It’s official! mHealth in the ‘trough of disillusionment’

Gartner annually issues its Hype Cycle for Emerging Technologies in the Dog Days of August, perhaps not to burst too many bubbles, derail too many fundings?

  • Lo and behold, ‘mobile health monitoring ‘ is heading towards the bottom of the Trough of Disillusionment. Moreover, its recovery is projected at 5-10 years to move out of the Trough, whip through the Slope of Enlightenment and enter the sunny uplands of the Plateau of Productivity. See Gartner chart below.

Forced to wear a fitness tracker for insurance? (US)

For those covered by corporate health policies, the day is not far away where employee health insurance programs will require wearing a fitness tracker and meeting certain metrics, such as walking a million steps or sleep quality. Already some programs have the employee log food, exercise, blood glucose, heart rate and other vital signs to qualify for a discount. The trajectory is much like BYOD–once unheard of, now it is expected to be the norm in 50 percent of US companies by 2017, with a concomitant loss of personal security and privacy. CVS Caremark and other companies have already made the stick, not the carrot, the norm of employee wellness programs [TTA 12 April 2013]. Writer Adrian Kingsley-Hughes asks: “How much access do we want our employers to have to our medical data? How much access to our daily activities do we want our employers and insurers having?” And what about spoofing those Fitbits and Jawbones? His ZDNet article notes the interest that Apple (plus Samsung and Google, despite Sergey’s and Larry’s vapors–Ed.) has in health, then takes it out a few more yards with Wearables and health insurance: A health bar over everyone’s head (and do check out the comments.)

Philips Lifeline introduces a mPERS app

click to enlargePhilips Lifeline has debuted in the US an unbranded mPERS-like app which allows the user from a smartphone (iPhone/Android only) to access the Philips Lifeline call center. The app is free but the service to voice connect to their call center, according to their customer center, is a (bargain compared to standard PERS) $13.95. The phone’s GPS geo-locates the person in need. The fact that the introduction is in the ‘dog days of August’ is one indicator that they are readying well ahead of the late fall (autumn) bump in demand. (Both this Editor and Mobihealthnews see a back and fill for the much-touted GoSafe introduction which 18 months later is still not in market.)

But walk with your Editor through this scenario:

  • Smartphone-equipped older person takes a fall, has an accident or is a crime victim
  • Despite the fact that all smartphones have accelerometers, the app does not tie in to this data, (more…)

Telecare helping Alzheimer’s patients live in the ‘connected home’

click to enlargeThere’s life in telecare–it’s (finally) morphing into ‘connected home’. Is this ‘slope of enlightenment’ and ‘plateau of productivity’ time?  We haven’t had a spotlight on the part of telecare which is sensor-based behavioral monitoring, but here’s one that shines on not just one but four systems which indicates a big change in focus, long developing: SmartThings, Lively, BeClose and certified Grizzled Pioneer GrandCare Systems. CNN.com crafted an article out of a fairly obvious placement by the Alzheimer’s Association, but all to a good end.

Notably SmartThings by Physical Graph (just purchased by Samsung for a reported $200 million after raising $15.5 million through Series A, undoubtedly for their algorithms and in its health reach strategy versus Apple Health) pitches itself on its website as simple home automation, yet this article is all about older adult safety. Lively, which is depicted with an interesting connected pill dispenser (above) and BeClose carve their approaches close to caregivers.  All three are DIY systems. GrandCare remains the anomaly, with the highest (custom) home install price ($699 and up) but with a home tablet that engages the older person with virtual visits, music, pictures, daily updates and family/clinician connectivity. They were also first to move in this direction; this Editor recalls their pioneering in the home automation area with CEDIA, the home electronic design association.

After years, are we finally seeing a shift in consumer perception?  (more…)

34 to 22 to 10: the Tricorder XPrize finalists

The Qualcomm Tricorder XPrize has arrived at the ‘Final 10’ for the $10 million prize going to the best (and working) “precision diagnostic technolog(y), making definitive health assessment available directly to “health consumers.”” . Less than one year ago, 34 companies had made it through from the initial 255 [TTA 12 Nov 13]. Further reductions brought the next stage to 22. Making the Final 10 are, as expected, Scanadu, but the UK/NI favorite has to be zensor (Intelesens) with its sensor-based patient monitoring in home, hospitals and assisted living (which your Editors have been following since 2010). Four are American companies with one Canadian (Cloud DX), one Indian (Danvantri), one Taiwanese (Dynamical Biomarkers Group), tw0 from the UK (zensor and SCANurse) and one from Slovenia (MESI). Next steps? Supplying X Prize with working prototypes sometime this wenter, 30 complete devices which will be tested at a medical center (not disclosed) May-October 2015 and the award in January 2016. Press release, Mobihealthnews.

Not X enough for you? There’s another, little-noticed XPrize–the Nokia Sensing XChallenge (more…)

Rubber Bands – The next big thing in wearable sensors?

Rubberbands

When you’re ten years old, pinging rubber bands across the classroom is fun. Getting caught doing so by your teacher is not. However you have to admit it’s kind of a novel use for those flexible little bands. Now Irish researchers may have upped the game by finding another, even more novel application for them.

The team at AMBER, the Science Foundation Ireland-funded materials science centre, and the School of Physics TCD, working with researchers from the University of Surrey, have discovered a method of creating wearable sensors from shop-bought rubber bands. If you were listening back in class, you’ll remember that rubber doesn’t normally conduct electricity. However, the researchers whose findings have just been published in ACS Nano, a leading international nanoscience publication, discovered that by adding graphene the rubber bands became electrically conductive. In tests, the bands were strongly affected by any electrical current flowing through them if the band was stretched, which means tiny movements such as breath and pulse could be sensed by the technology.

The potential of graphene to be used in wearable sensors was noted by our TTA Editor-In-Chief, Donna, in her Pointer to the Future item back in 2011, Nanosheets and graphene: powering sensors, computers. Because rubber is available widely and cheaply, this latest development could open up major possibilities in the manufacturing of wearable sensors worldwide. Which means we can all look forward to finding graphene infused biosensors in everything from our bras to our bionic underpants.

Read more: TANN IrelandENGINEERING.com

Electronic Alerts in EHRs Reduce Urinary Tract Infections (Study – US)

According to the World Health Organisation, urinary tract infections (UTIs) win top prize for most frequent health care-associated infection in high-income countries. And the cause?…A massive 75% of all of hospital acquired UTIs result from having a urinary catheter fitted (i.e. a tube inserted into the bladder through the urethra to drain urine). And it’s far from unusual to have this procedure done, for between 15 to 25 percent of hospitalized patients have one fitted during their hospital stay (Source CDC). Having a urinary tract infection can be nasty enough but if left untreated serious consequences can result including permanent kidney damage.

The most effective way to reduce the incidence of UTIs (apart from not having a catheter fitted in the first place) is by removing the catheter as soon as it is no longer needed. Unfortunately, all too often this does not happen. That’s why the findings from this new study from the University of Pennsylvania are significant. Results showed that automated alerts in Electronic Health Records (EHRs) reduced urinary tract infections in hospital patients with urinary catheters.

The EHR alert system worked by prompting physicians to specify the reason for inserting the patient’s catheter. On the basis of the reason selected, the system then helped them decide (a) whether urinary catheters were needed in the first place and (b) alerted them to reassess the need for catheters that had not been removed within a recommended time period. And it was no small-fry study. (more…)

Telehealth and telecare: 45 minutes on BBC Radio 4 ‘You and Yours’ (UK)

‘You and Yours’ is a long-running BBC UK consumer affairs programme that is regular listening for many people at home at midday on weekdays. Its estimated audience is three and a half million, many of whom will be of an ‘older’ age. Yesterday, 25 August 2014, they devoted a whole programme to telecare and teleheath and a good job they made of it too, thanks to their guests Dave Horsfield who runs the Mi Liverpool DALLAS project, Claire Medd, Clinical Director for Care Innovations and Professor Trisha Greenhalgh. If you want to get a sense of what is happening in the UK, listen to it.

Towards the end there is some discussion of the WSD RCT and we are reminded that the 3millionlives (3ML) initiative has been quietly shelved as projects like Mi Liverpool move on.

The whole programme can be heard again for up to one year from today on BBC iPlayer, here. Listening is restricted to the UK – others will need to spoof their location using a UK-based proxy server – try this VPN Freedome app from F-Secure (free six-day trial) to listen on your mobile device.

Patients should be less engaged, not more

click to enlargeWhat, the very premise of ‘increasing consumer engagement’ doesn’t work? Whatever will all the (startups, websites, gamification, personalized health, behavior modification, Quantified Selfing) do?

What the chronically ill really want is less engagement with, less time spent on their particular condition or disease–certainly not to be forced into Sisyphean tasks. What this Editor has termed the ‘perpetual Battle of Stalingrad’ of self-monitoring (especially apparent in diabetes) means extra effort with minimal/no reward, never achieving ‘normal’ and never catching a break. Glen Tullman, former CEO of Allscripts and currently a healthcare investor with 7WireVentures, points out that the endless promotion of ‘consumer engagement’ is not only patronizing, but also wrong-headed in blaming the patient for not managing their illness their way. People want simply to live their lives, not their problems.

  • “What if we ask patients—or “health consumers” as I call them—to do less rather than more?” (more…)

Testing the ‘blast response’ of synthetic bone

While protection against concussive and sub-concussive head blows that lead to brain trauma (TBI) and may lead long-term to chronic traumatic encephalopathy (CTE) is being developed in several areas, by DARPA, US Army research, universities and the NFL‘s helmet providers, the final test has to involve cranial bone similar to those belonging to 20-30 year olds. Testing on humans is out of the question, deceased animal and older human crania are dissimilar and surgical implants do not react like real bone.  The US Army Research Laboratory (ARL) along with university partners are developing synthetic cranial bone that behaves like real 20-30 year old bone when subjected to combat-intensity blasts, for testing devices to mitigate the adverse effects and/or track the effects of those blasts.  Armed With Science

CHS data breach estimated price tag: $150 million

Huge price tag, is the solution more ‘white hat hacker/crackers’, get a clue, C-Suite and why China leads in hacking (important updates!)

Dan Munro in Forbes got out his calculator and estimated that the cost to Community Health Services, based on prior incidents, may be as high as $150 million. He bases it on recent poster children Columbia-NY Presbyterian and BlueCross BlueShield of Tennessee. The message to healthcare business executives: pay now–by beefing up HIT and data security–or pay later in rush remediation of data breaches like identity theft protection, Office of Civil Rights-HHS fines, potential insurance fraud,  legal charges and damages awarded. On the latter, it took only hours after the announcement for the first class action to be filed in Alabama.

Of course cybersecurity experts, particularly the ‘white hat’ or ‘cracker’ variety, are in increasingly high demand across all business areas and internationally–and there aren’t many at that exalted level or even a rung or two below. Their commensurate compensation is one factor, but calls to hire less expensively overseas as explored in this article are, in this Editor’s estimation, a two-edged sword: much hacking, many sleeper bugs and ‘backdooring’ are engineered overseas (China, Russia, the Balkans, India); what is to say that these ‘former hackers’ aren’t playing both games? Cybersecurity’s hiring crisis: A troubling trajectory (ZDNet)

The C-Suite Must Care…The Workforce Must Be Aware

Since data security and data breaches threaten to swamp many sectors (universities and colleges, even more than healthcare, rank as the most vulnerable), the solution may not be wholly in the code. (more…)

European celebrity, cash and consultation: any interest?

Some interesting opportunities!

Firstly, how about nominating your favourite European Web Entrepreneur for a Europioneers Award? There are four categories including ‘youth’ and ‘gazelle’, so plenty of scope there.

Secondly perhaps you might like to participate in an EU health & wellbeing Horizon 2020 project bid? The 2014-2015 work program is here. More details on the Healthtech and Medicines KTN site.

Thirdly and finally (more…)

Aetna’s CarePass passing into history

Another Aetna Healthagen initiative is shutting its virtual doors–the much-touted CarePass aggregator for mobile health apps. Available to both Aetna and non-Aetna members, it incorporated leading apps such as Fitbit, Jawbone, Withings, MapMyFitness and BodyMedia. A dimming of its consumer/mobile health star which burned so brightly from late 2012 through last year was evident at this year’s HIMSS. CarePass was nowhere to be seen, and the iTriage patient engagement tool was off in the shadows [TTA 28 Feb]. From its redone website, Healthagen is increasingly concentrated on core areas for payers: ACOs, clinical decision support, data management and health information exchanges. MobiHealthNews broke the exclusive including Aetna’s confirmation and also the quiet departure of two CarePass executives from the company which took place earlier this summer. (more…)

The smartphone as great healthcare leveler: Eric Topol

Eric Topol MD, cardiologist, Chief Medical Advisor for the rebooted (but so far quiet) AT&T ForHealth and Chief Academic Officer at Scripps Health, is no stranger to the ‘big statement’ and is well known as an advocate for all things mHealthy. For at least two years, he has been promoting the smartphone’s ‘equalizer’ capabilities in health not only via apps and ‘add ons’ but also as a storehouse or central repository for individual health information, including genetic screening, which can be transmitted onward to a practitioner, lab or PHR. Dr Topol’s ‘big statements’ were fully on display in his keynote at HealthLeaders’ CFO Exchange conference. A promoter of the ‘creative destruction of medicine’ (the title of his most recent book, WSJ article), he believes that everything from the office visit (virtualized) (more…)

Five ‘Wellvilles’ found for five year experiment (US)

Tech angel investor, philanthropist and astronaut-in-training Esther Dyson and her HICCup (Health Initiative Coordinating Council) team have picked the five model communities with populations less than 100,000 on what is now dubbed ‘The Way to Wellville’. They are:  Muskegon, Michigan; Lake County, California; Spartanburg, South Carolina; Clatsop County, Oregon; and Niagara Falls, New York. Each of the towns will spend between (more…)

Ding! Telecare developer Healthsense raises $10 million in 8th round

Sensor-based remote monitoring company and certified Grizzled Pioneer Healthsense has completed a raise of $10 million, its eighth round of funding since its founding in 2003. This round was led by new investor Mansa Capital with previous investors Radius Ventures and Merck Global Health Innovation Fund. Mansa has current investments in only two other companies–smartphone med adherence platform HealthPrize Technologies ($3 million from Mansa just yesterday) and employer behavioral health risk manager E4 Health (CrunchBase) with a third, Independent Living Systems, listed on its website, but was a prior investor in well-known Athenahealth. Earlier investors Ziegler HealthVest Management (2007) and West Health did not join in this round. The VentureBeat article alludes to home monitoring pilots with home health providers Humana Cares/Senior Bridge and Fallon Health–odd since Healthsense has always had units in home health. Last year Healthsense bought rival telecare company WellAWARE [TTA 2 July 2013] after the latter experienced difficulty (more…)