STSI (Scripps Translational Science Institute), directed by the famous Eric Topol, MD, is undertaking a 200-person six-month research study to determine the results of telehealth monitoring for three conditions (diabetes, heart arrhythmia and high blood pressure) coupled with an active disease management program. Half of the survey group will receive a Withings Blood Pressure Monitor, an AliveCor Heart Monitor and an iBGStar Blood Glucose Meter delivered via Qualcomm Life’s 2net Hub and Platform to a web portal or mobile device; the remainder will not but will be part of the disease management program. Subjects will be drawn from Scripps Health employees and family, which to this Editor may be stacking the deck–most employees of a health system presumably are health-conscious. Participants also include Scripps Health, HealthComp (third-party healthcare administrator which will monitor health status), Accenture and Sanofi Diabetes. Though the release promises ‘social networks’, the only reference this Editor could find is interactivity between the person and the health care team. Scripps press release. MedCityNews Hat tip to former QuietCare colleague José Molina (via LinkedIn)
Horizon Monday 12th August – ‘Monitor me’ (UK) now with tech update
A good programme exploring vital signs measurement – well worth a look. If you missed it, it is on BBC iPlayer (only available in the UK).
The 3GDoctor has collated the tech demonstrated, if you want to buy/get more info. Even offer a discount plus a ‘free ECG read’ on the AliveCor ECG device.
Analysis of the Birmingham OwnHealth service – not the bad news it seems?
The BMJ has just published an open access paper entitled “Effect of telephone health coaching (Birmingham OwnHealth) on hospital use and associated costs: cohort study with matched controls” (BMJ2013;347:f4585, Steventon et Al). It reaches the rather depressing headline conclusion that telephone coaching did not reduce unplanned hospitalisations and if anything increased them.
This looks to fly in the face of the apparently less academically rigorous recent claims by the Leicester City CCG and Totally Health, that they reduced hospitalisations significantly, saving some £353,000 over a 30 week period with a cohort of between 47 & 50 patients that we reported recently.
However reading on, perhaps a key passage, in the conclusion, is (more…)
O2 – a retrospective
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/O2.jpg” thumb_width=”100″ /]With 1734 hits (and counting) the Telecareaware post on O2 Health’s telecare & telehealth withdrawal and associated comments was one of our most popular. It therefore seems appropriate to try to crystallise some important lessons from all those brilliant comments, so here’s my starter – please feel free to add your thoughts. (Almost all the comments are related to the retail telecare offering so unless specifically stated otherwise, all the following relates only to this side.)
Overall there was a huge sense of sadness that came through from many comments – many had seen the move into retail sales a confirmation that telecare had finally arrived as a mainstream technology in the UK, so a withdrawal so soon afterwards caused much grief. It was touching to see the concern for the staff too, who have worked so hard to get this venture airborne.
Although there were few comments specifically about the retail telecare kit, none were complimentary; it was seen as being single purpose, limited and hard to use. The ability to replicate the hardware functionality on a standard smartphone, (more…)
FDA publishes medical device interoperability standards (US)
While FDA is still dithering about issuing draft guidance on mHealth, it looks like medical device manufacturers can break out the champs, because FDA has now recognized 25 standards on medical device interoperability and cybersecurity. According to Bakul Patel of the Center for Devices and Radiological Health at FDA, “Making sure devices are interoperable requires the creation, validation, and recognition of standards that help manufacturers develop products that are harmonious and can “plug and play.” It’s an alphabet soup of industry standard abbreviations–IEEE, ANSI, AAMI, ISO, IEC and ASTM–and it’s purely voluntary, but various groups such as Continua and AAMI (Association for the Advancement of Medical Instrumentation) have praised this ‘first step’, and being published, it is now open for comment.
According to the Continua LinkedIn group announcement from Executive Director Chuck Parker, the 25 standards can be grouped into three categories:
- Risk management standards for a connected and networked environment
- Interoperability standards that establish nomenclature, frameworks and medical device specific communications and including system and software lifecycle processes
- Cyber security standards from the industrial control area most relevant to medical devices.
As the FierceHealthIT article cited, interoperability failure is a top 10 health technology hazard according to the ECRI Institute. One can hope the new standards can be applied retroactively to current devices which are not being patched and updated because manufacturers fear running afoul of FDA clearance regulations and counter that ‘discouragement’. [TTA 8 Aug] AAMI News, Federal Register 6 August, FDA Voice (blog article by Bakul Patel)
The five-point digital health checkup meets the FBQs
Checking up on some of the issues that the D3H crowd (Digital Health Hypester Horde) tends to skip merrily by, Dan Munro’s analysis hits several nails on the head and then some, with his points touching on our FBQs–the Five Big Questions*–we first outlined exactly three years ago (integration was added last year).
- Who has the rights to your data? You or only your doctor? (#3) And why not you?
- Need drastically improved standards of safety and security in devices. From those black hatted device hackers to the lack of updates by manufacturers and FDA‘s apparent discouragement–it may not be an an FBQ, but it impacts #5, data integration.
- Accuracy. Are these devices accurate or only ‘kinda’? How do you play off accuracy versus convenience?
- Privacy–what about it? Business models call for sale of ‘de-identified’ data which can be tracked back and re-identified. (#1) And what does your activity say about you-ooooo? (#3)
- The business model. Aside from who’s paying for the device and how much (#1, #2), #3 is still there–who’s looking at the data if you purchased the kit? And who’s liable for interpretation–and errors?
5 Point Digital Health Checkup (Forbes)
* The Five Big Questions (FBQs)–who pays, how much, who’s looking at the data, who’s actioning it, how data is integrated into patient records.
FDA’s discouraging role in medical device security
According to a Wall Street Journal report (unfortunately firewalled), hospitals are pointing a very long finger at medical device manufacturers for not updating software and leaving devices open to breaches. Yet the manufacturers readily cite FDA’s most recent guidance as prohibiting software updates and security patches without resubmitting their devices for approval–something a spokesperson for the FDA denies as long as the update is for cybersecurity only. If the draft guidance issued in June is actually finalized, it will go the distance in helping manufacturers and hospitals. Hospitals Say Device Manufacturers Resist Boosting Cybersecurity (iHealthBeat)
Big data in healthcare’s Tower of Babel: interview with Eric Topol
A short interview in iHealthBeat with Eric Topol, MD, Lydon Newmann of Impact Advisors and Lee Pierce from Intermountain Healthcare shows the bright side of business intel/’big data’. All that structured and unstructured data collected on individuals can be put to good use by data warehousing and analysis–a success story is Intermountain’s reduction of induced births from 30 percent to 5 percent. Yet the wins outlined are single system. Eric Topol agrees with this Editor that “The problem that exists is they lack any ability to transfer information from one to the next. There’s no interoperability. So we have a Tower of Babel.” Audio (and a dissenting comment) here, PDF transcript here.
Microsoft Kinect now as sign language translator
The versatility of Microsoft Kinect continues to astound, with uses ranging from human rehab/physical therapy to equipping robots with anticipatory powers for your drink to Ellie the Virtual Analyst. Add sign language translation to this list. The latest is Chinese sign language simultaneous translation via Kinect that will permit deaf and hearing individuals to understand each other. Sign languages are their own entity with grammar and rules that make the spoken/written language nearly foreign to the user. The system developed by Chinese Academy of Sciences’ Institute of Computing Technology and Microsoft Research Asia joins the one developed for American Sign Language last year. Wired.co.uk Hat tip to Toni Bunting, TTA and TANN Ireland.
Digital Health Days (Sweden)
21-22 August 2013, Stockholmsmässan, Stockholm, Sweden
If you prefer to cool off from summer’s heat in Stockholm, the first annual Digital Health Days is “designed to provide the perfect mix of visionary expert panels, learning workshops and demonstrations of real solutions.” It is both a conference and exhibition–and looks to be diverse based on the program (in English). Speakers include Don Jones of Qualcomm, IBM hosting a presentation on Watson and certainly a different mix of companies. Events include a health hackathon and the Digital Health B2B meeting sponsored by the Stockholm Business Region Development; pre-organized one-to-one meetings bring together partners and investors for European companies. (Registration for this only is here and free). Website, registration
Connected Health Symposium 2013
24-25 October 2013, Boston Seaport Hotel and World Trade Center
The Connected Health Symposium is celebrating its 10th Anniversary in a new venue and with the theme “Collaborations and Innovations to Engage Patients and Elevate Care.” It will likely draw the 1,500 or so attendees it has in recent years. It is a round robin of interesting seminars (almost too much) as well as continuing with “TED-style keynotes, book signings, debates, interviews, probing panels, innovative product demos and plentiful networking opportunities”. Based on the speaker list, what will also carry over is an emphasis on Washington policy, hospital and payer issues. Preliminary agenda is here and registration information here. Organized by Partners HealthCare Center for Connected Health.
Note: Early bird discount of $200 expires on 15 August.
New England Home Healthcare Consortium Summit 2013
3-5 November 2013, Foxwoods Resort, Mashantucket, Connecticut
To meet the rapidly expanding challenges and needs of baby boomers, nationally recognized industry experts on home healthcare, aging, and emerging technology will gather for the region’s first-ever New England Home Healthcare Consortium Summit . Seven speakers will share their insights and provide solutions to prepare the industry to effectively address such critical issues as increasing cost pressures, the affects on families and friends, as well as baby boomer demands for expanded care needs, including new technologies. The agenda is here, and largely on aging and care issues although speaker Greg Wellems, CEO of Imagine! in Boulder, Colorado, an organization which serves the cognitive and developmentally disabled, will speak on the role of technology in improving support. The Monday opening keynoter, Alexis Abramson, has also been a fan of health tech since early days in 2006 (she covered this Editor’s former company with one of the earliest major media stories on QuietCare). Website, registration Hat tip to reader Laura Abbott
23andMe advertising nationally in the US (sign of the times)
23andMe, the US personal genetics company, launched Portraits of Health, the company’s first (US) television advertising campaign on 5th August.
Anyone unaware of the company and its ambitions could do worse than watch the excellent video of Anne Wojcicki’s presentation at a recent RSM innovations summit.
Whilst the NHS talks about building a 100,000 person genomic database, and the RCGP sees the most advanced medical development in the life of the average GP by 2022 will be remote delivery of test results, it seems that 23and Me is powering toward’s Anne’s goal of one million genomes sequenced.
It’s not a totally fair comparison of course as the NHS ambition is full sequencing, whereas, as she explains in the video, 23andMe focuses on what they consider the key areas; nevertheless it’s impressive stuff and an indication of just how quickly technology is changing healthcare.
Is your body temperature looking hot? Soon you’ll be able to find out!
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/sony_vital_signs.jpg” thumb_width=”150″ /]In a Pointer to the Future, Sony has filed a US patent application describing a way to associate vital signs such as blood pressure, pulse rate or body temperature with your photographs.
The idea is to record your vital signs as you take a photo or make a recording on a smartphone (or other portable gadget such as a PDA or tablet). Readings would be gathered from strategically placed sensors within the casing of the device and could be recorded continuously or at intervals.
The sensor information would then be assigned to a tag (such as “general fitness tag”) and stored alongside the image, with the tag and/or sensor readings used to organize and sort the images.
Other types of sensors such as a GPS locator, ambient temperature sensor, or light detector, could also be integrated. In this way the tag could be a result of internal biological data combined with external factors such as current position.
As regards healthcare applications, the technology could serve as a non-threatening way for healthcare professionals and clinicians to obtain vital signs readings from patients, either in person or remotely. It could be a useful addition to face-to-face or online psychotherapy consultations, and for assessing the urgency of emergency ambulance calls.
As this filing is currently at the application stage, no patent has (yet!) been granted to Sony. The idea does however open up some interesting possibilities, not only in healthcare and for Quantified Selfers, but also in areas such as security and gaming. Also reported in Engadget.
The Berwick report on patient safety – is there a place for telemonitoring? (UK)
Reading and listening to the debates in recent days about whether the excellent Berwick report should have mandated staffing ratios, instead of leaving such guidance, as his report does, to NICE, I wondered to what extent technology had been considered to have an important role in improving patient safety.
The best example I can think of why this can be important, from my Newham days, was people prone to night-time fits that used to require dedicated human monitoring throughout the night. By installing appropriate telecare we were able both to improve patient outcomes by enabling people to sleep on their own without outside disturbance at the same time as reducing significantly the cost of night-time care: a case where technology simultaneously enabled an improved level of care and a reduced staffing level.
It was therefore reassuring to find on Page 22 under the heading “A note on staffing ratios”:
| “Our primary recommendation on staffing patterns is that NICE undertake as soon as possible to develop and promulgate guidance based on science and data. Such guidance, we assume, would include methods by which organisations should monitor the status of patient acuity and staff workload in real time, and make adjustments accordingly to protect patients and staff against the dangers of inadequate staffing. We also assume, and hope, that innovations will develop and continue in technologies, job designs, and skill mix that will and should change ideal staffing ratios, so that this role for NICE ought to be ongoing.” |
I’d hasten to add that I am not advocating general use of telemonitoring in response to the report – merely to point out that there are some specific occasions where technology can help, and those are increasing as new technologies, possibly such as smart floors, are developed.
First ‘Lucky Thirteen’ StartUp Health/GE program company sold
Breaking News
One of the ‘Lucky Thirteen’ companies, Arpeggi, which entered the joint StartUp Health/GE Ventures program back in April [TTA 4 Apr], has been sold to another early-stage company in the genetics analytics, data management and diagnostic space, Gene by Gene. It is the first acquisition of one of the joint program companies and according to StartUp Health spokesperson Nicole Kinsey, “this is a strong sign of how well the program is is working to accelerate and scale digital health startups. This new combined company will be a major competitor to companies like 23andme and will really offer the consumer market much greater access and affordability to DNA testing and sequencing services.” The Arpeggi group and tech platform will be incorporated fully into Gene by Gene, and according to Unity Stoakes, President of StartUp Health, the latter will now enter the StartUp Health/GE Ventures program. Release (PDF)
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