USAF researching brain stimulation for performance enhancement

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/08/TCDS.jpg” thumb_width=”100″ /]At the Air Force Research Lab, Applied Neuroscience Branch at Wright-Patterson AFB, researchers are testing transcranial direct-current stimulation (tDCS) as a performance enhancer. We noted last August that DARPA was one of the lead research organizations on tDCS for mental illness and neurological problems [TTA 18 Aug 14]. AFRL is evaluating its effects on boosting cognition, memory and attention–all important factors when one is flying RPAs (remotely piloted aircraft, a/k/a drones) for multiple hours in front of a computer console. USAF RPA pilots (a/k/a Drone Drivers) now log three times as many flight hours as do pilots of real aircraft, which says volumes about priorities. Drone Drivers are also reporting combat fatigue and high levels of stress, so AFRL is also evaluating non-invasive ways of detection through pupil dilation and heart rate. Video (09:16)  USAF photo. Also Mosaic Science (Wellcome Trust)

Australian military health data went straight to China: report

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/02/Hackermania.jpg” thumb_width=”150″ /]The Australian Defence Department confirmed to the Sydney Morning Herald that protected health data of hundreds of Defence Forces personnel went to (guess where!) China. However, as breaches go, this was an easy hack–it was sent by a health contractor, Luxottica Retail Australia, which contracts with manufacturer Tristar Optical in Dongguan, Guangdong province. Those affected included soldiers posted overseas to Afghanistan and special forces commandos who went on to be deployed to Iraq. Luxottica has since lost its contract with principal contractor Medibank Health Solutions. Both Medibank and Defence have had a lot of ‘splainin’ to do with the Government. According to the SMH, “the revelations raised particular concern within the Defence establishment because of China’s extensive involvement in state-sponsored hacking and cyber-espionage, with Beijing showing a particular interest in accessing personal records of government workers in the US.” A ‘twin-spin’ of Data Insecurity: healthcare and military! Hat tip to Malcolm Fisk of Coventry University via LinkedIn updates.

Arizona plans using health tech to engage Medicaid recipients

Arizona’s smartphone app-based outreach plan for its Medicaid (low-income health insurance) program has raised a few eyebrows. The app/online site would:

* Help beneficiaries find primary and urgent care providers
* Provide beneficiaries access to chronic disease management tools
* Send beneficiaries appointment reminders

The programs would use mobile, online and texting, which doesn’t require a smartphone and has historically worked well in compliance and information (e.g. Text4Baby). For the critics, however, Pew Research found that half of those with incomes under $30,000 have smartphones. This number also includes the elderly, and does not take into account recent growth–smartphone prices have decreased smartly, and are now available on pay-go plans. iHealthBeat

ATA Fall Forum updates

If you are thinking about attending ATA’s Fall Forum sessions in Washington, DC this September, the early bird discount of $100 has a week to go–14 August is the last day. This year’s meeting also has, in addition to the conference, a National Telehealth Lobby Day (16 Sept) with short briefings on how to lobby, the key issues and a half-day to make those previously scheduled visits to your Senator or Representative. The updated schedule for the three-day conference is here.

Also for ATA 2016 in Minneapolis next 14-17 May, the call for presentations has just opened. See details here.

TTA is a media partner of ATA Fall Forum, and previously ATA 2014 and 2015.

mHealth Summit now HIMSS Connected Health Conference

Another sign that mHealth is now in our rear view mirrors [TTA 24 July] is that one of the main conferences on the US and international conference calendar is changing its name. Since 2009, the mHealth Summit has closed the year. Its organizing groups have changed and it’s gone international to Europe (the recent summit in Riga). Now it has been renamed (though not on the website yet) the HIMSS Connected Health Conference-an umbrella event comprising the mHealth Summit (including the Global mHealth Forum), and two new conferences:  the Cyber Security Summit and Population Health Summit.

The shift in the industry and new concerns are clearly reflected in this reorganization. Transitions were visible last year to this Editor in covering the sessions, speaking with exhibitors and attendees. It’s not about the tech anymore, but how it fits into care models, saves money/avoids costs, improves care, improves the experience–all population health metrics–and fits with other technology and analytics. (It’s also how it fits into government payment models, an endlessly changing equation.) What is surprising is the lifting of cybersecurity to equal status, given the Hackers’ Holiday that healthcare is now (see TTA here). (Also this Editor notes that last year’s Big Buzzwords, Big Data and Analytics, has faded into where it should be–into facilitating population health and we should expect, inform data security. We also note that HIMSS has stepped forward as the organizer. HIMSS release  Telehealth & Telecare Aware has been a media partner of the mHealth Summit for most years since 2009. 

Telemedicine: critical massing or déjà vu, dear Humans, too?

A veritable blitz of telemedicine advocacy articles have appeared in the past week in leading healthcare and business publications. All of them promote telemedicine as a mix of consumer friendly (rapid care from anywhere at relatively low cost), a solution to the paucity of primary and specialty care in rural America, and contributing to quality affordable care. They both point out the increasing acceptability of the online consult (75 percent of consumers favor in a recent Cisco survey) and by doctors (60 percent). The writers are former Senator, Majority Leader and practicing surgeon Dr Bill Frist, and Dr Boxer is the chief telehealth officer of Pager and chief medical officer of Well Via. Health Affairs (Frist) and Wall Street Journal (Boxer).

Of course, do you need a human doctor at the other end, or will Humans do? The University of Southern California has tested Ellie, a virtual human,who’s been successful at getting patients to report honestly to her–more honestly than to real people.  (more…)

TBI, early brain aging and a seismic analogy

Traumatic brain injury (TBI) has been receiving extra study in the past few years due to battlefield blast/IED injury as well as football and other sports injuries as early as junior high. The insidious nature of TBI is that long-term effects of accelerated brain aging can appear in those who have mild injuries, or who never experienced the usual symptoms indicating TBI such as dizziness, nausea and disorientation. Researchers have struggled for the reasons why “51 percent of sufferers of mild head injuries were reported as still having disability one year later at follow-up” and why a large proportion of military veterans who sustained mild brain injuries experience the heightened and uncontrollable emotionality of pseudobulbar affect (PBA). This article in the Genetic Literacy Project website works with an earthquake analogy: that there are P-waves (blast pressure) that compress tissues and disrupt neuronal communication, and in the long term accelerate brain aging and cognitive decline. Something sports injury, CTE researchers and research organizations within the military such as DARPA and DoD should be investigating. Hat tip to author and reader Dr Ben Locwin via Twitter.

An abundance of related reading in TTA can be found in searches under TBI and chronic traumatic encephalopathy. Also see our 2012 and prior archives for our writing on TBI.

Cerner win at Defense a crossroads for interoperability (US)

Modern Healthcare’s analysis of the Cerner/Leidos/Accenture win of the Department of Defense (DoD) EHR contract focuses on its effect on interoperability. In their view, it’s positive in three points for active military, retirees and their dependents.

* EHR interoperability with the civilian sector is needed because 60-70 percent of the 9.6 million Military Health System beneficiaries—active duty military personnel, retirees and their families—is delivered by providers in the US private sector through Tricare, the military health insurance program.

* A major criticism by Congress and veterans’ groups of both DoD and VA is the lack of interoperability between these systems as well as civilian. Many military members change their status several times during service, and can cycle within a few years as active, Reserve, National Guard and inactive reserve. Records famously get lost, sometimes disastrously.

* It’s a boost to state health information exchanges (HIE) in states with large military bases and also for the CommonWell Health Alliance, an industry group which is establishing EHR interoperability standards.

Less optimistic are some industry observers who see the DoD contract as sidelining resources demanded by Cerner’s civilian hospital clients, and whether realistically they can develop a system to exchange data with every EHR, including dental, and e-prescribing system in the US (and probably foreign as well). Modern Healthcare

Tunstall partners with NHDS for after-hours home visits (Australia)

Tunstall Healthcare in Australia is adding an unusual (for telehealth) market with the National Home Doctor Service (NHDS), which provides after-hours home visits for urgent, episodic care. The NHDS’ 600 doctors provide one million patient visits in home, including calls on those living in residential aged care (assisted living), older adults and those with disabilities. Home visits (US=house calls) have the aim of reducing ED/ER visits which may require ambulance calls. NHDS coordinates records with the patient’s regular GP. Tunstall’s role is to provide on-call care consultants who coordinate NHDS services; they also match NHDS with the needs of current Tunstall clients. Australian Ageing Agenda Technology Review. Tunstall Australia release.