A Ph.D project at the Norwegian Centre for Integrated Care and Telemedicine has resulted in an interesting self-monitoring system for diabetics.  Eirik Årsandt based it on a smartphone, a glucose monitor, a step counter and software that trends and inputs information.  The monitor and counter upload wirelessly to the smartphone, the person can enter medication and diet information and the app creates a useful diary.  Further testing will be part of an EU project called "Renewing Health" starting this month, with a group of 200 subjects.  Article (in English).

Sensor device-maker Gentag is commercializing a disposable “skin patch” that looks like an ordinary bandage.  Targeted to orthopedic surgery patients, it enables the patient to self-monitor during recovery as long as they have an RFID enabled cell phone.  The patch combines advanced MEMS sensors with Gentag’s disposable wireless sensor platform.  Gentag has already developed other disposable diagnostic patches, including devices for fever and diabetes monitoring.  Article.

Of interest, perhaps, to telehealth suppliers: a discussion-piece in Product Design and Development. Five views from people in the medical devices industry on surviving the recession. The Brainstorm: Medical Device Market.

New game: brand spotting...telehealthcare is...

• a long-established brand name of Viterion Telehealthcare, a Bayer company. Website.
• a California corporation that performs administrative and technical duties for, and in conjunction with the Physician Association. Website.
• re-branding terminology being promoted by Tunstall for the past couple of years. Website.
• a brand name for UK (newcomer?) diabetes monitoring company Axon Telehealthcare. Website.

Summing up Brian Dolan's extensive coverage for MobiHealthNews of the 3-4 February mHealth Initiative conference are his thoughts on what will be driving mHealth--providers or consumers/patients?  While there are highly 'activated patients', the least activated are least compliant with care plans, most likely to be readmitted to the hospital--and the most costly.  The low consumer adoption of personal health records (PHRs) and other evidence is suggested in Rob Havasy's (Connected Health) tweet, "When providers adopt consumers will engage"--a doctor's prescription. Other highlights of the conference:

• Is the mHealth revolution unstoppable? The technology is ready--but the participants need to change their ways (kickoff keynote)
• The FCC's digital healthcare director on mHealth driving economic growth, jobs--the connectivity situation (10% of the US still has no wireless)--and sorting it out with the FDA
• Finding the 'willpower' to integrate mHealth into a neurological practice (with Verizon Droids)--its potential for practice management and 'remote virtual nursing'
• George Washington Medical Center's (Washington, D.C) case history of an intensive mobile phone based program for Medicaid patients with diabetes, teaming up with WellDoc and Medicaid PPO clinic Chartered Health Family Clinic
• AT&T's iPhone hospital launches:  Doylestown Hospital, Cedars-Sinai Medical Center; and Mt. Sinai Medical Center (Toronto, Canada)
• mDhil, a successful health text messaging company in India, with 150,000 users in 10 months (probably highly activated)

MassGeneral Hospital for Children and the Partners Center for Connected Health (both Partners HealthCare, Boston) are testing a videoconferencing arrangement that connects six pediatric ICU physicians' homes with a portable telemedicine station positioned at the patient's bedside.  When the on-call attending physician at home is needed for a consultation, the videoconference link enables the physician to see and evaluate the patient (with special cameras and scopes if needed), talk with clinicians on-site, and make treatment decisions. Healthcare IT News.

Text4Baby, a text messaging reminder program for expectant moms, launched today with a White House announcement from Aneesh Chopra, the White House CTO.  Coordinated by a mobile health information services provider, Voxiva, it provides three-times weekly health tips and reminders.  Once initiated by the user, the text messages are provided at no charge for the next two years by 15 major cellular providers.  There is a laundry list of 'collaborators' which include General Mills, Grey Healthcare Group and the Department of Defense.  This is what was once called a 'public service initiative' and presumably will be measured and tested for effectiveness in outcomes, such as reducing infant mortality.  Release on MobiHealthNews.

One of ZDNet's bloggers, Larry Dignan, digs into the Federal FY2011 $3.8 trillion budget. His focus is tech overall but here are what seem to be the healthcare related nuggets (largest first):

• Health and Human Services (HHS):  The proposed $81.3 billion HHS budget includes $110 million for health IT coordination and research. The funding is designed to “to assist providers with adoption and meaningful use of electronic health records.”
• Department of Defense (DOD):  as a result of two wars and growing veterans' needs, their healthcare budget is now $30.9 billion (up 5.8%).  DOD has been pioneering in mobile health and portable scanners (our recent WOW of the day).  Health IT is a major feature of spending, along with building 'virtual lifetime electronic records' for servicemembers and veterans.  Veterans Affairs (VA) spending is separate and can add to these initiatives.
• Department of Commerce:  The National Institute of Standards and Technology (NIST) is where there is more tech money with a budget of $712 million.  Not directly identified with healthcare, but nanotechnology is mentioned as well as $80 million allocated for something called the Technology Innovation Program 'invest(ing) in high-impact research'.
• National Science Foundation (NSF):  in their $7.4 billion, the emphasis is on 'green tech', renewable energy and education. Same with the Department of Energy.

All of this is up to Congress, of course, and what will be funded--and who will be the players--and how much of this will be allocated to smaller and early-stage companies--is anyone's guess.  Article.

A sign that Haitian medical relief has turned from 'emergency' to the 'continuing crisis' of caring for hundreds of thousands (millions?) of Haitian post-acute patients and the chronically ill:  five companies--one a wireless provider--are partnering in donating equipment and organizing them into a system.  The five are Advanced Warning Systems (disease management services), whose CEO Miles Moore took the initiative in organizing the group; MedApps (mobile wireless health monitoring); A&D Engineering (wireless scales, blood pressure monitors, stethoscopes); Nonin (portable pulse oximeters); and Digicel (major Caribbean wireless provider providing the connectivity).  This program will be implemented after rescue and recovery has been completed and long-term relief providing ongoing medical services and support, can start.  Also key to this is getting Haiti's wireless network running reliably beyond the current provisional patchwork. They are working through American Red Cross International Services which presumably will coordinate readiness of health providers 'on the ground' and the Haitian Government.  These five companies--none of them 'giants'--should be commended for taking the initiative and for their generosity.  It is also a real world test, just a few hundred miles away from the US, that remote monitoring can advance healthcare in less developed countries.  Release.

[Editor's note:  With Haiti's minimal and largely corrupt, dys/nonfunctional infrastructure in ruins, is this an opportunity to re-imagine Haiti as a high-tech center?  Steven van Zandt the E Street musician seems to think so and is calling on Jobs, Brin, Dell etc. to design a new Haiti in this Politico article.  Certainly Haiti now bears many similarities to Germany 'Year Zero' 1945 or Panama only 25 years ago.  What do you think? --Donna] [That last article is very interesting. I've just 'digged' it. So, don't bother to re-establish a wired telecoms infrastructure, but go wireless and give everyone mobile devices and the means to charge them... then stat building a wireless-based health and care system for the whole country. It could be done if there were a will. - Steve]

It's good to see someone else fretting at the terminology issues once again. This time Guy Dewsbury in his Telecare Blog focuses on people who play fast and loose with the phrase 'assistive technology' in particular. "If we fail to [understand what we mean by the words] then a conversation can be futile or even dangerous depending on what the other party takes away with them."

Who will - or can - take up the challenge in Guy's final paragraph? The Language of Telecare

Unilever Ventures created Imperative Health (then known as MiLife) in 2008.The system, tested with a focus on weight loss, monitors activity and weight and reports back to the user with "personalised adaptive coaching to encourage necessary behaviour changes... Additional tools such as habit breakers, reminders, community interaction, and meal planning all contribute to the highly engaging and successful system." Now, with new funding and a change of name, Unilever is set to market the system more aggressively in the UK. Press release.

Item 1 is a taster for  the forthcoming WSDAN event at Stansted on 11 February. As the WSD programme data cannot be analysed until the last person recruited in the Autumn of 2009 has been in the programme for a year, the meeting will concentrate on matters such as those people who withdrew from the programme, and integrated working. I hope that the session by Michael Dillon from the NHS Technology Office which will cover "some of the work being carried out at Newham on capturing data from telehealth systems into GP records" will be reported on the WSDAN website in due course.

Item 2 is a request for information on the use of telecare/telehealth with carers [US: caregivers]

Item 3 is the most interesting item: a Google Map tracking primary care trusts' (PCTs) reports on telehealth projects in the UK, based on publicly available information. The pins are colour-coded according to whether there is no information, an expressed intention or an actual project. It gives a snapshot of progress of interest in telehealth in the NHS and estimates that there are over 5000 telehealth remote units in active use covering heart failure, COPD and diabetes. (This includes WSD sites.)

Item 4 is low-key but potentially interesting link to individual telecare profiles for the 152 social care authorities in the UK based on the Care Quality Commission data from 2009 and the local authority performance reports published in December 2009.

Item 5 lists recent Department of Health (DH) documents with references to telecare. [Don't hold your breath looking for anything of significance - apart from by its absence.]

Item 6 contains new links the Buying Solutions telecare framework. [This is the follow-up to the NHS PASA National Framework Telecare Agreement which had the unintended consequence of distorting the market in the days of the Preventative Technology Grant.]

Item 7 is 37 pages of raw links to telecare/telehealth news stories. [All the worthwhile ones will be familiar to regular Telecare Aware readers.]

Item 8 has information about DH Care Networks events.

Download the PDF version of the eNewsletter here. (2.54Mb)

24th February 2010, London

One-day seminar, supported by Bosch, organised by the Westminster Health Forum and featuring luminaries such as

• Margaret Parton, Chief Executive Officer, NHS Technology Adoption Centre
• Murray Bywater, Managing Director, Silicon Bridge Research
• Richard Rees-Davies, General Manager for Home Health, GE Healthcare

Global Media of Scottsdale, Arizona, has an interesting position in the telemedicine market. It has expertise in visual conferencing but also produces devices and software that make it easy to incorporate telemedicine: items such as a cart system (featured in this general zdnet item on telemedicine) but, most interestingly, the small, multifunction camera 'TotalExam' (FCC and CE marks December 2009). See a YouTube video and read more in an Arizona Republic article. How long, one wonders, before such technology becomes part of a visiting kit for nurses?

Diversinet, a company that provides the security platforms for AllOne Mobile's health information services, announced that AllOne--not them--filed to terminate their relationship with a payment of $3 million.  Just last September, the two companies signed a five-year agreement, giving AllOne exclusivity in mobile health (with option to terminate after year 3 in 2011).  But this agreement, surfaced by Brian Dolan at Mobihealthnews, also lists substantially higher payments scheduled to date.  What is even odder is that AllOne Mobile's parent, AllOne Health, owns 15% of Diversinet.  AllOne Mobile has gained traction with their relationships:  the US Army for a mobile care pilot for wounded veterans (our article), Significa Insurance Group, Erin Group Administrators, plus partnerships with Microsoft HealthVault, MedFlash, and Clickatell.  This editor's been impressed by AllOne Mobile's progress; their parent is the only health management firm that's placed a big bet on mobile, a gutsy move for a smaller player in a challenged sector as corporate benefit managers cut back.  But the puzzle is:  what happened in only a few months, especially when Diversinet provides a critical part of AllOne Mobile's service, and there is a corporate ownership tie?

We haven't seen much from India in spreading telemedicine domestically, but here is a report about a small innovative company called KTwo Technology in Bangalore.  Their everyday products are a Bluetooth accessory for car stereos and a voice-recognition headset. But they have already developed (with Intel technology--video) a remote pathology delivery system called CytoSight, which captures impressions of a pathology sample from the microscope and makes it available to a pathologist/physician situated elsewhere.  They are testing it in four public health centres in Gadag and Bagalkot districts, with the objective being reduction of malaria deaths that occur in rural areas due to diagnosis delay.  Indian Express article. KTwo website.
[Useful video to help visualise the technology. It's interesting that Intel doesn't seem to have linked them up with the company producing the CellScope, which has also been produced in association with Intel. Steve]

Are you part of a startup which is seeking funding?  Here's another source.  An alphabet soup of Federal agencies (NIH, CDC, FDA, ACF) released something called the Omnibus Solicitation for SBIR (Small Business Innovation Research).  Two phases are supported by SBIR funds, the third is intended for commercialization. Many mentions of monitoring, but some highlights among the topics of interest listed in this Federal Telemedicine News summary (please see the article for translation of acronyms): 

• (Biomedical engineering) Software and hardware for telehealth studies (NIBIB)
• (Aging) Develop practical applications using innovative technologies to do research on hand-held devices, telemedicine, robotics, social networking, and communications technologies (NIA)
• (Cancer) Develop new telemedicine technologies, remote medical imaging, and bioengineering technology that can be applied to cancer detection and diagnosis (NCI)
• (Diabetes) Develop sensors and delivery devices for monitoring blood to prevent hypo and hyperglycemia in diabetic patients(NIDDKD) 
• (Drug abuse)  Develop eHealth tools, plus develop new technologies to integrate data from prescription monitoring programs to current clinical practices (NIDA)
• (Heart, lung, blood)  Miniaturized devices for home monitoring, how to assess periodic breathing infant apneas associated with hypoxemia and also use to assess disorders in adults (NHLBI)

Submission for grants starts 5 March.  NIH grant page

For your weekend viewing:
1) RTT News interviews Jonathan Linkous of the American Telemedicine Association on how technology and healthcare are converging (4 mins)
2) Larry Chu interviews Chuck Parker, Executive Director of Continua about the alliance, for HCPlive. (7 mins)
3) Tech journo Scott Mace visits the Continua Alliance booth at CES last week--the 'child's garden of wonders' we referred to. The video quality is only fair, but Mr Mace lets the demos speak for themselves. You'll also get an idea of the Digital Health part of the expo floor. This one includes IBM demonstrating the 'end-to-end' solution including A&D, Roche, Eurotech; Nonin Medical and Vignet. (7 mins)
4) Also by Scott Mace, this features Tunstall, Storento (sp?) med monitoring packaging, MedApps and a chronic disease management demo by a Continua representative that includes A&D, LNI Health Link uploading to a Google Health PNR. (10 mins)
5) A crystal clear MedApps demo using a pulse oximetry reading (the subject lived.) (1 min)

Washington, DC, February 3-4, 2010

First global conference on use of cell phones, smart phones and other wireless mobile devices in healthcare. Early booking discount ends 20 January. Programme. Sponsor a report?

For the healthcare minded, the Consumer Electronics Show (International CES), officially kicking off Thursday (7 Jan) in Las Vegas (but all over the press with Google's Nexus One, 'smartbooks'/slates etc.), has a section in the LVCC's North Hall dedicated to 'digital health'.  Unfortunately the exhibitor list in this 'tech zone' is a bit of a disappointment, with only Continua Alliance and GrandCare Systems of interest to our readers.  The neighboring Silvers Summit 'tech zone' has more of interest, with Dakim (brain fitness), Jitterbug (phones), Tabsafe (med dispensing) and Wellcore (fall detection).  But Continua seemingly has a child's garden of wonders in their booth.  They are demonstrating 'the first end-to-end connected health solution based on the Continua architecture':  Nonin Medical's wireless Bluetooth pulse oximeter sends data to a PC manager running Vignet's Connected Health Services platform (debuting at CES-release) which is then uploaded to an IBM server.  But...there's more:  A&D Medical (blood pressure and weight--see recent story on Halo partnership), Lamprey Networks, PDT, Renesas Technology, Tunstall Healthcare (Telehealth Platform--see below--and Connect) and ZyXEL are also demonstrating in the Continua booth. Continua's release and press advisory.

[Donna Cusano update 7 January] Live from CES--GrandCare Systems hosted their weekly open webinar/conference calls from the just-opened floor.

• Add to your visiting list: Carnegie-Mellon/University of Pittsburgh (Silvers Summit 'tech zone' booth #3013)--their display from their Quality of Life Tech Center is a 64 square foot room demonstrating their latest innovations, including RFID-assisted walls that change moods--color and brightness--to assist those with traumatic brain injury, plus touch screens for vital signs monitoring.  (Thank you Jeff Giuggio from C-M for the short briefing).
• Wellcore (#2909) is introducing at CES their in and out-of-home fall detector, which will be marketed through the firstStreet catalog starting in March. Beyond the usual accelerometer, it uses algorithms to track and discern type of motion, delivers voice messages from their online website and will prompt to be worn. Out-of-home, the Wellcore monitor connects via Bluetooth to a cell phone.  Releases.

Although this editor isn't there, we could have an 'inside source' for updates...we hope that what happens in Vegas, can't stay in Vegas!

[Donna Cusano update 8 January] According to this release, at today's 11am keynote Qualcomm chairman Dr. Paul Jacobs was joined by Dr. Eric Topol of the West Wireless Health Institute to highlight a selection of digital medical devices, including AirStrip OB (AirStrip Technologies), Mobile Baby (Great Connection), PiiX (Corventis) and Vscan (GE Healthcare).

San Diego, CA. February 9, 2010

Hosted by Continua Health Alliance and the Wireless-Life Sciences Association (WLSA) - "a day of insightful Mobile Health Solutions keynotes, panel discussions, product demonstrations and networking opportunities with venture capital and development organizations". Open to people who are not Continua members. Details here.