Tunstall, world leader in telehealthcare, starts to evangelize the USA

We are interested to note that Tunstall is starting to claim the term ‘telehealthcare’ in the USA just as we notice it starting to downplay its use in its recent UK marketing materials in favour of ‘telecare and telehealth’. (In the UK the term ‘telehealthcare’ gained ground in general usage in some parts of the country after Tunstall started to use it and, as no other major suppliers used it, they succeeded in owning it in the way that a team which has the ball in its possession ‘owns’ the ball.)

How do we know that Tunstall is about to do its telehealthcare thing in the US? Read this press release: Telehealthcare Leaders Forum Welcomes Assoc. Chief Medical Officer at Northwestern Memorial to Speak About Healthcare Innovation. American and Canadian readers will be highly amused to learn that “The Telehealthcare Leaders Forum is North America’s only educational and professional event dedicated to stimulating innovation and leadership in the emerging era of technology and healthcare delivery.”

Medicare to cut back rural telemedicine (US)

The Centers for Medicare and Medicare Services (CMS), part of Health and Human Services (HHS), talks a good game when it comes to telehealth and telemedicine as part of ‘healthcare reform’ and reducing same-cause readmissions–but gives away the real deal in bone-headed moves like this. In the US, telemedicine video consults are not reimbursable by Medicare unless one lives in a designated rural county. Because of population shifts, 97 counties are losing their rural designation, while 28 counties gain, based on Standard Metropolitan Statistical Areas (SMSAs). Thus Medicare recipients who’ve had the option of using video consults lose that option. The CEO of the American Telemedicine Association (ATA), Jonathan Linkous, has rightly been blasting this impending change, most recently here and to all who would listen (FierceMobileHealthcare), but Federal ears are on holiday. But this Editor will blast even harder and blunter: why Medicare does not include telemedicine as an cost-saving, effective and convenient option for every Medicare recipient, and encourage its use for both initial review and follow up to reduce readmissions, is (figuratively) insane. Here’s how it could be set up. Contract with a wide group of companies. Charge a $5 co-pay on initial visit. No charge on follow up. Work with seniors groups and senior centers–and the VA. Run the numbers and tweak appropriately. Americans have a government which squanders money (do not get this Editor, or The Gimlet Eye, started). With all the money being thrown at ‘pioneer ACOs’ and various awards programs, CMS can find some loose change under the couch!  Hat tip to reader Ellen Fink-Samnick, MSW and her ‘Ethical Lens’ LinkedIn group joining the blast furnace.

Related: For those who want to dive deeper into rural vs. urban readmission rates (pretty much a draw), David Lee Scher, MD cites the following:  from the Robert Wood Johnson Foundation, Interactive Map: The Revolving Door Syndrome; a study comparing rural and urban veterans’ admissions; and The Rural Hospital Advantage.

Diabetic foot ulcer ‘early warning’ system raises $1 million (US)

Rock Health accelerator alumnus Podimetrics raised $1 million in a second and final closing of its Series A round, according to a Form D filing with the Securities and Exchange Commission (SEC). The Boston-based company has developed a bathroom mat that in about 30 seconds of daily use, will scan the feet, collect data about blood flow, analyze it on a cloud-based platform for changes over time and also differences between feet to detect patterns that may indicate the presence of a developing ulcer. More than 90,000 people per year in the US lose a foot to diabetic ulcers at an average of $45,000 per surgery. The new funding will go towards development of new related products. MedCityNews

Ill health prediction from Facebook interests?

Joseph Kvedar, Director, Center for Connected Health, Partners HealthCare poses a ‘big data’ question on his cHealth (connected health) blog: Is Facebook a Predictor of Your Health? Well, per se it’s not, of course, but the interesting speculation is on how far collectors of data relating to our online behaviour and offline shopping habits might soon be able to start identifying our likelihood of developing particular health conditions. If you think it is far-fetched, find the link in the comments to the Forbes item spotted by David Doherty ‘How Target Figured Out A Teen Girl Was Pregnant Before Her Father Did’.

‘To Read’ lists for the holiday weekend

With both Easter and Passover coinciding, your Editor’s final post for the week will be a compilation of lists which are poking up like crocuses this week. A happy holiday to our readers!

  • 10 High-Tech Gadgets to Help Grandma and Grandpa.  Andrew Carle (Director, Program in Assisted Living and Senior Housing, George Mason University) and his updated ‘nana tech’ list: GrandCare Systems, VTech, GreatCall featured. Ignore the condescending Forbes headline.
  • Five New Technologies from What’s Next Summit 2013. Laurie Orlov in Age In Place Tech looks at new entrants in the senior tech area such as CareMerge, CareSquared (virtual visits and information exchange between residents in communities and family) and SingFit (music).
  • 6 Companies Cashing in on Obamacare. Like most CNN Money headlines, it’s a writer’s stretch as none of them are cashing in quite yet–most are just past startup or early-stage and are still finding their hospital readmission, insurer, physician, individual insured and health exchange markets: GoHealth, Health Recovery Solutions, Eligible, QuantiaMD, Connecture and hCentive. Since costs will be going up on average 32 percent by 2017 for insurers in the individual market, according to the Society of Actuaries–only 6 percent today but expected to balloon as smaller companies abandon ever-costlier group plans–there is a huge future market in wringing out costs.
  • Which Emerging Markets Are Best Bets for Health Care Returns? If you had $1,000 to invest, what countries would be best? The answers will surprise you! From last month’s 2013 Wharton Health Care Conference.
  • Four Robots That Are Learning To Serve You. Your Friday Robot Fix courtesy of National Public Radio: FURo robot tour guide, Bestic eating assistant, EPFL’s amphibious ‘salamander’, mobility devices for smartphones including Botiful, Romo and SmartBot. For more on robots, quick search TTA.
  • Five Fallacies of Remote Patient Monitoring. Another list from David Lee Scher, MD which will disabuse many of their preconceptions.
  • Five mobile health projects on Indiegogo. For health tech eyeing crowdfunding, here’s a list from Mobihealthnews surveying Indiegogo, which permits but does not specialize in healthcare, unlike MedStartr and Health Tech Hatch, the latter buzzing in The Hive at TEDMED 2013 16-19 April. It also illustrates the drawbacks–for the hits such as Amiigo’s app/bracelet/shoe clip fitness system, there are others that do not make goal.
  • NEW 29 March  16 Billionaires Investing in mHealth Continues to Grow. David Doherty’s mHealth Insight roundup which includes the new $97 million fund started by two founders of RIM/BlackBerry, Mike Lazaridis and Doug Fregin; unfortunately no phone numbers or emails!

1st European Conference in eHealth and Telemedicine in Cardiovascular Prevention and Rehabilitation

June 7-8, 2013, Bern, Switzerland (Conference language – English)

Endorsed by the European Society of Cardiology Working Group on e-Cardiology and the European Association for Cardiovascular Prevention and Rehabilitation, the main topics of this conference concern the development and application of tools such as telemonitoring, telecardiology, telerehabilitation and mHealth applications in the field of cardiovascular prevention and rehabilitation. Preliminary programme and further information here: European Conference in eHealth and Telemedicine in Cardiovascular Prevention and Rehabilitation. NOTE: March 2013, To submit an abstract or poster please use the online submission procedure.

March Telecare LIN newsletter published (UK)

“March was a busy conference month with the ALIP Showcase in Liverpool and Healthcare Innovation Expo in London showcasing a range of digital technology and services including the DALLAS and 3millionlives programmes. A new NHS health apps library was announced by the NHS Commissioning Board and there were several new product announcements at the Expo. March also saw the launch of the Technology Strategy Board’s ‘Long Term Care Revolution’ and Paper 6 (of 15) from the Whole System Demonstrator Programme was published on cost-effectiveness. The NHS major changes in England begin on 1 April 2013 – 211 Clinical Commissioning Groups have been authorised and will hold £65bn of NHS budget. April to July is a busy time for conferences and events and the newsletter has a full listing including Health 2.0 in London and Manchester, the 4th Annual Conference on Telecare and Telehealth in Glasgow and the King’s Fund Congress in July.” Download the Newsletter (PDF) here. The Useful Links Supplement is available in a separate PDF.

If not FDA to regulate mHealth, then who?

For those looking for alternatives to FDA approval of  mobile health or medical apps, some organizations have been tossed into the Suggestion Box. It’s a veritable alphabet soup of abbreviations, starting with ONC (Office of the National Coordinator for Health Information Technology). There’s the private sector review entity initially created for EHR certification with the formation of CCHIT (Certification Commission for Healthcare Information Technology, part of HHS) or what CCHIT has now become, a private/federally monitored model. There’s also the FTC (Federal Trade Commission) which pulled an acne treatment app of the market, and the ever-popular FCC (Federal Communications Commission) which has been searching for a Director of Health Care Initiatives and after all has millions to dole out in the Health Care Connect Fund. Neil Versel’s latest over at Mobihealthnews focuses in on this (omitting the FCC), considers the suggestion by Thomas Santo, MD in a recent column at KevinMD that medical industry associations (AMA–American Medical Association, ACP–American College of Physicians, etc.) should also be involved with health tech tools, to the extent of a rating system or even endorsement–and argues against it. (This excludes Happtique’s certification program standards/performance requirements.) But since both FDA and the FCC are involved, now separately, in most things mHealthy, and at least one proposed bill (HIMTA) would create an FDA Office of Mobile Health, why not have a joint office as a single point of contact? FDA regs would remain the same, but the review would encompass both medical effectiveness and wireless issues.

Rock Health’s guide to FDA for the health tech entrepreneur (US)

In 26 slides, Rock Health has neatly summarized for those unfamiliar with the FDA approval thickets (99% of us) on what is a regulated health tech product and is not. Instead of a MEGO (my eyes glaze over) experience (familiar to all those who’ve sledded through the FDA website), there are simple examples in how to determine what class your device falls into (I, II, III) and what you need to do to gain approval. It also clearly defines the substantial difference between 510(k) premarket submission and the far more complicated PMA premarket approval–and the fact that after approval, FDA will forever be in your life. It also notes that other approvals such as FCC may be required and many other tips on how to make the process easier and less garment-rending for your organization. Features comments from Chris Bergstrom of WellDoc and Geoff Clapp, who co-founded Health Hero which is now Bosch Health Buddy. SlideShare link

Is telehealth a busted flush? (UK)

Caroline Price, in an article in Pulse, one of the UK’s magazines for general practitioners “looks at telehealth’s uncertain future” in Analysis: Is telehealth a busted flush?. Free registration is required to access it but it may be worth doing as it is a fairly comprehensive round up of the mood of NHS GPs and commissioners in the wake of the recent Whole System Demonstrator (WSD) analyses. She has also included some figures she has rounded up from the 3ML pathfinder sites. “Pulse has also discovered that even the most enthusiastic CCGs are struggling to roll out the scheme. Of the seven pathfinder areas announced by Jeremy Hunt at an Age UK conference last November, two were unable to provide any figures for the number of patients benefiting from telehealth.”

Readers with access to the (‘private’) 3ML discussion group on LinkedIn will find a relevant, interesting discussion in progress. It was started by Chris Wright, the 3ML Programme Manager at the Department of Health: WSD data – help or hindrence? [sic]

Smart pill bottles 2.0

click to enlargeBack in 2009, this Editor was wowed by pill container-reminder Vitality GlowCaps, and has been cheered by its recent developments in developing a reminder pouch for non-pill medications. Now NYC-based startup AdhereTech adds to the med reminder picture through a specially designed compact bottle for pills or liquids that not only has lights, speakers and a built-in 45-day-long battery, but also is fully M2M–each bottle connects from anywhere via cellular 3G and LTE with no base station required. Thus the containers can be used by those ‘on the go’. Sensors in the containers also measure humidity and opening/closing–but what’s new here is providing a measurement of pills/liquids remaining in the bottle. This is done by measuring the capacitance, or stored charge, along the container walls, without actually touching the meds. Alerts are planned to be customizable in type and style (lights, chimes, emails, text). Testing is planned initially with Walter Reed Army Medical Center, Wake Forest University and University of Pennsylvania against standard containers on whether it increases adherence for a variety of disease conditions. The AdhereTech team is initially targeting use of the containers for specialty medications which require accurate dosing and where adherence is critical. Thanks to founders Josh Stein and Michael Morena for clarifications. This Pill Bottle Is a Smartphone Wannabe (Wired)

IBM, EME, UCLA fighting TBI

Another IBM-related item, this time on IBM using big data analytics software (but not Watson) developed in conjunction with Excel Medical Electronics (EME) used to alert for signs of dangerous brain pressure increases in traumatic brain injury patients. The UCLA Department of Neurosurgery will be analyzing real-time streams of vital signs collected from bedside monitors at the Ronald Reagan UCLA Medical Center ICU to spot subtle changes in the patient’s pulse, blood and intracranial pressure, heart activity and respiration. These changes can alert for dangerous high-risk increases in brain pressure. UCLA Relies on Breakthrough ‘Big Data’ Technology from IBM To Help Patients with Traumatic Brain Injuries (IBM release) Hat tip to Toni Bunting of TANN Ireland.

IBM discovers telecare as “Solutions for an Aging Population”

IBM, along with its ad agency Ogilvy, produced this four-minute, expensively produced ‘ad-doc’ (umentary) on the trial of (drum roll) a remote monitoring technology for elder care in Bolzano, Italy as part of their Smarter Cities initiative. Yes, it’s telecare, brushed up, dressed in blue and looking spanking new again! The story of Zita, a elderly woman and seamstress who lives in a lovely apartment in a hill town your Editor wouldn’t mind moving to, is the exemplar of both Italy’s growing aging population (23.5 percent are over 65) and how to accomodate both the older person living at home to ease the hard realities of aging cost impacts on local social services. IBM’s system and sensors (blue sensor box perched on the refrigerator at 2:34) appear to be unique in design. The rest will sound familiar. At about 3:00, “The sensor’s job is to recognize any abnormalities you can understand if someone could show signs of illness and eventually send an alarm to social services personnel.” Even the malapropism on the sensors recognizing abnormalities (see the web platform graphing at 3:14) and Nicola Palmarini of IBM’s remark “Preventing events means we avoid catastrophic events–dangerous for people…” were features/benefits your Editor worked with for QuietCare back in 2006-7. There’s nothing really new here except that IBM is trying what Care Innovations, HealthSense and GrandCare already have. But will IBM’s backing of telecare, which has been largely sidetracked to assisted living in the US and pushed to the side by consumer mobile health and apps, gain a new lease on life? Can we hope? Or are we back to the Same Old Struggle? Adweek article on IBM’s ad-doc.

[This video is no longer available on this site but may be findable via an internet search]

Doctor, organize thy apps

click to enlargeYou know there are a lot of physician-directed apps when a startup develops an app to organize apps. Omnio by Physicians Interactive promises to help the harried doc with an iPad identify the most relevant resources for the specialty and tag the most used everyday. They also plan to take a page from LinkedIn and design a home page with an activity wall. What is mystifying is that they do not have a native e-prescribing app yet, but a quick look at their website indicates that Physicians Interactive’s bread-‘n’-butter is advertiser-supported sampling and mobile media promotion/marketing.  PI releaseVirtual “black bag” iPad app to help healthcare professionals customize reference material, tools (MedCityNews)

Aging in America 2013: conference report

Joop Koopman, reporting for Bayard Presse, has generously shared with us (in English) his report on the annual conference of the American Society on Aging, which took place in Chicago 12-15 March. Commentary on presentations by Aging in Place Technology Watch’s Laurie Orlov, gerontologist Ken Dychtwald, Mary Furlong’s What’s Next Summit preceding ASA, AARP, Scott Collins of LinkageConnect, Caring.com and Louis Tenenbaum. Technologies: Care Innovations, GrandCare Systems and Philips. Communities: OnLok Lifeways, Avenidas (virtual).  PDF (10 pages)

Joop Koopman is an experienced writer/journalist, with a background in Catholic media (as editor and publisher), baby boomer-oriented marketing, as well as public relations serving both commercial and non-profit clients and causes. He currently provides a stable of European magazines catering to the 50-plus audience with information on US marketing trends. He is fluent in Dutch and French.