Fortis Healthcare back in black, reports Rs 135-crore profit in Q4

Business Standard | May 26, 2019

Fortis Healthcare showed signs of revival in the fourth quarter of FY19, with improved earnings before interest, tax, depreciation and amortisation (Ebitda). The Gurugram-headquartered health care major reported net profit (profit after tax and minority interests) of Rs 135.6 crore after accounting for exceptional items for the fourth quarter of the FY19. This was against a loss of Rs 932 crore in the same period last year. Exceptional items for the quarter primarily include allowance for doubtful advance and security deposit given to corporate entities, along with impairments taken in capital work in progress (Rs 47.4 crore), impairment of investment and allowance for doubtful loans to subsidiary company (Rs 55 lakh) and impairments of goodwill of Shalimar Bagh property, among others. The exceptional items for the quarter stood at Rs 66.31 crore while for the full year it was Rs 67.95 crore. The full year saw additional expenses on composite scheme of arrangement and amalgamation.

Spotlight

This is the story of a nurse, who was treating my eighty year old father. He had suffered an incredible fall and was about to have his second back surgery in two weeks. My dad recognized the nurse caring for him and he joked that he was back after just a week. Upon hearing this, this nurse remarked, “Wow, I really don’t remember my patients.” At that point I noticed that she hadn’t introduced herself and she had her badge on backwards. I got her attention, and asked her name. She replied, "Well that depends, I will only tell you my name after you tell me if you think I am doing a good job." And she wasn’t joking. My trust level went to zero. I countered with, “My name is Barbara.” She eventually replied with, “My name is Cindy.” To this day, I wonder if Cindy was her real name. Her answer impacted my trust, but I also worried about what she might be experiencing. What was the culture like there and was that considered acceptable.


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HEALTH TECHNOLOGY

Tebra Secures More Than $72 Million at Over $1 Billion Valuation to Expand Digital Healthcare Technology Platform

Tebra | July 08, 2022

Tebra, the digital backbone for independent healthcare practices, announced that it has closed more than $72 million in funding at a valuation greater than $1 billion. Golub Capital led the investment which includes both growth equity and debt financing. Late last year, Kareo and PatientPop, cloud-based leaders in clinical, financial, and practice growth technology, joined forces to form Tebra to support the connected independent practice of the future and modernize patient care. This capital infusion will accelerate Tebra’s merger plans including expanding market share, developing and launching the combined product line and advancing the new branding for the company. Tebra supports over 100,000 providers who are delivering care to more than 90 million patients in the U.S. A New Era of Healthcare Consumers expect digital access, simplicity and convenience in all aspects of their lives. You can quickly research and order a meal online, hail a ride, and buy a car from your smartphone. Meanwhile, healthcare has been left behind in a sea of complexity and fractured solutions. Tebra is simplifying and modernizing this experience through a platform of tools built for the new era of healthcare. The platform connects patients to the best providers in seconds and delivers a modern, digital-first patient experience. Tebra is the Digital Backbone for the Connected Healthcare Practice Tebra provides independent healthcare practices with a complete operating system for practice success. Built through the combination of Kareo and PatientPop, the offering includes modern websites, messaging and scheduling, telehealth, EHR, care delivery, practice management, billing, payments, and analytics. Since the companies merged in late 2021, the company has successfully built and launched a two-way product integration that allows both platforms to share scheduling information and physician availability. The integrated solution also reviews appointment information and sends out surveys for better reputation management. Over 800 providers now use the combined operating system, and the company plans to grow significantly both into their existing base and the healthcare industry at large. “With this new investment from Golub Capital, we’ll be able to accelerate Tebra’s mission to unlock better healthcare by helping independent practices bring modernized care to patients everywhere. Simultaneously, we will broaden our market reach and launch new solutions, helping an even larger number of physicians with digital tools and support to attract new patients, get paid quicker, and operate their practice more efficiently.” Dan Rodrigues, Co-Founder and CEO of Tebra From practice growth technology to clinical and financial software, Tebra’s complete operating system is structured to modernize every step of the patient journey and support the connected practice of the future. Headquartered in Southern California, the company currently has over 1,000 employees. Golub Capital’s Late Stage Lending team was administrative agent and led the investment. Golub Capital also supported the 2021 merger with $65 million in growth funding, bringing its total commitment in the last year to more than $137 million. “We are delighted to be a long-standing financing partner to Tebra, supporting them through multiple growth phases, add-on acquisitions and new product development since 2017,” said Peter Fair, Managing Director at Golub Capital’s Late Stage Lending team. “Our mission is the success of our clients and being able to offer flexible solutions that meet the changing goals of their business.” Golub Capital is one of Tebra’s top-tier institutional investors, which also includes CommonFund, HLM Venture Partners, OpenView Venture Partners, StepStone Group, Stripes Group, Montreux Equity Partners, Toba Capital, Transformation Capital and Vivo Capital. About Tebra In 2021, with a combined mission to unlock better healthcare, Kareo and PatientPop joined forces to form Tebra — the operating system for the connected practice of the future. With an all-in-one, purpose-built platform to drive practice success and modernize every step of the patient journey, Tebra provides digital tools and support to attract new patients, deliver modern care, get paid quickly, and operate efficiently. Tebra’s all-in-one platform includes a fully certified Electronic Health Record (EHR), scheduling, insurance billing, patient payments, telehealth and more. About Golub Capital Late Stage Lending Golub Capital is a market-leading, award-winning direct lender and experienced credit asset manager. The firm’s Late Stage Lending group provides flexible growth capital to venture-backed, late stage SaaS companies. Our custom financing solutions are designed to help proven SaaS businesses accelerate sales growth, drive new product development, pursue strategic acquisitions and provide shareholder liquidity. As of April 1, 2022, Golub Capital had over 620 employees and over $50 billion of capital under management, a gross measure of invested capital including leverage. The firm has lending offices in Chicago, New York, San Francisco and London.

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FUTURE OF HEALTHCARE

Signify Health Opens New Regional Service Center in Oklahoma City

Signify Health, Inc. | June 15, 2022

Signify Health, Inc. a leading healthcare platform that leverages advanced analytics, technology, and nationwide healthcare networks to create and power value-based payment programs, announced the official opening of its new regional service center in Oklahoma City. The Company will mark the opening of its 25,000 square-foot site with a ceremonial ribbon cutting event with state and local government representatives, business community leaders, and employees. “Our investment in workforce and economic development is attracting industry-leading companies like Signify Health who recognize the many attributes Oklahoma has to offer growing businesses,” said Oklahoma Governor Kevin Stitt. “We are delighted to officially welcome Signify Health to our business community and look forward to supporting their continued success for many years to come.” Last December, Signify Health announced its decision to locate its third regional service center hub in Oklahoma City and plans to bring more than 200 new jobs to the region. Since that time, the Company has hired more than 130 new employees who work both on-site and remotely. “We truly appreciate the warm welcome and support we have received from both the Governor’s and Mayor’s administrations. They helped make the process of opening up a new facility and sourcing talented people a seamless and positive experience. We knew at the outset of this journey that Oklahoma City was a place where we would find people who share our values and passion for making a positive difference in people’s health. What we found here exceeded our high expectations,” David Pierre, Chief Operating Officer at Signify Health “The healthcare industry in Oklahoma City is an extremely important economic driver for our region, and more importantly it’s a major contributor to a high quality of life for our residents,” said Oklahoma City Mayor David Holt. “We congratulate Signify on opening its doors in Oklahoma City and look forward to the contributions they will make to our community, from both economic and quality of life perspectives.” Located at 5400 E. Memorial Road, Signify’s service center was designed to support the distinct needs of a hybrid workforce, including a flexible floor plan and collaboration spaces. In working with Turner & Company, Signify adopted a number of healthy workplace elements used in its Dallas office. Among the eco-friendly features are a geo-thermal HVAC system, LED lighting and an onsite wastewater treatment system. Signify Health’s Chief Operating Officer, David Pierre, will host a ceremonial ribbon cutting event on June 15, 2022 at 10:00 AM CT. Oklahoma Governor Kevin Stitt; Brent Kisling, Executive Director of Commerce, Oklahoma State Department of Commerce; and, Jeff Seymour, Executive Vice President, Greater Oklahoma City Chamber of Commerce are expected to participate in the ceremony and offer remarks. About Signify Health Signify Health is a leading healthcare platform that leverages advanced analytics, technology, and nationwide healthcare provider networks to create and power value-based payment programs. Our mission is to transform how care is paid for and delivered so that people can enjoy more healthy, happy days at home. Our solutions support value-based payment programs by aligning financial incentives around outcomes, providing tools to health plans and healthcare organizations designed to assess and manage risk and identify actionable opportunities for improved patient outcomes, coordination and cost-savings. Through our platform, we coordinate what we believe is a holistic suite of clinical, social, and behavioral services to address an individual’s healthcare needs and prevent adverse events that drive excess cost, all while shifting services towards the home. For more information on how we are taking health homeward, visit us at signifyhealth.com.

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FUTURE OF HEALTHCARE

Winner Medical Acquires Majority Stake in Pingan Medical to Fuel Growth

Winner Medical | June 02, 2022

Winner Medical Co. Ltd. a leading manufacturer of disposable wound care and surgical products, announced on May 18 that it will acquire a majority 65.55% stake in Hunan Pingan Medical Device Technology Co. Ltd. for 652 million yuan as the Company continues to expand its disposable medical supply lineup. Upon the completion of the deal, Winner Medical is set to hold a total of 68.7% stake in Pingan Medical for a total of 752 million yuan. The Company's move comes as it looks to make a foray into the field of injection products to diversify its product offerings besides consumer products, and comes in line with its strategy to provide one-stop disposable medical supply solutions. Established in 2010, Pingan Medical mainly produces disposable medical devices, such as syringes, infusion sets, and blood collection tubes among other medical supplies. In 2021, Pingan Medical recorded 360 million yuan in revenue and booked a net profit of 85 million yuan. The acquisition will leverage both companies' strengths and help fill the product gap in injection-related disposables of Winner Medical, enabling it to expand into new medical verticals and achieve its goal of becoming a major supplier for the domestic market. Specifically, the Company plans to roll out medical sets that comprise needle-type products from Pingan Medical and wound care supplies from Winner Medical, providing one-stop customized solutions for hospitals and large medical centers. Meanwhile, Winner Medical will help Pingan Medical with its industry-leading R&D capabilities to develop medical device solutions and build smart manufacturing plants. To fuel the growth based on the new deal, Winner Medical has signed an investment note with the local government of Li County in Hunan Province, where Pingan Medical is headquartered, to build medical equipment production lines, smart warehousing, and R&D facilities. The latest deal follows Winner Medical's April-11 acquisition of wound dressing maker Zhejiang Longterm Medical Technology Co. Ltd. as part of its expansion strategy to stay competitive in the area of high-end wound dressings. The Company has also set up a dedicated team to promote its self-developed wound dressing products as the market for such medical supplies is still in its infancy in China. Founded in 1991, Winner Medical has made efforts to offer quality cotton-based medical dressings and disposables, and will continue to push ahead with its strategy to diversify its product lineup and boost consumption. On the manufacturing front, the Company aims to expand to new medical verticals through acquisitions, while on the consumption front, it plans to enhance product sales through digitization and gradually phasing out less popular products. As such, the Company has made significant progress in digitizing its operations. Winner Medical has gone live on multiple e-commerce platforms, and has gone digital in terms of online and offline warehousing and order management.

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FUTURE OF HEALTHCARE

SpineGuard Announces a New Partnership with Sorbonne, CNRS and Inserm to associate its DSG® Technology With Ultrasound and Serve Surgical Robots

SpineGuard | June 08, 2022

pineGuard an innovative company that deploys its DSG sensing technology to secure and streamline the placement of bone implants, announces the launch of a new three-year collaboration program with two labs of Sorbonne University CNRS and Inserm: the ISIR. DSG is based on the local measurement of electrical conductivity of tissues in real time without X-ray imaging, with a sensor located at the tip of the drilling instrument. Its efficacy was proven by more than 90,000 surgeries across the globe and 19 scientific publications. SpineGuard has entered in 2017 a collaboration with ISIR for the application of DSG to surgical robots and the enhancement of their safety, accuracy, and autonomy. SpineGuard and ISIR capitalize on first order outcomes published so far… At the close of a first collaboration phase, SpineGuard announced sub-millimetric accuracy experimental outcomes in bone boundary detection and automatic stop of a vertebral drilling performed by a robot using the DSG technology. These impressive outcomes were presented as they were produced successively at the Hamlyn medical robotics conference in London in May 2019, receiving the first price for best scientific paper, then in plenary session at the SMISS minimally invasive spine surgery (SMISS) in Las Vegas in November 2021, and lastly during the CRAS conference in Naples in April 2022. … and join forces with the LIB laboratory in order to add ultrasound to the project. Encouraged by this success, the research and development teams wish to go even further in surgical robots advancement: the guidance technologies that allow the robot to position itself properly relative to the patient to find the drilling entry point rely today on X-Ray imaging, dangerous for health, in combination with space-consuming optical registration. SpineGuard has long explored the possibility to use ultrasound complementarily to DSG for this preliminary step, before the tool is penetrating bone, and was granted two families of international patents on that topic. The LIB laboratory, who features an international level expertise in the field of ultrasound imaging, answered with enthusiasm the invitation to join the project. SpineGuard, ISIR and LIB thus start a new 3-year collaboration that is expected to produce breakthrough results in the field. “We are happy to launch this partnership that will allow us to go even further in improving surgical robots in orthopedics. This new phase of the project aims at enabling robots to perform bone drilling and cutting, as well as implant placement, in a secured and more autonomous manner in the human skeleton. Our goal is to implement first-class collaboration between French Research and Industry and trigger commercial ventures in the orthopedic field via strategic agreements with industry partners.” Stéphane Bette, co-founder and Deputy CEO of SpineGuard Guillaume Morel, Professor at Sorbonne University and ISIR Director, and Brahim Tamadazte, Researcher at CNRS and member of ISIR, added: “We are delighted to continue the close and dynamic collaboration initiated in 2017 with SpineGuard. The entry of robotics and associated new technologies in operating room is no doubt one of the biggest medical advances of the last twenty years. Robotic approaches often allow the surgical gesture to be less invasive, more accurate, safe and intuitive in numerous surgical procedures. The first outcomes from the previous collaboration gave us more visibility on the clinical added value that a robot with original and effective sensors can bring to Orthopedic Surgery in general and Spine in particular. This new collaboration will be about ultrasonic sensors coupled with robotics. This original and promising association will allow the surgeon to define the entry point and the pedicle screw trajectory accurately and non-invasively, without relying on ionizing or costly preoperative imaging (scanner, MRI). The association of two prestigious labs of Sorbonne University (ISIR and LIB), whose competencies are highly complementary to SpineGuard’s industrial vision constitute a stimulating work environment favorable to innovation. The journey with SpineGuard goes on for three more years with a target of several technologic and scientific innovations to serve patients and care providers.” Quentin Grimal, Professor at Sorbonne University and Manager of the team “Ultrasound and imaging for bone quality characterization” at LIB, concludes: “Using ultrasound to position a surgical tool is particularly relevant. Ultrasounds are danger free and provide real time information about interfaces, bone anatomy, even bone mechanical quality. The use of an ultrasound probe should allow to position the robotic arm in an optimal manner to place pedicle screws. In general, echography does not allow to see beyond the bone surfaces because ultrasounds are strongly reflected at the surface and strongly attenuated when propagating in bone. Low amplitude signals coming from inside bone can however be exploited through specific treatments which are a specialty of our team. Our team, pioneer in ultrasound utilization to probe bone, has introduced several approaches that offer an alternative to X-Rays for characterization of trabecular or cortical bone health. For our team, this partnership with SpineGuard and ISIR is a great fit: it will accelerate methodology and instrument developments for a broader utilization of ultrasound in orthopedic surgery. We are very happy to participate in this innovation rich project.” About SpineGuard® Founded in 2009 in France and the USA by Pierre Jérôme and Stéphane Bette, SpineGuard is an innovative company deploying its proprietary radiation-free real time sensing technology DSG® (Dynamic Surgical Guidance) to secure and streamline the placement of implants in the skeleton. SpineGuard designs, develops and markets medical devices that have been used in over 90,000 surgical procedures worldwide. Nineteen studies published in peer-reviewed scientific journals have demonstrated the multiple benefits DSG® offers to patients, surgeons, surgical staff and hospitals. Building on these strong fundamentals and several strategic partnerships, SpineGuard has expanded the scope of its DSG® technology in innovative applications such as the « smart » pedicle screw, the DSG Connect visualization and registration interface, dental implantology and surgical robotics. DSG® was co-invented by Maurice Bourlion, Ph.D., Ciaran Bolger, M.D., Ph.D., and Alain Vanquaethem, Biomedical Engineer. SpineGuard has engaged in multiple ESG initiatives. About ISIR ISIR is one of the largest French Research institutions in robotics and intelligent systems, reporting mainly to Sorbonne University, CNRS (National Center for Scientific Research) and Inserm (National institute for health and medical research). It regroups more than 50 teaching researchers and permanent researchers and approximately 80 PhD ad post-doc students. ISIR is structured around 6 research teams focused on artificial intelligence and machine learning, mobile robotics, small scale robotics, assistance robotics (physical therapy and mobility support), human-robot interaction and surgical gesture assistance. ISIR has a rich expertise in the design of innovative robotic architectures, simulation and control, clinical validation and transfer of high industrial potential results. Over the last 5 past years, 10 pre-clinical or clinical studies were conducted at ISIR. 8 patents were granted, and 2 start-up companies created. About LIB The Laboratory for biomedical imaging (LIB) is specialized in Fundamental and Applied Research for biomedical morphologic imaging methods, functional and molecular on small animal and human. It reports to Sorbonne University, CNRS and INSERM. It regroups 35 permanent researchers and teaching researchers, of whom half are also hospital practitioners, approximately 10 engineers and technicians and more than 30 PhD students and post-docs. LIB is structured around 6 teams whose focuses correspond to key priorities of 21st century Public Health: cancer, cardiovascular and neurologic diseases, bone quality. LIB develops new diagnostic and treatments methods exploiting various modalities: ultrasound, MRI, CT, SPECT-PET, etc. LIB has a strong commitment to technology transfer. Over the last 5 years, 6 patents were granted, 7 software were filed, and 5 startup companies launched.

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Spotlight

This is the story of a nurse, who was treating my eighty year old father. He had suffered an incredible fall and was about to have his second back surgery in two weeks. My dad recognized the nurse caring for him and he joked that he was back after just a week. Upon hearing this, this nurse remarked, “Wow, I really don’t remember my patients.” At that point I noticed that she hadn’t introduced herself and she had her badge on backwards. I got her attention, and asked her name. She replied, "Well that depends, I will only tell you my name after you tell me if you think I am doing a good job." And she wasn’t joking. My trust level went to zero. I countered with, “My name is Barbara.” She eventually replied with, “My name is Cindy.” To this day, I wonder if Cindy was her real name. Her answer impacted my trust, but I also worried about what she might be experiencing. What was the culture like there and was that considered acceptable.

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