What’s caught my digital health interest recently

At the Royal Society of Medicine we’ve just announced our next medical apps event on 7th April next year, Medical apps; mainstreaming innovation in which we feature for the first time a presentation by Pam Kato, a Professor of Serious Games, so it’s intriguing to see the iMedicalApps review of a clinician-facing serious game, iConcur, for anaesthetists.

We also have a powerful presentation on mental health apps from Ieso Digital Health which doubtless will make the same point as has been made in previous events that online mental health services typically are more effective than face:face. The abstract to the recent Lancet paper by Dr Lisa Marzano et al, examining this topic in great detail, suggests that the academics are now a long way to working out why this is the case and offers further potential improvements; aspiring mental health app developers unable to access the full paper may consider it worth paying $31.50 (or join the RSM to access it for free).

A regular at the RSM’s Appday is Dr Richard Brady’s presentation on Bad Apps, which next year will now doubtless include mention of the FTC’s recent fifth action against an app provider, UltimEyes, with deceptively claiming they their program was scientifically proven to improve the user’s eye sight.

Moving to good apps (more…)

TSA Annual Conference 16th & 17th November: reminder (UK)

Logo - TSAWe have been asked to post a reminder for the TSA’s Technology-enabled Care Event of 2015. Taking place on the 16th and 17th November 2015 at the Celtic Manor Hotel, South Wales, this is a ‘must-attend’ annual event in the sector calendar.

This year’s conference is entitled Inspiring Change and Progress. It will carry three main themes throughout the two days:

  • Entrepreneurship: How to think differently to make things happen for you, your business and the sector.
  • Education: Preparing for the future of the sector, what do we need to know?
  • Evolution: What’s next for the future of technology-enabled care?

The conference will feature a host of high profile speakers who will be tasked with giving attendees the ‘need to know’ sector picture, including ministers, sector leaders, innovators, business motivators, technology gurus, and the people who benefit from using technology-enabled care.

The two day programme will be packed with stimulating presentations, challenging debates, and informative parallel sessions that will include masterclasses & interactive workshops.

The complete programme is here. A limited number of Early Bird booking rates are now available; book here.

Personal health ‘big data’ exchange is all good, right? Perhaps wrong.

Many of our recent stories have touched on ‘big (health) data’ as Achieving the Holy Grail–how it can be shared, how it can work with the Internet of Things and how poorly implemented personal health record (PHI) databases can derail national health systems (and careers) [TTA 22 Sep]. They are, after all, 1) extremely difficult to design to preserve privacy and 2) must satisfy patients’ requirements for easy use as well as privacy including opting out. But when despite all good intentions, data goes awry, the consequences can be severe.

  • A daughter applies for health insurance from Aetna, and her mother’s medications, about which she had no knowledge, are attributed to her. How? Data mining off Milliman’s IntelliScript data service which mixed up the records.
  • EHR exchange can spread errors such as a dropped critical health or medication record. One led to the death of an 84 year old woman. VA also had a problem with its EHR (not cited but likely VistA) slotting medication histories into the wrong patients’ files. An Australian hospital mixed up discharge files in electronically sending them to doctors. The more records are exchanged, the more possibility there is for propagation of errors.
  • More information is shared with third-party suppliers; survey companies are increasingly tapping into these databases to send annoying, potentially privacy-invading treatment questionnaires to individuals.

Bloomberg Business’ conclusion is that this could be a problem, but much beyond the tut-tutting doesn’t get into solutions. The Pitfalls of Health-Care Companies’ Addiction to Big Data

A ‘feel-good’ car seat to reduce driver stress

click to enlargeIn-car massage and therapy? A notion that gets The Gimlet Eye off the beach…again! Now a Canadian (HQ’d France) auto design company (sixth largest globally) gets into the wellness act with a prototype car seat that when you are stressed, gives you 1) a specific massage and 2) more refreshing air. Sensors built into the seat monitor respiration and heart rate, gauging stress and energy level. If your energy is low, you get an energizing massage; stressed, a relaxing one. Faurecia’s ‘Active Wellness’ seat was announced at the big Frankfurt Auto Show, and while it didn’t drown out the breathless hubbub around Volkswagen’s dodgy diesel emissions (turn on that refreshing air!), it made the Drudge Report. The non-contact sensors are from Hoana Medical in the US; Faurecia also worked with the Spine Research Institute at Ohio State University to develop the algorithms and signal processing. It also connects to wearable fitness devices so the ‘read’ begins when you start ‘er up. While Eye have no need for any of this being A Million Miles From Dull Care on A Dot On The Map, the poor New Yorkers living through this week’s UN General Assembly/Pope Francis Traffic Disaster do today and almost every day. But they’ll have to wait till 2020. Yahoo!Canada

Does telemedicine video quality influence clinical acceptance?

A pointer for connected health designers. An Australian study reviewing telemedicine virtual consults examined the technical factors that may influence clinical acceptance. It compared the quality of cellular (3G) connectivity with broadband fiber-based service during virtual visits. While overall clinicians rated the telemedicine visits highly–equivalent to or better than a home visit 76 percent of the time and conducting a video consult compared with a home visit as equivalent or better 90.3 percent of the time–the lower audio/video quality of the visits over a 3G data connection versus broadband was apparent, enough that ‘statistically significant associations were found between audio/video quality and patient comfort with the technology as well as the clinician ratings for effectiveness.’ The high failure rate of 3G was also dramatic–23.5 percent of visits calls dropped.

The study was conducted at south Australia’s Flinders Telehealth in the Home (more…)

ROBOSOFT’s Kompaï-2 assistive robot debuts, wins award (FR)

click to enlarge click to enlargeIt’s a far cry from May 2011, when Founder Steve visited with the early version of the French Kompaï assistive robot for what is delicately termed ‘frail people’ (left). Kompaï-2 (second left), still with the tablet in the front, appears a bit taller and has acquired a backpack basket (for wine, a baguette, Le Matin), a rotating torso, laser autonomous navigation, a 3D camera, facial expressions and a new color. Other new features include physical assistance features plus the ability to assist with position changes, walking and medications to reduce caregiver workload. (more…)

ONC gets in study game in designing the Consumer Centered Telehealth Experience

ONC (the Office of National Coordinator for Health Information Technology, HHS) in the spring conducted a design session on creating a more consumer-centered telehealth experience, commissioning the engagedIN research firm to help select a panel, run it and produce the study. The white paper focuses on how telehealth can either further fracture or integrate PHR (study pages 7-11), and what’s needed to make telehealth and telemedicine more convenient and effective for consumers. The panel avoided the big telemedicine providers (a bone that Mobihealthnews picks with the study) which typically dominate these panels–to this Editor a positive action–but included other telehealth providers like Qualcomm Life, Care Innovations and Zipnosis, as well as the US’ largest user of telehealth, VA Home Telehealth. Among the key drivers of telehealth are HHS’ and private insurers (UHC) shift to value-based payments; CMS’ target of 50 percent of Medicare value-based care is cited (page 5). There are nine principles at the end (pgs 13-16) to guide the way forward. Designing the Consumer Centered Telehealth and e-Visit Experience (PDF) (Though it is confusing why e-Visit was used rather than ‘virtual visits’ or, in fact, telemedicine.)

The difficulty in bringing telehealth to those needing it most

California’s Center for Connected Health Policy, which is the National Telehealth Policy Resource Center, has published a study which concludes that community health centers (CHC)–a general term covering Federally Qualified Health Centers (FQHC) and Rural Health Centers (RHC)–have difficulty sustaining telehealth programs to support the underserved and ill with chronic conditions including mental health without grants or other subsidies. Consultant Milliman studied five California CHCs and determined that other than financial, major impediments to successful implementation were structural: complex billing and reimbursement rules, and difficulty tracking telehealth visits through multiple EHRs that weren’t necessarily compatible with each other or with billing systems. Many of these CHCs cannot financially provide telehealth without grants or other subsidies. This study holds lessons for telehealth companies which are working with ACOs, hospital discharge programs and practices in rural areas, as well as the Indian Health Service. Study (link to PDF), Healthcare Informatics, California Healthline  Hat tip to Elizabeth Olis of Viterion Digital Health

FDA, new technology approval and the Ossification Tango (US)

When it comes to new technologies–and drugs for that matter–the worst thing that can happen to your invention is to receive a letter from FDA that you have been classified into Class III. Based on regulations passed by Congress in 1976, there are three FDA classes primarily based on device risk. Exception: Class III. Anything not ‘substantially equivalent’ to an existing device is automatically put into Class III, regardless of risk level. Author and health tech legal advocate Bradley Merrill Thompson of Epstein Becker Green takes a comprehensive review at this flawed and outdated system that puts groundbreaking health tech at an extreme disadvantage in his latest article on regulation in Mobihealthnews. (more…)

IoT’s biggest problem? Communication of Things.

click to enlargeThe Gimlet Eye joins us for a ‘blink’ from an undisclosed, low-tech dot on the map. The fave rave of 2015 is IoT, the annoying shorthand for Internet of Things. Well, can Aunt Madge go into a store and buy an Internet Thingy? But it seems fundamental that The Things Speak with each other, if only to compare football scores and conspire against their owner to drive him or her Stark Raving Mad by producing too many ice cubes in the fridge, turning lights on/off at the wrong times or sending out for a deli order of 20 pounds of Black Forest sliced ham. Our fear about The Things was in considering that they could be hacked in doing Things Against Their Will and Not In The Owner’s Manual. But never mind, it’s not this we should be concerned about, or whether Uncle Aloysius will go off-roading in his Google Galaxie after it’s hacked for fun by an eight-year-old Black Hat. It’s that practically all of these same or different brand TVs, parking meters, cars and health/activity monitoring devices to make life simple for Auntie and Oncle are built on different platforms without a communication protocol. The Eye is now relieved of the fear that IoT devices will be crawling out of the water onto her faraway from dull care beach anytime soon. But you may not be. The Biggest Problem with the Internet of Things? Hint: It’s Not Security (Tech.co) Hat tip to follower @ersiemens via Twitter

Health data changes Down Under: My Health Record, Tim Kelsey and Telstra

Australia’s federal government is hoping for a boost to its national personal health records system, starting with a renaming of Personally Controlled Electronic Health Record (PCEHR) to My Health Record. Proposed in the government’s $485 million budget announcement on eHealth is a resolution of implementation issues and introducing trials of participation models including designing opt-out approaches. Currently enrollment stands at a paltry 10 percent of Australians. Computer World (Australia) Hat tip to Mike Clark via Twitter

Come December, also taking the long trip there will be NHS England national director for patients and information Tim Kelsey to join Telstra Health as commercial director. Telstra is Australia’s largest telecom developing a footprint in health, and earlier this year acquired Dr Foster LLP, the UK-based health informatics company. Coincidentally (?), Mr Kelsey co-founded Dr Foster prior to 2006, when he joined the NHS to start up the information site NHS Choices. During his NHS tenure, Mr Kelsey faced numerous controversies which are detailed in the Guardian and IT news/opinion site The Register reports, mainly concerning the Care.data database for all English medical records. Concerns were raised about inadequate privacy, transparency and confidentiality provision in its design, and after a halt it has still not restarted, although 1 million people have preemptively opted out–another issue in common with My Health Record. According to the Guardian, “The scheme was recently labelled “unachievable” by a Whitehall watchdog, the Major Projects Authority, which said the future of the programme should be reassessed.” A successor to Mr Kelsey has not yet been named.

Now mobile metabolism tracking

“I have a slow metabolism.” Anyone who’s fought The (Literal) Battle of the Bulge has always wondered if this statement could be true. For $350, you can find out. At last June’s CE Week, one mobile health technology was Breezing, which through breath analysis measures how many calories are burned at rest and reports the results on your smartphone. It’s available for sale in US and demo’d on video (YouTube)

IMS Health report: mainstream health app adoption remains elusive

click to enlargeDespite 165,000 apps (and counting). A followup to IMS Health’s report of 2013, Patient Adoption of mHealth demonstrates how far mHealth has to go. Over 50 percent of apps have a single functionality, but connectivity to external sensors (e.g. wearables) has improved to 10%. 36 apps account for nearly 50 percent of downloads and 40 percent of all health apps have 5,000 downloads or less. Providers give limited if any guidance to consumers on app choice despite greater interest; ‘curation’ efforts, including IMS Health’s own [15 Dec 13], have largely failed. Other barriers to adoption are reimbursement (though many are free), limited healthcare system integration, regulator and privacy unknowns.

Where’s the progress? Chronic condition monitoring (left), with clinical trials more than doubling in the past two years, and focusing on treatment/prevention largely for older adults. These clinical trails are looking at mental health, diabetes, cardiovascular disease, weight management and oncology. IMS Health also recommends that users and stakeholders, including clinical organizations such as the CDC, ASCO and the Cancer Support Community tap into their clinical resources to develop and promote patient-centered apps. Download report (information required.)  A decidedly less cheerful take on the report is Stephanie Baum’s at MedCityNews.

Have we arrived at another, multi-functioning generation of telecare?

click to enlarge Profiled in Reuters in an article on home monitoring for older adults is a desktop-sized, sleekly telecare unit called OnKöl (that’s On Call for those who wonder what an umlaut is doing there) for the home market. Debuting back in January at International CES, it monitors activity in an area of the home (that green eye looks like a vintage radio DuMont Magic Eye tuner) and is extended through home monitoring sensors such as bed, door and window. Like Lively, it also has an in-home wrist/pendant emergency alert device and is self-installed. But what’s new about it is its telehealth side–connecting via Bluetooth and USB cable to typical medical monitors such as weight scales, blood glucose and pressure, as well as a med reminder setup. These seem to be brand-agnostic. A unique safety feature is a caller ID recorder for tracking calls. Activity and health information are stored, with alerts going to designated family members. According to the article, the founder designed it for monitoring his mother recovering from colon cancer. The Milwaukee-based company is financed through Series A (Capital Midwest Fund, $2.8 million), moving towards Series B, and OnKöl will be in market early next year. What is not apparent (more…)

Online Masters and Modular Learning in eHealth – last chance to enrol

Build your skills and study while you work!

The University of Edinburgh has a few places left on their Masters programme in Global eHealth. This is studied part time, via interactive online learning, supported by a network of international experts in the field (disclosure, of which this editor is one), and is designed for working professionals with some experience in healthcare, IT or eHealth, who are looking to grow and consolidate their knowledge and skills.  Courses are available as individual 10-week modules, or accumulated for a certificate (6 courses over 1 year), diploma (12 courses over 2 years) or MSc (the latter plus a supervised research project).

Readers may be particularly interested in the courses on ‘mHealth’, ‘Telemedicine & Telehealth, ‘The Business of eHealth’ (summer term), ‘User-Centred Design in eHealth’ and ‘Consumer Health Informatics’.

Applications for the new academic year close on Monday 21st September, so don’t delay applying!

For more information, please visit their website  or contact the programme team on Global.eHealth@ed.ac.uk or the programme director claudia.pagliari@ed.ac.uk

Philips tests diabetes app developed with Radboud UMC, Salesforce (NL)

Philips Healthcare unveiled a prototype of a diabetes tracking app that also links to a secured social ‘community’ at this past week’s Dreamforce 15 conference in San Francisco. It was developed in conjunction with Salesforce and the Radboud University Medical Center (NL). Philips claims the app is the first to collect and connect data from EMRs, multiple personal health devices and patient self-reported data, with the patient directing sharing via private messaging and shared posts with providers and fellow patients (‘community’). It is built on the HealthSuite Digital Platform which is a product of Philips’ collaboration with Salesforce. The app provides tracking information to the patient on blood glucose levels, insulin use, nutrition, physical activity, mood and stress. The patient also receives data-driven feedback and coaching guidance. It will be ready before end of this year in select non-US markets. At Dreamforce, Philips demo’d their joint Virtual Health Record initiative, which is being promoted as “a digital toolkit that makes it easy for health systems, institutions and care providers to utilize the power of the HealthSuite Digital Platform technology in dedicated localized solutions.” Release