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Archive for the ‘Digital HealthCare – biotech & internet joint ventures’ Category


M&A of Online health publisher, WebMD Health Corporation by KKR & Co.: Dynamics in Health Care Media, Web-Health and Health Information Markets

Reporter and Curator: Aviva Lev-Ari, PhD, RN

 

The New York-based WebMD Health Corp., health-information provider (WBMD) was acquired by KKR & Co., deal reached on 7/24/2017.  The deal, approved by the WebMD board, is expected to close in the fourth quarter of 2017.

New management at KKR was announced: Co-Presidents and Co-Operating Officers:

  • Joe Bae, and
  • Scott Nuttall

They are replacing Henry Kravits and George Roberts, who started KKR in 1976. 

  • J.P. Morgan Securities LLC is WebMD’s financial adviser 
  • Shearman & Sterling LLP is WebMD’s legal adviser.
  • Simpson Thacher & Bartlett LLP is KKR’s Internet Brands’ legal adviser.

 

WebMD’s chairman Martin Wygod said Monday’s deal was the culmination of a sale process that reached 100 possible buyers as is seen as the best possible premium for shareholders. Though Monday’s deal is struck at a substantial premium to WebMD’s beginning-of-year share price it is roughly the same price as the company’s May 2016 highs. Over the past three and five years, WebMD has returned 15% and 190% respectively, indicating the company’s volatile run on public stock markets as a midcap web health brand.

Herald Chen, head of KKR’s technology industry team, “KKR and Internet Brands are pleased to be investing behind the experienced WebMD management team and trusted WebMD platforms. The combined portfolio of leading vertical internet assets will be a powerful one.”

https://www.forbes.com/sites/antoinegara/2017/07/24/kkr-strikes-deal-to-buy-health-information-giant-webmd-for-2-8b-and-a-former-partner-scores/#6f3f567b2730

Founded in 1996, WebMD has grown into one of the most popular health websites for consumers and medical professionals, attracting more than 70 million monthly unique visitors in 2016, according to analytics company comScore Inc (SCOR.PK). WebMD was founded by Jeffrey Arnold, who became a billionaire at age 29 when the company merged with Healtheon Corp. in 1999.

https://research.tdameritrade.com/grid/public/markets/news/story.asp?docKey=1-SN20170724000559&provider=CBSMarketWatch

Internet Brands, which launched as CarsDirect.com in 1998, licenses and delivers its content and internet technology products and services to small and medium-sized businesses. It was acquired by KKR in 2014 for $1.1 billion from two other private equity firms, Hellman & Friedman LLC and JMI Equity.

Under KKR, the company has expanded its portfolio of brands to include Demandforce and Fodor’s Travel.

A deal would make WebMD the latest healthcare media company to be sold. In December, j2 Global Inc’s (JCOM.O) digital media arm Ziff Davis LLC acquired Everyday Health Inc, a U.S. operator of health-related websites, for $465 million, including debt.

SOURCE

http://uk.reuters.com/article/us-webmd-m-a-kkr-exclusive-idUKKBN1A80US

https://www.wsj.com/articles/kkr-co-near-deal-to-buy-webmd-1500851095

 Results for WebMD 4Q2016

 

Fourth quarter revenue was $207.5 million, compared to $192.1 million last year, an increase of 8%. Advertising and sponsorship revenue grew 8% to $171 million, compared to $158.3 million in the prior year period. Breaking down our advertising and sponsorship revenue further:

• revenue from biopharma and medical device clients increased 11% compared to the prior year period; and

• revenue from OTC, CPG and other clients was comparable to the prior year period.

Health services revenue was $28.8 million, an increase of 6% compared to $27.2 million in the prior year period. Information services revenue was $7.7 million, an increase of 16% compared to $6.6 million in the prior year period. Fourth quarter net income increased 32% to $36.2 million or $0.73 per diluted share compared to $27.5 million, or $0.60 per diluted share in the prior year period. Fourth quarter Adjusted EBITDA increased 16% to $78.1 million, or 38% of revenue, compared to $67.4 million, or 35% of revenue, in the prior year period. Capital expenditures were $5.3 million in the quarter. Operating cash flow was approximately $66.9 million in the quarter. This includes a cash tax benefit of $28 million related to the use of our tax NOL’s generated by stock based compensation which, as required by GAAP, are included in the financing section of the cash flow statement rather than in the operating section.

SOURCE

TRANSCRIPT OF Q4 2016 WEBMD EARNINGS CONFERENCE CALL – Feb. 16, 2017

http://files.shareholder.com/downloads/WBMD/4075514959x0x929898/89CBE95F-8CF1-4234-B809-D93060391CE5/WBMD_Q4_16_TRANSCRIPT.pdf

Current Portfolio of Assets in Health-related Websites: Outcome of 

M&A of WebMD by KKR 

The deal brings together WebMD’s websites, such as

with those owned by KKR unit Internet Brands Inc, including businesses serving 50,000 health practices and boast a big footprint in cloud web hosting geared towards practitioners such as dentists, chiropractors, veterinarians, eye doctors and therapists. Its operating businesses include

 

SOURCES

http://www.cnbc.com/2017/07/24/webmd-to-be-acquired-by-kkr-for-66-point-50-a-share-in-cash.html

https://www.forbes.com/sites/antoinegara/2017/07/24/kkr-strikes-deal-to-buy-health-information-giant-webmd-for-2-8b-and-a-former-partner-scores/#6f3f567b2730

The DEAL

 

…On a P/E basis the deal price represents 32.4x our 2017 GAAP EPS estimate of $2.05 and 31.7x our 2018 estimate of $2.10. EVDY received 9.6x FY1 and 7.5x FY2 Adj. EBITDA last year when it was acquired by JCOM. On an EV/Adj. EBITDA basis we estimate the deal represents 10.7x 2017E EBITDA and 10.1x 2018E EBITDA, which is well above the multiple that EVDY received. This news is a significant positive given that the deal price is slightly above the range we had been assuming, and there had been some news commentary recently that WBMD was having some challenges agreeing on a price with prospective buyers.

SOURCE

http://www.barrons.com/articles/kkr-deal-revives-webmd-shares-1500903910

WebMD Is Said Near a Sale to K.K.R.

The health publisher WebMD could soon join a stable that also houses DentalPlans.comVeinDirectory.org and AllAboutCounseling.com.

K.K.R. is near to an all-cash deal to buy WebMD Health Corporation, which owns WebMD.com,Medscape.com and MedicineNet.comReuters and The Wall Street Journal reported.

The deal would bring all the WebMD websites into K.K.R.’s company Internet Brands.

WebMD, which has a market capitalization of $2.1 billion, had said in February that it would explore its options after a slowdown in pharmaceuticals advertising.

SOURCE

From: CNBC Morning Squawk <morningsquawk@response.cnbc.com>

Reply-To: CNBC <reply-feef1278736c00-23_HTML-4897801-7204331-344@response.cnbc.com>

Date: Monday, July 24, 2017 at 8:34 AM

To: Aviva Lev-Ari <AvivaLev-Ari@alum.berkeley.edu>

Subject: Earnings, Fed hold keys to Wall Street’s recent record run

 

 

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Arrhythmias Detection: Speeding Diagnosis and Treatment – New deep learning algorithm can diagnose 14 types of heart rhythm defects by sifting through hours of ECG data generated by some REMOTELY iRhythm’s wearable monitors

Reporter: Aviva Lev-Ari, PhD, RN

 

Long term, the group hopes this algorithm could be a step toward expert-level arrhythmia diagnosis for people who don’t have access to a cardiologist, as in many parts of the developing world and in other rural areas. More immediately, the algorithm could be part of a wearable device that at-risk people keep on at all times that would alert emergency services to potentially deadly heartbeat irregularities as they’re happening.

said Pranav Rajpurkar, a graduate student and co-lead author of the paper. “For example, two forms of the arrhythmia known as second-degree atrioventricular block look very similar, but one requires no treatment while the other requires immediate attention.”

To test accuracy of the algorithm, the researchers gave a group of three expert cardiologists 300 undiagnosed clips and asked them to reach a consensus about any arrhythmias present in the recordings. Working with these annotated clips, the algorithm could then predict how those cardiologists would label every second of other ECGs with which it was presented, in essence, giving a diagnosis.

http://news.stanford.edu/2017/07/06/algorithm-diagnoses-heart-arrhythmias-cardiologist-level-accuracy/

 iRhythm, maker of portable ECG devices

Image Source:

https://www-technologyreview-com.cdn.ampproject.org/c/s/www.technologyreview.com/s/608234/the-machines-are-getting-ready-to-play-doctor/amp/

Cardiologist-Level Arrhythmia Detection with Convolutional Neural Networks

We develop an algorithm which exceeds the performance of board certified cardiologists in detecting a wide range of heart arrhythmias from electrocardiograms recorded with a single-lead wearable monitor. We build a dataset with more than 500 times the number of unique patients than previously studied corpora. On this dataset, we train a 34-layer convolutional neural network which maps a sequence of ECG samples to a sequence of rhythm classes. Committees of board-certified cardiologists annotate a gold standard test set on which we compare the performance of our model to that of 6 other individual cardiologists. We exceed the average cardiologist performance in both recall (sensitivity) and precision (positive predictive value).

Subjects: Computer Vision and Pattern Recognition (cs.CV)
Cite as: arXiv:1707.01836 [cs.CV]
(or arXiv:1707.01836v1 [cs.CV] for this version)

Submission history

From: Awni Hannun [view email]
[v1] Thu, 6 Jul 2017 15:42:46 GMT (852kb,D)

SOURCE

Active Learning Applied to Patient-Adaptive Heartbeat Classification

Part of: Advances in Neural Information Processing Systems 23 (NIPS 2010)

[PDF] [BibTeX] [Supplemental]

Authors

Abstract

While clinicians can accurately identify different types of heartbeats in electrocardiograms (ECGs) from different patients, researchers have had limited success in applying supervised machine learning to the same task. The problem is made challenging by the variety of tasks, inter- and intra-patient differences, an often severe class imbalance, and the high cost of getting cardiologists to label data for individual patients. We address these difficulties using active learning to perform patient-adaptive and task-adaptive heartbeat classification. When tested on a benchmark database of cardiologist annotated ECG recordings, our method had considerably better performance than other recently proposed methods on the two primary classification tasks recommended by the Association for the Advancement of Medical Instrumentation. Additionally, our method required over 90% less patient-specific training data than the methods to which we compared it.

SOURCE

Cardiologist-Level Arrhythmia Detection With Convolutional Neural Networks

Pranav Rajpurkar*, Awni Hannun*, Masoumeh Haghpanahi, Codie Bourn, and Andrew Ng

A collaboration between Stanford University and iRhythm Technologies

https://stanfordmlgroup.github.io/projects/ecg/

JULY 6, 2017

Stanford computer scientists develop an algorithm that diagnoses heart arrhythmias with cardiologist-level accuracy

A new deep learning algorithm can diagnose 14 types of heart rhythm defects, called arrhythmias, better than cardiologists. This could speed diagnosis and improve treatment for people in rural locations.

The Machines Are Getting Ready to Play Doctor

An algorithm that spots heart arrhythmia shows how AI will revolutionize medicine—but patients must trust machines with their lives.

by Will Knight,  July 7, 2017

https://www-technologyreview-com.cdn.ampproject.org/c/s/www.technologyreview.com/s/608234/the-machines-are-getting-ready-to-play-doctor/amp/

The Dark Secret at the Heart of AI

No one really knows how the most advanced algorithms do what they do. That could be a problem.

by Will Knight, April 11, 2017

https://www.technologyreview.com/s/604087/the-dark-secret-at-the-heart-of-ai/

 

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2017 Top 50 in Digital Health by Rock Health

Reporter: Aviva Lev-Ari, PhD, RN

 

We found the following to be very interesting:

 

Most Prolific Corporate VC

UPMC Enterprises

UPMC Enterprises, the commercialization arm of UPMC, is shaping the future of health care through innovation. Focused on generating impactful technology solutions, they invest in key focus areas: clinical tools, population health, consumer-centric health care, and business services and infrastructure. As the most active corporate venture investor of the year in digital health, UPMC contributed to several funding rounds including investments in Health Catalyst and Lantern.

Most Prolific VC

Khosla Ventures

Khosla Ventures helps entrepreneurs with large problems that are amenable to technology solutions. A longtime tech and healthcare investor, Khosla Ventures participated in five digital health deals this year, including Neurotrack and Color Genomics.

Best Performing IPO

Evolent Health

Evolent Health partners with health systems to accelerate their transformation to value-based care. By integrating the people, processes, and technology needed to drive clinical and financial growth, Evolent has found the secret to success—it is one of the digital health stocks with the biggest returns YTD, up 114% since the start of the year.

Crowdfunding Hero

BSX Technologies: LVL

LVL is the first wearable hydration monitor that gives users the complete picture of their health by also tracking activity, sleep, mood, and heart rate. Their wildly successful Kickstarter campaignresulted in over $1.1 million pledged of their $50,000 goal, and backers will soon be able to measure their hydration in real time. Fewer than 200 crowd funding campaigns have ever raised over $1 million.

SEE ALL CATEGORIES in

https://rockhealth.com/announcing-the-2017-top-50-in-digital-health/

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Digital Medicine: Leaders in Technology and Therapeutics for Clinical Care, September 15, 2016, Boston Marriott Copley Place, Boston

Reporter: Aviva Lev-Ari, PhD, RN

 

Digital Medicine Connect at BioPharm America | September 15, 2016 | Boston, MA

Bringing together the trailblazers of modern medicine

Meet the top thinkers and leaders in digital medicine at
Digital Medicine Connect 2016

REGISTER
Hear from industry leaders about how they continue to push the boundaries of technology and therapeutics to make clinical care more successful.
Adam Brickman Director of Strategic Communications and Public Policy, Omada Health
Alex de Winter Director, GE Ventures
Cris De Luca Digital Health Innovation Leader, Johnson & Johnson Innovation
Steve Dickman CEO, CBT Advisors
Nick Dougherty Program Director, PULSE@MassChallenge
Eric Elenko Executive VP, Science and Technology, PureTech Ventures
Nicole Fisher Founder and CEO, HHR Strategies
Katya Hancock Director of Industry Partnerships, StartUp Health
Christine Lemke Co-Founder and President, Evidation
James Mault VP and Chief Medical Officer, Qualcomm Life
Corey McCann CEO, Pear Therapeutics
Kathy McGroddy Goetz VP, Partnerships and Solutions, IBM Watson Health
Yarmela Pavlovic Partner, Hogan Lovells
Asher Rubin Global Head, Life Sciences and Healthcare Industry Group, Hogan Lovells
Digital Medicine Connect is a one-day program at BioPharm America™ taking place September 15 in Boston.
Learn more about the conference
Apply for a presentation slot

 

SOURCE

http://portal.emailnetworks.com/vm2/f6d28ccc30ea399d/25320/8669713da0d03a0a09e5cb74f1f037a9

From: Katie MacPherson <conferences@ebdgroup.com>

Date: Tuesday, August 2, 2016 at 2:07 PM

To: Aviva Lev-Ari <AvivaLev-Ari@alum.berkeley.edu>

Subject: Omada Health, IBM Watson Health, Qualcomm Life, J&J Innovation added to #DigitalMedicineConnect speaker lineup

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Point of care pulse oximetry

Curator: Larry H. Bernstein, MD, FCAP

LPBI

 

Not All FDA-Cleared Finger Pulse Oximeters Perform Alike

http://www.mdtmag.com/news/2016/05/study-not-all-fda-cleared-finger-pulse-oximeters-perform-alike

Nonin Medical, Inc., the inventor of finger pulse oximetry, today announced the results of a new independent hypoxia lab study in humans that demonstrates that Nonin’s PureSAT pulse oximetry technology captures and reports worsening patient conditions better than other Food and Drug Administration (FDA)-cleared oximeter brands.1Nonin made the results available in a white paper at the American Thoracic Society (ATS) and American Telemedicine Association (ATA) conferences this week.

Not all FDA-cleared finger pulse oximeters perform alike, says a new study. Nonin Medical’s pulse oximetry technology was found to be more accurate in patients with challenging conditions, such as COPD.

In the study, conducted independently by Clinimark Laboratories in Boulder, Colo., three finger pulse oximeters were tested; one from Nonin Medical and two from large, private-labeled manufacturers. All oximeters had FDA 510(k) clearance as “medical devices,” but two of them did not provide the clinical accuracy required to track desaturations in patients with low blood circulation and labored breathing. Only the Nonin Medical oximeter was able to accurately track the desaturation events as compared to an independent hospital tabletop oximeter control device.

Not all FDA-cleared finger pulse oximeters perform alike, says a new study. Nonin Medical’s pulse oximetry technology was found to be more accurate in patients with challenging conditions, such as COPD. (Credit: PRNewsFoto/Nonin Medical, Inc.)

“Over the years, a number of inexpensive, imported FDA-cleared oximeters have flooded the market, all claiming to be accurate,” said Jim Russell, vice president of quality, regulatory and clinical affairs for Nonin Medical. “This study dispels the myth that all pulse oximeters perform alike, especially on challenging patients such as those with chronic obstructive pulmonary disease (COPD).

“Clinicians, hospitals and telemedicine providers can better manage COPD patients and potentially reduce readmission rates by choosing pulse oximeters that provide early and accurate data on all patients, including the sickest patients. Nonin Medical’s oximeter performance is proven,” Russell said.

References
1Batchelder, P.B., Fingertip Pulse Oximeter Performance in Dyspnea and Low Perfusion During Hypoxic Events. Clinimark Laboratories, Boulder, Colorado. 2016. White Paper.

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Diversification and Acquisitions, 2001 – 2015: Trail know as “Google Acquisitions” – Understanding Alphabet’s Acquisitions: A Sector-By-Sector Analysis

Reporter: Aviva Lev-Ari, PhD, RN

 

GoogleAcquisitons

SOURCE

https://www.cbinsights.com/research-google-acquisitions?utm_source=CB+Insights+Newsletter&utm_campaign=2d8a0dbc59-TuesNL_05_03_2016&utm_medium=email&utm_term=0_9dc0513989-2d8a0dbc59-87377285

 

Understanding Alphabet’s Acquisitions: A Sector-By-Sector Analysis

Google has made nearly 200 acquisitions since 2001. When the company reorganized as a new entity called Alphabet in late 2015, the new structure refocused attention on Google’s non-advertising businesses, including Calico (healthcare), Google X (self-driving cars , robots, etc.), and Nest (smart home), all of which now effectively operate as their own divisions.

We analyzed some of the sectors outside search and digital advertising where Alphabet has made recent acquisitions:

MEDIA AND ENTERTAINMENT

Google paid $1.7B for YouTube in 2006 in what is widely regarded as one of the most important consumer tech acquisitions of all time. Since then, Google has acquired more video-related companies whose technologies were absorbed into YouTube, including an easy-to-use video-creation tool (Directr), video-rendering tech (Zync), and social video software (Omnisio).

More recently, YouTube has signaled its interest in content, acquiring Next New Networks in 2011 (it became YouTube’s Next Lab to scout talent) and Vidmaker (a kind of Google docs for video editing, used by semi-professional and professional video creators). The rollout of YouTube Red, an ad-free subscription-based version of YouTube, could point to more content-related acquisitions if the model succeeds.

VR is another area of interest for Google. The company acquired Skillman & Hackett, which makes software that allows users to “paint” in virtual reality environments, and also acquired the team from Thrive Audio, which specializes in “positional audio” which will be key for adding a soundtrack to immersive VR experiences. Digisfera, a company that specializes in 360-degree imaging, has use cases in Google’s mapping projects, but could also be useful since 360-degree images are also used in VR content (YouTube has already 360-degree video support for VR enthusiasts).

AUTO TECH AND NAVIGATION 

The two fields are interrelated, with Google’s market-leading maps giving the giant a good footing in the race to build autonomous vehicles. Several of Google’s acquisitions helped make Google Maps and its underlying data more robust, including companies focused on satellites (Skybox Imaging) and crowdsourced traffic data (Waze). Google also acquired Lumedyne, a company that creates microsensors, which could be used in various car parts that could help power and refine self-driving cars.

ROBOTICS 

Alphabet made more than 7 robotics acquisitions in 2013 as the company continues to make serious forays into the space including a recently filed patents for controlling large groups of robots and creating downloadable personalities. The robotics companies that were acquired develop machines for a wide set of use cases. Boston Dynamics has developed a robotic cheetah, Industrial Perception’s robots are designed to locate objects and move them in warehouse environments, and Bot & Dolly develops robots to assist in filmmaking.

SMART HOME

Google’s largest acquisition ever was for Nest in 2014 for $3.2B, and now operates as one of Alphabet’s divisions under Tony Fadell. The company has made other acquisitions to bolster its home offerings, including Dropcam for home security and Revolv, a smart home hub. While the Revolv product was discontinued, the team helped develop Google’s OnHub, a centralized Wi-Fi and Smart Home device. Alphabet also acquired Flutter, a gesture-recognition company, which would allow for new, convenient ways for consumers to control smart home devices (Project Soli is already using gesture-recognition in really interesting ways).

COMMERCE

Since 2011, Alphabet has bought more than 15 companies involved with powering commerce and small businesses. Many acquisitions helped build “Google Shopping”, which is the company’s foray into ecommerce, and “Google Express”, a gigantic logistics endeavor for product delivery. Google also bought Rangespan and Channel Intelligence, both designed to use data to help businesses sell their goods online. In the past, the company has also purchased daily deals sites (DailyDeal, The Dealmap), targeted coupons (Incentive Targeting, Zave Networks), and loyalty programs (Punchd).

GOOGLE FOR ENTERPRISE/PRODUCTIVITY

Alphabet has several productivity products aimed at least in part at enterprises, including Drive, Hangouts, and Docs. Many of the acquisitions were early (pre-2011) and helped these products come into being, including Urchin Software (acquired in 2005), which became Google Analytics, and Writely (acquired in 2006), which fed into documents. Virtual assistants like Google Now might be enhanced through the recent acquisitions of Timeful (artificial intelligence) and Emu (natural language processing), technologies that could help create smart scheduling features. Alphabet could also be trying to enter the mobile enterprise market with the acquisition of Divide, a company that allows employees to carry a single phone with a “work” mode and “personal” mode.

CLOUD

Google has also made acquisitions to bolster its Google Cloud Platform and help it compete effectively for users and app deployments with Amazon’s AWS Microsoft’s Azure, and other providers. In 2014, Google made 4 acquisitions on this front in the form of Stackdriver, Appurify, Zync Render, and Firebase.

HEALTHCARE

While Google is heavily involved in healthcare through Google X, Calico, and its Life Sciences division, the company has made few disclosed healthcare acquisitions. The most recent was Lift Labs, a company that has developed a stabilizing spoon for people with neurodegenerative disorders like Parkinsons.

Healthcare is also a major investment area for the company’s venture arm, Google Ventures. They’ve invested in several different areas of healthcare, including insurance (Oscar), big data (Flatiron Health), and genomics (23andMe).

PAYMENTS

Google announced Android Pay almost directly after Apple announced Apple Pay. Google’s most notable payments acquisition was Softcard, a contactless NFC based mobile payments solution. originally a joint venture between AT&T, Verizon, and T-Mobile. In exchange, the carriers have agreed to pre-install Google payment apps on their phones. However, it’s unclear whether the platform has gained any traction.Google has also invested in other areas of fintech, including digital currency, crowdfunding, and more recently insurance.

TELECOMMUNICATIONS

Alphabet has become directly involved in cell and internet services through projects like Project Fi, Google Fiber, and Project Loon. Google also bought satellite company Skybox Imaging and high-altitude drone company Titan Aerospace. Both are acquisitions that could have possible ramifications for providing connectivity to developing countries, without the need for expensive and logistically complex submarine or terrestrial infrastructure.

SOURCE

https://www.cbinsights.com/research-google-acquisitions?utm_source=CB+Insights+Newsletter&utm_campaign=2d8a0dbc59-TuesNL_05_03_2016&utm_medium=email&utm_term=0_9dc0513989-2d8a0dbc59-87377285

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iPhone Application: The CareKit by Apple – Embedded Algorithms in every Diagnosis Tool

Reporter: Aviva Lev-Ari, PhD, RN

Apple’s CareKit: Useful Tool for Health and the Encryption Debate

WATCH VIDEO

http://www.mdtmag.com/blog/2016/03/apples-carekit-useful-tool-health-and-encryption-debate?et_cid=5191801&et_rid=461755519&type=headline&et_cid=5191801&et_rid=461755519&linkid=http%3a%2f%2fwww.mdtmag.com%2fblog%2f2016%2f03%2fapples-carekit-useful-tool-health-and-encryption-debate%3fet_cid%3d5191801%26et_rid%3d%%subscriberid%%%26type%3dheadline

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