[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/07/Kizon-LG.jpg” thumb_width=”175″ /] Just in time for school start in North America and Europe is LG
‘s September intro of the Kizon
bracelet for keeping track of your small child through an Android app. This child-friendly, colorful (but a little bulky) wristband seems to pack a lot into a one-button package: GPS/Wi-Fi tracking, 2G/3G cellular ability for the child to call out to a pre-loaded phone number and to accept calls from pre-approved numbers. And it appears to be a water and stain-resistant watch as well. LG is marketing to parents of pre-school and primary/elementary school children but pricing is not available. It’s a big change stylistically from the GPS trackers like Lok8u
which have typically been marketed for primarily autistic children and others at risk. Launch will be in South Korea this week according to BBC News
. Is there an opportunity to use this with older people as well?
Editor Chrys on background:
The idea of using mobile phones for tracking kids goes way back to around 2003. The earliest service I know of was one called Child Locate and was launched in the UK by Jon Magnusson. It was intended for parents to track kids (or rather their phones) on a map on the internet. Child Locate has now morphed into Mobile Locate and tracks any mobile device and claims 100,000+ users.
The other service that comes to mind straight away is Disney Mobile – Disney’s MVNO over Sprint. In 2006 Disney launched what seems a great idea at the time – a service for parents to track kids – the Family Center. Similar to Child Locate this service allowed parents to locate the mobile on a map, plus limit call and text spending. It was launched with two handsets, one from, wait for it – LG and the other from now almost bankrupt third largest Korean handset company Pantech. So LG was dabbling in this in 2005/6. Disney Mobile had plans to expand to UK over the O2 network though that never materialised. Disney Mobile closed down a year later.
The Kizon may look cute at first glance but it is definitely not unobtrusive. When my neighbour’s 18-month-old is playing Peppa Pig incessantly on her iPad I think LG’s marketing department is behind times thinking they can get a Western kid to be tracked by her dad for everyone to see. Make no mistake Korea and Japan are the leading nations for high tech consumer products but the psychology of those countries don’t work here. Having worked for a leading Japanese company I have seen this from the inside. If this takes off in London I’ll eat my hat – even if I have to buy a hat to eat!
[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /] Oh, the discomfort that Sergey and Larry
must be feeling being
interviewed by “billionaire venture capitalist Vinod Khosla
” (grudgingly respected in TTA 30 May)
at one of his eponymous Summits.
Here they are with Google Glass
in all sorts of adaptations from Parkinson’s to gait improvement to surgery [see multiple TTA articles here
a ‘moonshot on aging and longevity’ dubbed Calico [TTA 19 Sept 13]
and even a contact lens
to measure blood glucose in tears [TTA 17 Jan].
All good stuff with Big Change potential. Instead they whinge on about how the health field is so regulated, and all the cool stuff you could do with the data
but for that privacy thingy (those darn EU, UK regulations and in US, HIPAA
). Page to Khosla: “I do worry that we regulate ourselves out of some really great possibilities that are certainly on the data-mining end.” Brin to Khosla: “Generally, health is just so heavily regulated. It’s just a painful business to be in. It’s just not necessarily how I want to spend my time.” Gee. Whiz. What is apparent here is a lack of personal respect for us ‘little folks’ privacy and our everyday, humdrum lives.
Advice straight from The Gimlet Eye: My dear boys, you’ll just have to get people’s data with that old-fashioned thing, permission. (And you’d be surprised that many would be happy to give it to you.) Or if it’s all too painful, Sergey can play with his superyacht, latest girlfriend and follow his estranged wife Anne Wojcicki’s 23andme‘s ongoing dealings with the FDA. At least she’s in the arena. Google leaders think health is ‘a painful business to be in’ (SFGate) Mobihealthnews covers their true confessions, with an interesting veer off in the final third of the article to Mr Khosla’s view of Ginger.io’s surprising pilot with Kaiser and then to WellDoc’s Bluestar diabetes therapy app–the only one that is 510(k)Class II and registered as a pharmaceutical product [TTA 10 Jan]. Also interesting re the Googlers’ mindset is a SFGate blog piece on Larry Page’s attitudes towards leisure and work in a Keynes-redux ‘vision of the future‘. < work + > people may= >leisure, but certainly<<<$£€¥ for even the well-educated and managerial!
[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /]Updated…
Released on this ‘getaway day’ (in the US), and surprisingly only covered by the local Yorkshire Post,
is the report of Tunstall Healthcare Group’s
year-end closing (30 Sept 2013) results. The short term news is positive: 21 percent revenue growth to £221 million in its 2013 statutory accounts. However, this adds in the acquisition of Spanish monitoring provider Televida for £27.4m in January 2013 and the 2012 purchases of AMAC in the US and STT Condigi in Sweden. The official posture of the company, expressed by CEO Paul Stobart, is that “with continuing Government austerity measures and a fragile global economy, the business does face challenges in the short term.” And one of those challenges making for a gloomy picture is debt service.
We’ll let the YP
speak: “The group, which is owned by private equity house Charterhouse Capital Partners (CCP)
paid £13.7m of interest in cash on its senior and mezzanine debt of £265m, as well as a total of £114.4m non-cash interest on long-dated shareholder loan notes and other loans. This results in a statutory reported loss for the group of £127.8m.” That change of nearly £350 million, which includes operating costs and other expenses, illustrates the critical consequences of debt service on the bottom line, indeed [TTA 22 May
]. Many thanks to one of our reliable sources for picking up this report.
New: Founder Steve reminds us of his related (and oh, so prescient) analysis from 2010 about Tunstall’s earnings versus debt service balancing act in Telecare Soapbox: Equity capital. A cautionary tale. (Thank you Steve for adding)
It is worth a detailed read because the 2009 numbers were also ‘challenging’. Steve dug through 2009 publicly filed (in UK) numbers to reach his conclusions. In sum, “The important question is whether their underlying position is sound and reliable, or whether they are shaky. They also tell me that the robustness of a company’s cashflow is the most important survival factor.” If I am reading the report on CompanyCheck correctly, the eye-watering negative net worth of the Group and the low cash positions of both the Group and UK are oddly reminiscent of airline financial statements when this Editor was still in that business. Do remember the object examples of Texas Air Corporation (once the world’s largest airline holding company), Pan Am and TWA! You also have to have some sympathy for the management which was not part of getting into this ‘pickle’ now tasked with getting the company out of the barrel.
On July 11th, the free-to-join Digital Health And Care Alliance (DHACA) will be holding it’s first members’ day. The primary aim of DHACA-Day is to kick start operational activity within the Alliance. DHACA will respond to members’ priorities through the vehicle of Special Interest Groups (SIGs), which members are free to join in accordance with their interests. DHACA SIGs will generally follow the requirements gathering processes, leading to the generation of assets in the form of Interoperability Profiles, Guidance, Informational Briefings, and Reference Material.
Key to getting off to a good start will be the optimum selection and scoping of SIGs, and so during DHACA-Day we want firstly to hear from members, and then collectively to propose and define the priority SIGs from the key issues emerging.
To begin the process, the morning will comprise a range of motivational speakers talking on key topics such as integrated care, citizen identity, technology enabling care services and future challenges.
The event is being held in the DTG offices very close to Vauxhall tube station and is free to attend – sign up here for a great day!
When it comes to home health care, the C in CMS (Centers for Medicare and Medicaid Services) should perhaps stand for ‘contradiction’. According to recent reports appearing in the pre-holiday ‘dead zone’ of late last week, CMS has decreed that it must save, as part of a four-year plan under ACA, $58 million (0.3 percent) in fiscal 2015 (starting 1 Oct) from home health agencies which were formerly touted as a great way to save money. To put this in perspective: in 2013, Medicare paid about 12,000 home health agencies $18 billion to provide services to 3.5 million patients. In the US, Medicare has always had more restrictive rules for home and community-based services (HCBS); state-administered (but Federally subsidized) means-tested Medicaid still pays for the vast majority of long-term care (well over 60 percent, according to another Federal agency, Housing and Urban Development [HUD]), which strikes many observers as one pocket to another. So where are the contradictions?
- Conundrum #1: CMS has emphasized post-discharge, post-acute care as part of reducing acute care costs, exemplified in the penalty for 30-day same-cause readmissions. Nursing home expenditure is at least three times more costly than in-home LTC (a conservative estimate used by HUD).
- But CMS plans to cut Medicare home health funding in total so fewer people may receive it at all or less of it even if needed. What will be their alternative, and the effect on outcomes? (more…)
Even if you are an unpaid Telehealth & Telecare Aware editor, believe it of not, you still get asked to post the most ridiculous stuff by people trying to make out it is important to the world of remote monitoring.
It’s great therefore to be able to put the boot firmly on the other foot and point out a new sensor that seems likely to add real value that is not even, today at least, referencable online. This is the chair sensor, reported by FierceMedicalDevices as having just received FDA approval. The sensor, made by EarlySense and placed under the chair cushion, can apparently measure the heart rate and respiration rate of someone sitting in the chair, without any connection to that person. Sadly I can currently find no reference to it on their website though.
The use envisaged is in hospitals, where patients are in individual rooms and to be encouraged to walk about and sit rather than stay in bed (where, if I read it right on the EarlySense website, they can also be similarly monitored by a sensor under the mattress), with the readout at the nurse station. Changes in either pulse or respiration rate then give warnings of impending problems
I can see lots of other uses too though, supporting independent living.
Radiology was one of the first specialties to freely locate the evaluation and reporting on patient imaging almost anywhere in the world. The objective of teleradiology was to increase volume, increase RVUs (relative value units used for Medicare reimbursement) and decrease turnaround times. What has been lost is the face-to-face contact between clinicians and radiologists with live interaction for the patient’s benefit and the clinician’s knowledge base. The addition of real-time video consults synchronized with an image viewer may be a solution. Imaging 3.0 shifts the emphasis to increased quality, increased patient safety and improved outcomes. Remote radiologists can be consulted earlier in diagnosis and during rounds ‘face-to-face’, which is far easier than by telephone. This recent article by reader Howard Reis of HealthePractices explains how even patients can participate in these consults. Real-time Video: Imaging 3.0 Toolkit? Originally published in Radiology Business and with the author’s permission.
Last Thursday, the 11 winners of the second annual Pilot Health Tech NYC program were announced at Alexandria Center, NYC. A joint initiative of the New York City Economic Development Corporation (NYCEDC) and Health 2.0, it provides early-stage health tech companies based in NYC a ‘test bed’ in partnership with many of the most prestigious metro area healthcare organizations, and another platform to keep health tech growing in the city. Each project represents a distinct need in the spectrum and a common theme is integration of care into workflow. Some needs are obvious: senior care, pediatrics, rehabilitation, cardiac disease and diabetes management. Others are less so: vision, medication adherence, data analytics, blood donation and social support.
The winners are supported by $1 million in funding to operate and report results from the individual pilots which will take place starting in late summer through end of year. An interesting fact from the announcement release is that the Pilot Health Tech inaugural class companies [TTA 1 July 2013] have raised over $150 million in private investment since their win: AdhereTech, eCaring, Rip Road, Vital Care Services, BioDigital, Flatiron Health, Sense Health, Bio-Signal Group, Opticology and StarlingHealth (acquired by Hill-Rom).
The winners (some of which we’ve been following like GeriJoy, NonnaTech and eCaring) and their partners are:
- Smart Vision Labs / SUNY College of Optometry
- GeriJoy / Pace University
- QoL Devices, Inc. / Montefiore Medical Center
- Urgent Software, LLC / Mount Sinai Health System
- Nonnatech / ElderServe
- Fit4D/ HealthFirst
- AllazoHealth / Accountable Care Coalition of Greater New York
- Canopy Apps / Visiting Nurse Service of New York (VNSNY)
- Healthify / VillageCare
- Tactonic Technologies / NYU Langone, Rusk Rehab Center
- Hindsait, Inc. / NY Blood Center
More information in their release. Many thanks to NYCEDC and Eric Vieira of ELabNYC (another NYCEDC initiative) and CUNY.
Related reading: ELabNYC Pitch Day in March
Politico is a website (and if you’re in Foggy Bottom-ville, a magazine) much beloved by the ‘inside government’ crowd and the media ‘chattering classes’. With some aspirations to be like Private Eye but without the leavening sharp satire, the fact that they’ve turned their attention to–gasp!–the potential hackathon that is health records is amazing. They mention all the right sources: Ponemon, HIMSS, the American Medical Association, BitSight, AHIMA. In fact, the article itself may be a leading indicator that the governmental classes might actually do something about it. This Editor applauds Politico for jumping on our battered Conestoga wagon with the other Grizzled Pioneers. We’ve only been whinging on about data breaches and security since 2010 and their researchers could benefit from our back file.
And speaking of 2010, the Department of Health & Human Services (HHS) is doing its part to close the budget deficit by collecting data breach fines–$10 million in the past year. A goodly chunk will be coming from New York-Presbyterian Hospital/Columbia University Medical Center: $4.8 million for a 6,800 person breach (iHealthBeat) where sensitive records showed up online, readily available to search engines. And yes, we covered this back on 29 Sept 2010 when breaches were new and hushed up. Politico: Big cyber hack of health records is ‘only a matter of time’
Oddly, there is nary a mention of Healthcare.gov.
Philips Healthcare and Salesforce announced last week their partnership to construct a connected, multi-point and collaborative data platform to benefit providers, payers and patients. The initial step is the launch later this summer of the Philips eCare Coordinator app for healthcare providers and a patient-centered Philips eCare Companion app, which will uptake data from Philips Healthcare medical devices into a variation on the Salesforce1 cloud platform. What’s emphasized in the releases and information from media sources is that it will be designed as an open platform for other device and software providers. (Data security problems down the line are anyone’s guess.) While Philips’ global CEO was part of the announcement and it’s expected that Philips will be lead dog for this, the only two customers mentioned were US and Salesforce’s. There were also few details on how clinical staff would access and use the data.
Cui bono from this? Philips of course, which of late has been lagging (more…)
[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/07/ReWalk-side.jpg” thumb_width=”130″ /]Finally one of the several exoskeletons under development to aid paraplegics to walk has gained FDA approval for its ‘personal’ version for use at home. The Argo ReWalk
[TTA 21 Nov 13
and 2011 coverage] enables mobility for many paraplegics and mimics natural gait through wearable brace supports, motion sensors and a computer-based control system. Crutches are used for additional stability. It also has a rehabilitation version for clinical settings. The importance of mobility, even if limited, cannot be exaggerated. Wheelchair-only mobility can lead to muscle deterioration, blood clots and heart conditions. As part of the de novo
clearance, ReWalk will be doing a post-market study for FDA to determine adverse events. One of the early adopters is Captain Derek Herrera, who works for the Marine Special Operations Command and whose unit is being donated by the MARSOC Foundation
. ReWalk release and website
In a reversal from the ‘¡No pasarán!’ (‘They shall not pass!’) position 23andme and its QS fans famously took back in the winter and spring [TTA 2 Apr, with prior links] vis-a-vis FDA on interpretation of genetic tests, this report from VentureBeat indicates that 23andme is holding out an olive branch. It’s not your usual cutting. It’s an application for Bloom’s Syndrome, a rare inherited genetic disorder, which FDA just accepted. Adding to it is that CEO Anne Wojcicki is a carrier of this disorder. VentureBeat’s speculation is that if successful, the Bloom’s Syndrome application would be the template for future test applications. The tone on both sides has grown conciliatory. For example: sitting on the same Congressional panel on healthcare last Tuesday was an FDA physician directly involved in the approval situation and Ms Wojcicki. There was a well-timed, quite emollient interview with Ms Wojcicki in the Wall Street Journal this past weekend. Certainly a factor is that 23andme is still growing, but less quickly–up 150,000 from its pre-FDA contretemps level of 550,000. And its funders, even though closely related to Ms Wojcicki, hate to wait on numbers which are certainly below projections.
[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/07/stick_figure_push_up_arrow_400_clr.png” thumb_width=”120″ /]It’s geometric! Rock Health’s total of $2.3 billion in digital health funding as of June 2014 just rocketed through the $1.97 billion 2013 full year total. Year over year to date, it’s up over 16 percent. And there’s stardust on every sub-sector: software, digital health, biotech and even medical device, the laggard (negative growth) in previous reports. Funding rounds must have taken vitamins, because they are 50 percent larger on average at $15 million versus last year’s $10 million. But there’s the same concentration on big deals like NantHealth, Flatiron Health, Alignment Healthcare and Proteus, heavily skewed towards payer administration, digital health devices, data analytics and healthcare consumer engagement. But the clouds on the horizon are there. Last year’s disproportion in seed/Series A accelerates, and the ‘down the line’ weakness continues with proportionally fewer companies reaching B, C and D rounds. Crowdfunding has also lost its luster–50 percent off with Indiegogo dominating–but its blowout with Healbe GoBe [TTA 26 June, CEWeek] accounted for 41 percent of total crowdfunding dollars; MedStartr stayed in the game at a distant second. IPOs haven’t been great, the ‘digital health index’ is an underperform yet funders are still itchy to cash out multi-round companies like Practice Fusion (EHR/billing), Proteus and ZocDoc via IPO. VentureBeat. Rock Health report on Slideshare.
If you are a health tech developer, entrepreneur or marketer lost in the forest of the 50+ market, Laurie Orlov of Aging in Place Technology Watch and the new Boomer Health Tech Watch just handed you a map with her latest study for AARP, Challenging Innovators: Matching offerings to the needs of older adults (link to PDF). To appeal successfully to the multiple segments and sub-segments of 50+, there’s more to it than a strong belief that your tech would have been just the thing for your mum or grandmere. The hurdles like reluctant long-term care providers and tech-unfamiliar older adults are significant. Misreading the market, making the tech too complex or identifying it too strongly with ‘old folks’ usually lead to ‘lights out’. Ms Orlov’s pointers take you through testing, crowdfunding, accelerators, the right way to price disrupt, transition point mapping, partnerships and more. A recommended guide.
Over at Aging in Place, Ms Orlov serves up another idea with The ideal wearable for seniors – why not a much-modified PERS which incorporates smartwatch/fitness band capabilities such as dehydration monitoring, activity, blood pressure and other tracking, putting them up on a smartphone app.