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18 digital health exits (mergers, acquisitions, and IPOs) in Q3 2016
October, 08th 2016

As we reported just a few weeks ago, 2016 has thus far proven to be a pretty big year for mergers and acquisitions, and the third quarter was a nice representation of that trend, with 15 acquisitions, one merger, and two IPOs.

Mergers and Acquisitions

The acquisition that has gotten the most attention this year (most likely for the digital health outsider aspect) is Apple’s acquisition of health data-focused startup Gliimpse. The amount of the acquisition was undisclosed. Inspired by founder Anil Sethi's experiences with his sister's cancer, Gliimpse has a mission to collect the "bread crumbs of health data" consumers create and bring them all together in one platform. By moving that process into the hands of patients, the company argues on its website, it can tackle problems that exist in promoting interoperability on the back-end.

Ever since Apple launched its HealthKit framework in mid-2014, the company has seen enabling health data sharing as its entry point into healthcare, and Gliimpse fits right into those plans. Apple also has a history of working with EHRs, most notably Epic, to integrate HealthKit data. Gliimpse's code could help Apple products to more easily interact with hospital systems, or it could bolster safety and security for the company, as those are also major selling points of Gliimpse. More

In another acquisition that was noteworthy for the simple aspect that the purchaser was previously outside of the digital health game, San Francisco-based Mapbox, an open-source mapping platform, acquired fitness-tracking app Human, which allows users to track activity all day and aggregates the data anonymously to create information about cities. Human is a passive app with a simple goal: move every day for 30 minutes or more, dubbed the “Daily 30.” Instead of complex workout-setting and data entry every time you use it, Human allows users to just set the app up and it gets to work, automatically tracking biking, walking, running or anything else that burns calories. It will send an optional notification if the user meets the Daily 30. The app is available on iOS and Android, and integrates with HealthKit. More

A few acquisitions showed certain companies’ desire to have as much technological capability and growth opportunity as possible under one roof. Amsterdam-based Royal Philips announced that it acquired Wellcentive, an Atlanta, Georgia-based population health management software company, for an undisclosed amount. Once the acquisition is complete, Wellcentive and its employees will become part of Philips’ Population Health Management business group. Under that sector, Philips currently offers enterprise telehealth, home monitoring, personal emergency response systems, and personal health services that address multiple groups in the population from prevention to ambulatory care to high-risk patients. More

athenahealth, a provider of cloud-based EHR, practice management software and population health services, acquired Austin-based care coordination platform Patient IO (officially known as Filament Labs), which allows patients to access their care plan through a series of actionable daily tasks on a mobile or web-based application. The financial terms of the deal were not disclosed. Patient IO will form the basis for AthenaHealth’s new patient-facing application, AthenaWell. Patients can use Patient IO to play more engaged, ongoing role in their own care, including medication management to recording self-reported data or learning more about their health. This builds on AthenaHealth’s shift towards mobile – the company acquired Epocrates in 2013. More

We also explored what that acquisition meant for the cloud-based provider of EHRs and population health management. For one, it shows athenahealth’s increasing focus on patient engagement in order to manage chronic conditions. It’s also the second such acquisition from athenahealth’s More Disruption Please accelerator (the first being Arsenal Health). The accelerator was athenahealth’s effort to identify and grow patient engagement companies that would be promising to their population health strategy. More

Nashville-based employee wellness company Healthways agreed to sell its population health business to Atlanta-based Sharecare. In an interview with MobiHealthNews, Sharecare CEO Jeff Arnold called it "by far our biggest acquisition." Sharecare will give Healthways $30 million in common stock in exchange for the population health business, which includes 1,700 employees and, according to Arnold, does about $259 million annually in revenue. Healthways will also pay Sharecare $25 million upfront to fund an expected negative cash flow. If losses exceed $25 million, Sharecare can also reduce the stock payment to as little as $10 million. More

In yet another acquisition for Sharecare, it announced it would buy virtual reality company BioLucid for an undisclosed amount. BioLucid's technology, which uses virtual tours of the body to educate patients, will be incorporated into Sharecare's growing stable of patient engagement tools, but the company will also continue to operate out of its Sarasota, Florida office under the name "Sharecare Reality Lab.” This marks Sharecare's 11th acquisition, and those acquisitions are strategically building toward a comprehensive patient engagement engine, Arnold told MobiHealthNews in an interview a few months ago.

"Our vision is we want to be the only health app on your phone. The same way you don’t have 12 apps to manage your money, you’re not going to have 12 apps to manage your health," Arnold said at the time. "We have made 10 acquisitions over the last several years putting together what we think the key pieces are that are going to enable you to manage all your health and wellness in one place." More

In an display of what some VCs say is an example of what’s to come in the future of digital health acquisitions, wherein two big, successful companies merge their complementary capabilities, two diabetes management companies merged in September. Mountain View, California-based Glooko and Gothenburg, Sweden-based Diasend, will merge into a unified company, leveraging the global capabilities of Diasend and the user-friendly platform of Glooko. The joint solution, which will operate under the Glooko name, will now serve 4,000 diabetes clinics in 23 countries across 15 languages. The joint platform downloads data from more than 160 different devices, including glucose meters, insulin pumps, continuous glucose monitors and activity trackers, accounting for 95 percent of diabetes devices used worldwide.

“Glooko and Diasend are the dominant players in their respective markets. Due to the differences in our products (and competition in general) both companies have had significant demand from the opposite market (Glooko from EU, Diasend in USA),” Vikram Singh, Glooko’s product analytics and marketing manager said in an email to MobiHealthNews. “Rather than expand each company’s international presence, it made more sense to merge.” More

We saw a device maker acquiring a company that offers the back-end infrastructure that integrates devices. iHealth Labs, the connected device subsidiary of Andon Health with offices in Paris and Mountain View, California, has acquired Bordeaux, France-based eDevice for $106 million (98.33 million euros).

eDevice is a longtime European provider of back-end infrastructure that connects remote monitoring devices to hospitals and healthcare providers. iHealth is one of the earliest players in the smartphone-connected health device space. It offers a variety of weight scales, activity trackers, blood pressure monitors, and glucometers in the US, Europe, and China. Recently the company has shifted from a primarily direct-to-consumer focus toward a business-to-business market through products like iHealth Connect, its enterprise health management system, which it announced at HIMSS this year. The system includes iHealth Gateway, a secure hub for collecting data from various iHealth devices in the home as well as software systems for diabetes management, outpatient care, and population health. Acquiring eDevice seems like another step along this path. eDevice's technology will help iHealth to transfer data from its various devices to healthcare providers. More

We also saw acquisitions that blend communication and workflow management technologies. HMS Holdings, which owns a number of subsidiaries providing software tools for payers, has acquired Essette, a web-based care management platform which helps payers and providers with population health management and patient engagement. The acquisition was a cash deal and the purchase price was $20 million. Essette works with risk-bearing provider organizations including managed care organizations and care delivery organizations. Its software helps care teams coordinate, helps organizations manage multiple data repositories, and also improves patient-doctor communication. More

Nashville, Tennessee-based Hospital Corporation of America (HCA), which operates 169 hospitals and 116 freestanding surgery centers in 20 states and the United Kingdom, announced it will purchase clinical workflow and team communication app maker Mobile Heartbeat. Terms of the agreement are not being disclosed. The company’s technology, Clinical Urgent Response (CURE) works through an app on either an iPhone or Android that can be used by caregivers inside and outside the hospital with an integrated user experience, so nurses and physicians can hand off tasks to one another. Caregivers can text, call, review patient information, receive lab alerts and respond to nurse calls and more so long as they have the app. The app works to consolidate clinical communications, including alarms and notifications, patient information and lab data, secure texting, voice and photography. The acquisition follows a pilot study HCA ran with Mobile Heartbeat using CURE for its iMobile Project, an initiative to implement smartphone-based critical care team communication. HCA rolled out the initiative last year, and staff quickly adopted the technology More

Pennsylvania-based CRF Health, provider of electronic clinical outcome assessment solutions (eCOA) for clinical trials, acquired pioneering digital health company Entra Health for an undisclosed amount. The acquisition will expand CRF’s offerings into the mobile and wireless medical device sector, helping to establish the global company’s network of solutions to collect, manage and analyze biometric and clinical trial data. The acquisition of San Diego, California-based Entra Health formalizes an existing relationship, representatives for CRFs said in a statement. Entra is perhaps best known for inking a deal with Nokia in early 2010 that put an app in Nokia's appstore that connected early smartphones to Entra's Bluetooth-connected glucose meter. More

Silver Spring, Maryland-based mental health care management company Mindoula Health acquired Care at Hand, a Boston-based healthcare analytics company that offers a mobile-based early warning system for home caregivers, for an undisclosed amount. Care at Hand has raised just shy of $2 million in seed funding, including small equity investments from two accelerators: StartUp Health, where Care at Hand participated in one of the first classes co-sponsored by GE; and Rock Health, which chose Care at Hand for its second-ever class back in 2011. Care at Hand's offering helps home care managers identify and head off the risk factors that presage hospital readmission using a combination of surveys delivered to caregivers via mobile devices and data analysis. More

An undisclosed company acquired San Mateo, California-based Gamgee, a digital health startup that has done business as 22otters. Both the Gamgee and 22otters website inform visitors about the acquisition but reveal no additional details. More

Imprivata, the Lexington, Massachusetts-based developer of health IT security tools, agreed to be acquired by an affiliate of Thoma Bravo, a San Francisco private equity firm. The deal is valued at approximately $544 million. Under the terms of the agreement, shareholders of record will receive $19.25 in cash per share of Imprivata common stock - a 33 percent premium to Imprivata’s last closing stock price of $14.50.More

We saw a health system purchasing a communication and messaging platform, with Washington state-based Providence St. Joseph Health acquiring Medicast. "I’m thrilled to announce that Medicast has been acquired by Providence, and that we will be joining the system’s Strategy & Innovation group," the founding team wrote in a Medium post. "We’re super excited about the value that Providence sees in our technology and our team, and we intend to continue building great new features into our platform. As Providence continues to move healthcare into the digital age, the Medicast platform will be a key component of a wider strategy to ensure that more patients can have access to convenient, compassionate care delivered both in-person and virtually."According to the Medium post, Medicast started out with a direct-to-consumer mindset, but later started working with providers -- including its eventual acquirer Providence St. Joseph, which has been a customer of Medicast for about 18 months. More

Nashville-based employee wellness company Healthways divested itself from MeYou Health, its Boston-based innovation and digital health subsidiary. Rick Lee, a serial entrepreneur who sold early digital wellness platform Healthrageous to Humana in 2013, led a group of investors, including Ballast Point Ventures, Blue Shield of California, and several prominent individual investors, in an $11 million buyout of the company. Lee will serve as CEO of the newly independent MeYou Health. More

IPOs

There haven’t been many IPOs this year, and MobiHealthNews tracked just two this quarter.

Burlington, Massachusetts-based Everbridge, which makes an emergency communications platform for many enterprise and government organizations, set the terms of its initial public offering. The IPO is set at 7.5 million shares, offered at between $11 and $13 per share, equating to a midpoint of $90 million, according to the company’s SEC filings.The company was founded in the wake of 9/11, when the gaps in many communication systems became evident, and now has over 3,000 customers worldwide. Among the many other organizations it serves, Everbridge provides a SaaS-based critical communications platform for over 800 hospitals and emergency departments. The company offers a real-time alert management platform wherein each organization can create customized communications. Should an emergency arise, the system leverages all available communication channels including text, email, voice and chat to keep contacting all recipients until the confirm receipt of the message. More

iRhythm, maker of the wearable-and-wireless-but-not-connected Zio heart rate monitoring system, filed with the SEC to raise up to $86 million in an initial public offering. The Zio patch, iRhythm's sole product as of now, is a small wearable sensor, used for multi-day monitoring of arrhythmias in cardiac patients (up to a fortnight). Unlike many participants in that space, however, the device does not wirelessly transmit data to a mobile device. Instead, readings are stored in the patch itself, which is then mailed back to iRhythm at the end of the monitoring period.

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