposed to risks outside of HIPAA protection that they may not be knowledgeable of or may not have consented to. Beyond the oft-repeated risks of personal data being sold to payors, employers, advertisers, and corporations, the “self-fulfilling prophecy” risk -- i.e., that identifying “high-risk” patients can adversely impact those patients’ clinical outcomes and quality of care received. Despite the risks, digital phenotyping technologies offer opportunities to address disease in novel ways (e.g., early diagnosis and progression monitoring for Parkinson’s using smartphone accelerometers, disease-specific risk prediction based on social media language, smartphone-enabled analysis of breathing patterns for predicting overdoses).
TLDR: In the past couple digests, we’ve covered how AI chatbots, predictive digital surveillance, and social media-based AI are aiding the fight against coronavirus. Here we cover new digital technologies being deployed in the continuing coronavirus crisis. Last week, the Chinese government launched an app using smartphone tracking to alert people who have crossed paths with suspected or confirmed coronavirus-infected civilians. Privacy advocates have tweeted videos of Chinese government drones following civilians to enforce mask wearing, limit outdoor activity, and check temperatures of private residences. An InTouch (now part of Teladoc) robot helps take vitals and communicate with a coronavirus patient to reduce clinician exposure to the virus.
So what? Global public health crises demand swift and innovative responses that may bypass the typical regulatory, operational decision-making and approval, and moral / ethical review processes that health technologies are subject to. In China, where innovation already often bypasses these looser processes, the coronavirus crisis has yielded applications of digital technologies with clear clinical utility but deployed in ethically questionable ways -- e.g., real-time passive location monitoring of private citizens by the government, Orwellian monitoring of public spaces for law / guideline enforcement, or in the U.S., dehumanized care through isolation and treatment by a robot. Global regulatory and ethics communities should initiate proactive summits on appropriate use of digital technologies during global crises.
TLDR: ONC coordinator, Donald Rucker, claps back at health systems who signed onto Epic’s letter to oppose ONC’s pending information blocking “interop” rules. Rucker pointed out that “many of [Epic’s] customers did not sign” and that out of the 60 providers who did,, only 3 were academic medical centers (out of 100 requested to sign). Rucker went on to call out health systems who signed in the name of “patient privacy concerns”, but have a history of taking patients to court, releasing private health information into the public record.
So what? ONC leadership, leading tech and healthcare companies, and KOLs appear unmoved by Epic’s last-ditch attempt to derail the pending interop rules. While patient privacy will certainly continue to be top-of-mind for innovators and regulators helping put patients in control of their own data, they have firmly dismissed Epic’s argument that the rules increase the risk of data leaks and misuse. Bloomberg sources anticipate a release of the long-awaited rules in the coming week.
TLDR: XRHealth plans to launch its first VR telehealth clinic in 8 states and DC in March with coverage by Medicare and most major insurance providers. After an assessment by an XRHealth clinician, patients are sent a VR headset with which they can receive real time training from a clinician and use independently for traumatic brain injury, stroke rehabilitation, stress, anxiety, chronic pain, and spinal cord injuries.
So what? XRHealth’s success echoes growing trends of VR use in clinical settings as well as uptake of real-time remote care tools (also see Pear Therapeutics' recent VR acquisition). While a number of clinical VR and AR modules are in use, they largely remain in clinical trials or are limited to medical education and training applications. XRHealth's virtual clinic marks a move of patient-facing VR into routine clinical care.
TLDR: C. Light Technology uses a noninvasive laser scan to measure the minuscule motions of the eye and track movements of the retina to identify patterns that can be used to screen people for AML, Alzheimer's, and concussions.
So what? Though eye movements have long been a way to evaluate brain function, C. Light Technology’s application of AI/ML techniques has broad opportunities in difficult to detect neurological disorders such as Alzheimers. The start-up joins a growing wave of digital diagnostics players leveraging computer vision techniques to promote screening, early diagnosis, and disease progression monitoring.
TLDR: A randomized, controlled study in 40 women hospitalized in labor suggests that immersion in VR can relieve some pain contractions before delivery. The study used a Samsung VR headset paired with a Samsung smartphone along with Labor Bliss visualization developed by AppliedVR in a half-hour test displaying relaxing scenes and messages. Participants who used the VR headset reported an average reduction in pain while those without reported an increase in pain.
So what? Positive findings from this study contribute to a growing trend of VR as a pain relief method (e.g., Cedars-Sinai study). VR may become an alternative for narcotics, epidurals, nitrous oxide, or other pain medications. Additionally, the technology could utilize signals from a woman’s body such as contractions to change visualization scenes, thus personalizing care to the needs of each individual.
Funding and M&A
Headspace raises $93M The funds will help support 70+ current and pipeline clinical validation studies
Innovaccer Raises $70M The Microsoft-backed company connects 200+ IT vendors to link patient data across locations and time points in the patient journey to create "longitudinal" records for ~4M patients
Oxford VR secures $12.5M in Series A The Optum-led round marks the largest ex-U.S. funding for VR therapy, with initial focuses on acrophobia, psychosis, and social engagement
Headlines curated weekly by DeciBio's digital health team
Chris Lew
Senior Associate
Fanny Anderson
Associate
Tina Wang
Senior Analyst
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