Accelerometers, false positives/negatives and fall detection

Tom Doris, KeepUs project founder and technical lead, responds to our recent post [TTA 28 Aug] critiquing Philips Lifeline with AutoAlert’s accelerometer and its possible failure to detect a fall which resulted in the death of a Massachusetts woman. His analysis concludes that accelerometers on their own are surprisingly inaccurate. The false positives/negatives may be minimal but they do exist, and they should not be the only indicator of a fall.

Mr Doris has a PhD in computer science and was formerly an R&D engineer at Intel. Earlier in TTA: 4 Oct 13, 22 July

Falling Down is a Surprisingly Hard Problem

More than 250,000 people suffer a hip fracture in the US every year. More than 20 percent will die within 12 months as a consequence of their fall. One in three who lived independently before the fracture will need at least a year of rehabilitation in a nursing home. While rehabilitation methods are improving, the single most important factor influencing the long-term outcome is the length of time between the fall and getting medical attention at a hospital. A few hours more or less makes the difference between life and death.

People are living longer, and current projections make it clear that elderly people will have to live independently in their own homes for as long as possible. You just can’t provide residential care for 20 percent of the population. Smartphones and wearable technology have the potential to dramatically improve eldercare. A relatively cheap smartphone can track activity and location. Modern platforms analyze the data in real-time over the internet and can, in theory, immediately spot when something is wrong and raise an alert.

The theory doesn’t always work however. (more…)

AARP/Intel’s simplified tablet–insulting to 50+?

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]Earlier this month, AARP announced its marketing of the RealPad, a simplified 7.85″ tablet. Its positioning is clearly aiming at the less tech-savvy cohort over 50. With much fanfare, AARP is touting its partnership with Intel in this ” intuitive, easy-to-use software interface for RealPad” on Android KitKat 4.4. It will be available at Walmart this fall at $189 (preorder via AARP) and it has the requisite big icons, front and back cameras and free 24/7 customer service. Release.

The Eye Rolls. We know that the AARP bread ‘n’ butter is creating loyalty for their products by catering to those who pay for their association’s services, but a press release headline like this sounds tinny to many of the younger and not-so-young people in this age group:

AARP ANNOUNCES REALPAD, FIRST OF ITS KIND TABLET DESIGNED FOR AMERICANS 50+ APPREHENSIVE ABOUT TECHNOLOGY

Powered by Intel, RealPad to Serve as Digital Gateway to Over 70 Million Americans 50+ (more…)

A free event for all those interested in medical apps (UK)

On Wednesday 17th September the Health Technology Forum in London is meeting again at Baker Botts’ head office at the back of the Bank of England to hear presentations from:

Joe Hagan-Brown, Regulatory Affairs Specialist at the Medicines and Healthcare products Regulatory Agency (MHRA) who has very kindly agreed to present on a huge range of app-related issues including:

The Medical Devices Directive – definition of a medical device; Software- qualification as a medical device; A brief background to software in the context of medical device legislation; Meddev 2.6/1; The market for Apps; MHRA guidance on software as a medical device; Five categories of apps; Classification; Conformity assessment; Telehealth; Vigilance/Post market surveillance; General requirements; Specific considerations

Alex Denoon, from Lawford Davies Denoon who has very indly agreed to talk to us on the impact of the proposed Data Protection Regulation on biomedical research. The talk will cover the (largely unintended) potentially catastrophic effects on matters are diverse as biobanks, personalised medicine, e-health and the development of new medicines.

The plan is to give both speakers plenty of time both for their presentations and to respond to questions, whilst still enabling all present to enjoy Baker Botts’ legendary hospitality for the networking session afterwards.

There are currently 12 spaces left. More details, and how to book are here

EHRs *do* take more time! (JAMA)

If your doctor or nurse is frustrated by their EHR, it’s not because they are a technophobe or klutzy on the keyboard. According to a research letter published in JAMA Internal Medicine (8 Sept), internal medicine physicians reported a loss of time of 48 minutes daily due to EHR use. 411 internal medicine attending physicians and trainees who worked in an ambulatory practice and used an EHR system responded to a 19-question survey in December 2012 by the American College of Physicians. The trainees reported a lower time loss–18 minutes. No conclusion is reached for this difference. Other findings indicated what took more time: (more…)

41 percent of healthcare employees don’t encrypt mobile devices: Forrester

Just after this Editor rhapsodized that one of the unrecognized (except here) wins for Apple’s new iPhone 6 in healthcare will be to give the docs what they want–larger screens–is this sobering stat from Forrester. Only 59 percent of healthcare employees use full-disk encryption or file-level encryption on mHealth computing devices used at work. Yes, here is another hole in the data security dike that needs plugging, because Forrester also cites that 80 percent of data breaches relate to lost or stolen devices. (What, not mulch?)  Author Chris Sherman also quoted street prices for health records to The Wall Street Journal’s CIO Journal blog  (more…)

Shoes that direct you where to go (India)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/09/shoe-sideview.jpg” thumb_width=”150″ /]The LeChal casual shoe and insoles are wearables which relate to a ‘job to be done’–guiding you to your destination–as well as using an Android app and Bluetooth transceiver to record steps taken, distance and approximate calories burned. The app uses Google Maps to guide your feet by haptics: the left shoe vibrates when the wearer is supposed to go left and right when the direction is right. Ducere Technologies in Telangana, India originally conceived it for the visually impaired but (more…)

Simplifying engagement in diabetes management

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/09/Livongo.jpg” thumb_width=”180″ /]Launched at TechCrunch’s Disrupt SF 2014 was a new wireless glucometer, Livongo Health’s InTouch. A M2M palm-sized cellular glucometer, it transmits not only conventional blood glucose readings from test strips, but also activity information (steps) and how you’re feeling. The user also sets it up for who looks at the data and what they see. Data goes to what they term a ‘smart cloud’ (a/k/a data platform) which reviews it based on clinical rules and accumulated personal health history. It is also backed by a virtual care team of certified diabetes educators. Founder Glen Tullman, who was quoted extensively in our well-read Patients should be less engaged, not more, has an FDA clearance in hand, (more…)

Yesterday’s Apple intros and implications for health monitoring

A knockout or a catch up? Now that the Hype Dust is settling (along with Apple’s stock price), let’s take a look at what we know today about the new, larger iPhones and the Apple Watch regarding health monitoring.

Where it was a catch up:

  • Size and screen in phones. Apple got the message: squinting at tiny type and swiping to enlarge is rapidly becoming yesterday’s pain. As smartphones and larger screens knocked out the Blackberry, Samsung led the way in sizing up and higher resolution–and others followed suit. The awful fact is that the smartphone market is aging, both in users and who’s left in the market to grow it, and we want to see, not squint.
  • [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/09/apple-watch-beauty-shot.png” thumb_width=”150″ /]Finally (drum roll), a sleeker smartwatch with fitness tracking, out sometime next year–and not just a sports model. The basic model is a rubbery Sport watch, the mid-line has a sapphire crystal, stainless steel case and (proprietary) swappable bands. The beauty is the upmarket version in gold with a leather band (left, courtesy re/Code).
    • Here Apple is up against multiple in-market competition from Fitbit to Moto to Withings to Samsung Gear–whose pricing is well below the starter Apple Watch at $349 in the $200 and below range.
    • The Apple Watch looks seriously great, distinctively thinner and it’ll be a prestige item. But does it track more and better? No. According to reports (updated today) this is what it has: heart rate monitor, pulse, daily activity for which you need the phone. No sleep monitoring. It also has to be charged every night. There may be other features from developers, but they are under wraps for now and will likely require phone tethering. (re/Code) It’s not a comprehensive lifestyle watch–yet.

Where it could be a knockout in healthcare:

  • Finally, a compelling reason for health care providers to ditch the old iPhone and not go Android. Healthcare providers in the US are heavily wedded to iOS: (more…)

Breaking news on the Apple phones & smartwatch

Breaking News from the CNet live coverage moving along in real time:

  • New iPhone 6 phones are both retina display. Phablet is 5.5″ screen (iPhone 6 Plus) and standard is 4.7″
  • Big play on NFC-driven mobile payments: Apple Pay at 220,000 locations, via 83 percent of US banks plus American Express (international?)
  • Security: Eddy Cue, senior vice president of Internet software and services–We’ve integrated security from software and hardware. We create a device only account number and put it in the Secure Element. No longer have the static code on the back of the card.
    • One time only use and claim no tracking on your purchases, no card info shared with retailer (!!!) Implications for healthcare payments?
[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/09/Activity.jpg” thumb_width=”200″ /]
  • Here comes the Apple Watch (not iWatch)—CNet commentator says it’s like iPod Nano with sexy design upgrade. Health implications to follow. (more…)

2015: mHealth’s breakout year–or more of the same sideways?

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/09/the-thinker-statue-flickr-satyakam-khadikar-480.jpg” thumb_width=”150″ /]Adopting or Ditching It? We’re barely into September, yet the first 2015 prediction-of-a-sort is on the record from Center for Connected Health‘s Dr. Joseph Kvedar in The eHealth Blog. Does Apple HealthKit+Samsung‘s SHealth’s iterations+Google Fit+smartwatches everywhere (including LG’s G Watch R) equal $7.2 billion in wearables alone by 2018 as part of a mHealthy $49 billion by 2020? He’s optimistic, yet he hedges his bets with the caveat

“The challenge in health care is that, though we know what patients/consumers need to do to improve their health, most of them don’t want to hear about it.”

Which indicates that Dr. Kvedar has joined our small group of Thinkers puzzling out why health apps haven’t taken off beyond their Quantified Selfer early adopters and what Parks Associates termed ‘Healthy and Engaged’ [TTA 11 Aug]. With 1/3 of the purchasers of activity trackers putting them in the drawer after six months and the unstickiness of apps (80 percent are abandoned after a shocking two weeks), the winning combination isn’t obvious. But is it ‘focus on engagement’ and ‘personal, motivational and ubiquitous’? Certainly key factors, but how do we get the ‘Challenged but Mindful’ with a chronic condition–or two or three–to track and reward their real progress, even on a bad day–which an activity tracker which constantly presses you to exceed your performance has trouble gauging. (more…)

Bayer AG enters the healthcare accelerator game (DE)

Bayer HealthCare AG’s Grants4Apps program announced its support of five startups that, in their words, will support improved outcomes or pharmaceutical processes. Unlike companies like GE or Pfizer, Bayer is outright granting a substantial amount of cash to each–€ 50,000–and offering space plus 3 1/2 months of mentoring in their Berlin HQ in return for the usual small equity stake. Of 70 applications, five were granted to European companies which will have their Demo Day on 1 December:

  • Cortrium:  their C3 device is a state-of-the-art wearable tech sensor for clinical-quality hospital wireless monitoring of health data including electrocardiogram (ECG), body surface temperature, respiratory rate, and body posture/physical activity. Blood oxygen and blood pressure to come in 2015. (Denmark, spun off from Nokia R&D)
  • PharmAssistantself-management tool for chronic disease patients, consisting of a smart pill container and a remote cloud-based monitoring service (Portugal) (more…)

Fashion Week’s fickle fitness favorites

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/09/Misfit-shine-wearable.jpg” thumb_width=”150″ /]Last September during NYC Fashion Week, the must-have fashionista accessory for the wrist was a Jawbone, in hard-to-get colors like aqua [TTA 17 Nov 13]. This year, Misfit Shine hit the runways with a vengeance (so to speak) with some…er, interesting…wearables with hard-core appeal. Courtesy of Chromat, it was incorporated into this interestingly air-conditioned evening look. We doubt we’ll see it at Connected Health Symposium in Boston at the end of October…but maybe at CES Unveiled on 11 November in New York.

But Jawbone is the one that’s scoring big funding–they’ve ‘jawboned’ another $100 million, the same amount they received in financing last year at this time. It’s a chunk of the $250 million they were raising earlier this year. According to Re/Code, new investors include Rizvi Traverse Management. The round puts the company valuation north of $3.3 billion. Like Misfit, it is also opening up its UP software API to be used by developers on other smartphones, watches and wearables.

Is digital health neglecting The Big Preventable–medical errors?

 

Preventable medical errors persist as the No. 3 killer in the US – third only to heart disease and cancer – claiming the lives of some 400,000 people each year.

(US Senate hearing, cited in HealthcareITNews 18 July 2014)

At the end of last month, this Editor questioned the efficacy of our current state of ‘consumer engagement’ in Patients should be less engaged, not more. The ‘less engaged’ was a call for simplification: regimens and devices which were easier to use, less complicated and far easier to fit in everyday life. (Aesthetics helps too.) Back in 2013, HeartSister/Ethical Nag (and Canadian) Carolyn Thomas called for health app (and by inference consumer engagement) designers to ‘skate to where the puck is going’–as in “For Pete’s sake, go find some Real Live Patients to talk (and listen) to first before you decide where you’re going!” Often it seems like these apps and platforms are designed in a vacuum of the entrepreneur’s making. The proof is the low uptake (Pew, Parks, IMS) and the apps’/programs’ lack of stickiness after all this time (Kvedar 8 Sep blog post).

Now Laurie Orlov tells us we were looking at the wrong puck, as analysts do. First, all that ‘nudging’ and all those apps haven’t moved the needle on diabetes and obesity. Second, why are app developers neglecting that third largest killer, preventable medical errors? Add to that 400,000 yearly–over 1,000 per day–the 10,000 estimated patients every day who suffer serious complications. (more…)

Data breaches and ‘hackermania’ running wild

Data breaches remain in the news–and the debate around how best to secure data rages.

Everything old is new again. UK website Computing reported that East Midlands Ambulance Service NHS Trust lost a data cartridge containing 42,000 records from its divisional headquarters in Nottingham. It was a small but deadly cartridge containing scanned handwritten copies of Patient Report Forms from September to November 2012. However, it can only be read on a now-obsolete cartridge reader, one of which is on the Trust’s premises. An interesting project for a ‘cracker’? Perhaps someone thought it was an old paperweight? Is this the virtue of old tech?

Wakey, wakey Hermann! Memorial Hermann Health System in Houston, Texas had an unauthorized employee nosing around patient records for seven years up to July, affecting at last count 10,604 patients. Compromised were health insurance information, Social Security (SSI) numbers, names, addresses and dates of birth (DOB). Obviously they weren’t firewalled and easy to access. No motive cited. According to HealthITSecurity, this person has been suspended, not fired. Also iHealthBeat.

Nothing to see here…move on. Breaking News. Healthcare.gov was breached in July by a hacker uploading malicious software to a server used to test code. No evidence that personal information was compromised. HHS maintains this was the first successful intrusion. We’ll see. MarketWatch (excerpt of WSJ paywalled story)

Is any system hackerproof? Reader Joanne Chiocchi cited this Editor’s first article on the massive CHS breach (from the reprint in HITECH Answers–thank you, Roberta Mullin) and posed this question on LinkedIn’s Ellen’s Ethical Lens group. 48 comments later, (more…)