Catch-up: what you may have missed whilst on holiday

This was the month when the UK Press seemingly finally woke up to the existence of STPs (Sustainability & Transformation Plans). This article by Derek du Preez and this in Digital Health are two one of a few that pick out the hope that digital health can help with making the NHS more sustainable. Sadly the headlines were grabbed with concern over closing hospital beds, which politicians in the UK still seem to consider to be a Bad Thing. Even though hospital beds have been reduced in most European countries over recent years, and those such as Denmark now trumpet reductions in hospital beds as progress, we have still to break the connection in people’s minds in the UK that beds are a good surrogate for health service delivery volume, (even though when pressed no individual seems keen to spend longer in hospital than absolutely necessary, or would prefer a treatment as an inpatient over treatment as an outpatient.)

Though not directly connected, the NHS offered over £100m to acute care trusts for “global digital excellence” – in line with the previous comments, perhaps the money could alternatively be spent on the UK building on its excellent primary care IT with the specific intention of moving more treatment out of hospitals…and follow that up with a proposal to put the hospital that is judged to be the least “globally digitally excellent” (more…)

Connected health: what’s different than last year?

This Editor was interested in what the organizers of the annual Connected Health Summit, now taking place in San Diego, are seeing as the differences in the digital health and remote monitoring sector over the past year. This year, Parks Associates promoted it as “spotlight(ing) health technologies as part of the Internet of Things (IoT) phenomenon and the transformational impact of these connected solutions on the US healthcare system.” I’ve been reading Parks’ research since 2006, when telecare was riding quite high, but the marketplace between consumer and enterprise-focused tech, monitoring and analytics has exploded. I asked Stuart Sikes, President of Parks Associates, for toplines on the key differences in the market and the conference between last year and this. It’s shifting to implementation, how to streamline processes around data, making data useful….and still finding someone to pay for it.

What is different this year than 2015?
The primary difference this year is that we will be discussing case studies and implementation and engagement issues, shifting the focus from “what elements are needed to encourage engagement” to “how is implementation working.” In addition, the emphasis on the power of data to provide meaningful data that empowers both consumers and care providers will increase, as secure collection and management of data is a central theme to most of the solutions on the agenda.
Regarding the agenda, one difference this year will be presentations by emerging companies to members of the investment community, who will offer some feedback on the company concepts and approach.

Do you see progress in adoption by physicians, healthcare organizations, consumers–and who is paying? (more…)

Is ‘ZDoggMD’ restoring humanity to health care? (weekend reading)

click to enlargeZDoggMD–an advocate/video artist, real name Zubin Damania, MD, internist, former hospitalist at Stanford Medical Center and founder of a member-based healthcare service called Turntable Health HQ’d in reviving downtown Las Vegas–has a cause, and that is reforming primary care out of the present failing model, saving patients and healthcare professionals as well. The ZDoggMD videos focus on the breakdown of the system, including that doctors–and nurses–have become the face of a system that is bankrupting both older adults and the chronically ill. This Editor would also add that it’s a system that is burning out and driving out older, more experienced doctors and nurses to retirement and admin-type jobs, and making the entire field unattractive to 20-somethings, as it gets more formulaic, cost savings-driven and care-short. See Dr Damania on ‘stopping playing the game’ in this TEDMED talk on Zombie Doctors.

The Unbreak Healthcare movement has a specific list of grievances, here as listed in investor/consultant Dave Chase’s Rosetium.com article:

  • Doctors: Working as glorified billing clerks to insurance companies and are abused by the system leads to burnout
  • Nurses: Volume-driven disregard for patient safety & understaffing cause major stress (focus on computer data entry instead of bedside care)
  • Middle class: Healthcare’s hyperinflation caused an economic depression & is #1 driver of bankruptcy
  • Millennials: Their health care “bill” makes their college debt look small and will make them indentured servants to healthcare (more…)

Writing an ‘Electrical Prescription’ for biosensing ‘neural dust’

How can sensors better communicate with and regulate the central nervous system (CNS)? DARPA (Defense Advanced Research Projects Agency), which is part of the US Department of Defense, is on the case with research on miniaturized electronics suitable for chronic use for biosensing and neuromodulation of peripheral nerves in the Electrical Prescriptions (ElectRx) program.  A DARPA-funded ElectRx research team led by the University of California, Berkeley’s Department of Electrical Engineering and Computer Sciences has developed what they term ‘neural dust’–a millimeter-scale wireless device small enough to be implanted in individual nerves, using ultrasound for power coupling and communication. In vivo test results on rodents have been published in the peer-reviewed neuroscience journal Neuron. A nice return to Armed With Science, which has been bereft of device or robotics news for months.

Startupbootcamp Digital Health Berlin–applications close 31 August (DE)

click to enlargeThis Berlin digital health accelerator has space for ten early-stage companies in its upcoming ‘bootcamp’ that starts 7 November, but is closing for applications next Wednesday. They boast major support from Philips, arvato CRM Solutions, apoBank, Sanofi and Munich Health to “shape your startup, get on stage on Demo Day (16 Feb 17), pitch and win the hearts (sic) of your investor audience.” There are seven digital health foci listed, six months of co-working space, €15,000 in cash per team, a wide variety of international mentors, etc. Details and application on their website.

We note there is also a digital health program from the same organizers in Miami which is starting 6 September with its Demo Day on 1 December.

Now an app to aid doctors with inflight emergencies

click to enlarge“Is there a doctor on board?”Having spent the first half of my career in and around the travel industry, including a three-year stint working as an advertising manager for an airline, near the top of The Worry List was the communications fallout of a Bad Outcome in-flight medical incident. When my brother took a flight to somewhere, it was also his concern–while he was familiar with emergency medicine, it was generally of the psychiatric variety. Doctors, at least in the US, are covered by ‘Good Samaritan’ laws that shield them from most liability, but most will be up in the air if an emergency presents itself.

According to the New England Journal of Medicine (NEJM) (YouTube), in-flight medical emergencies occur in about 1 in every 604 flights, which in 2013 equaled annually 44,000 in-flight emergencies with nearly 50 a day in the USA (USA Today). While cabin crews receive training, they usually don’t have specialized medical training unless they moonlight as (or were formerly) EMTs. And an airplane cabin and a flight are deceptively difficult environments–pressurized, dry, confining and with help not exactly nearby.

Now there is an app for that. AirRx was developed by a six-person team (with CSE Software) led by a physician at the University of Illinois College of Medicine at Peoria, Raymond E. Bertino, MD, a clinical professor of radiology and surgery as well as a practicing radiologist. He had the ill luck to find himself in three in-flight situations plus one where he was a patient. The app, which also works in airplane mode and without live internet, guides doctors through 23 common situations, from chest pain and seizures to emergency delivery. It is available in the Apple Store and via Google Play for $4.99, with any proceeds going to the non-profit they organized to maintain the app. According to Dr Bertino, “The only person who doesn’t know what they’re supposed to do is the doc who’s volunteering. Docs aren’t taught about this in medical school and AirRx is meant to fill the gaps.” Mobihealthnews, mHealthIntelligenceChicago Tribune.

Bucharest–the next hot European digital city? 170 startups say ‘da’. (RU)

It certainly came as a surprise that the second fastest growing economy in the EU is–Romania. Identified in your Editor’s mind with the monstrous dictator Nicolae Ceaușescu, grinding poverty and the lost orphans (who are now lost and underground–see this horrific Daily Mail article), it has a burgeoning tech startup scene and a superior digital infrastructure including the fastest internet in Europe, achieved through a combination of post-Ceaușescu entrepreneurship and state avoidance. The Communist emphasis on what we call STEM also has paid off for both young men and especially for women as techies and developers. There are even accelerators: Innovation Labs and MVP Academy. Where Romania lags versus similarly situated Estonia and Bulgaria is native investment–angel investors are almost unknown. Being also an EU member, most of the best are lured away to attractive opportunities in other countries (including the US) at least for some time. But the low cost of development versus other digital cities like London and Berlin, educated workforce and a robust infrastructure are factors favoring Romania. Hat tip to reader Jerry Kolosky. One of the poorest countries in the EU could be its next tech-startup hub (Quartz) and the Digital City Index. (We note the photo at the top of the Quartz article is Google Chicago, not Bucharest)

Patient engagement: a digital divide in health technology accessibility

click to enlargeGuest editor Sarianne Gruber (@subtleimpact) scopes the ‘digital divide’ separating those who need health services the most from the patient engagement and other tools they need in this article. The studies are US, but the lessons apply anywhere in the world. This Editor notes that many patient engagement tools are over-designed and over-complicated for users, even if they are fairly competent and frequently use online and mobile. (I entered a ‘pilot’ of a stress reduction program which proved to be anything but–and quitting because it is invasive and the reporting is ludicrously burdensome.)

To developers: Imagine your patient engagement platform being used by a person on the less sophisticated, less educated and disconnected end of the spectrum–or by someone less able due to physical (vision, touch) or cognitive impairment. Put on bad glasses and gloves–and start. Better yet, find a few people and put it in front of them. If we can make the mental shift in developing mobile apps for Africa or India, certainly we can do so for Americans, Britons and Europeans.

What the Studies are Showing

Hallmarked as a solution to improve healthcare quality, cost and safety, studies are showing health technology is up against a “digital divide” when it comes to patient engagement. At the Internet Governance Forum, Pew Research Center’s Lee Rainie, Director of Internet, Science and Technology Research presented the Fact Tank Report discussing the “digital divide” that exists in 2016. The report documents that lower income, less educated, non-white, seniors and rural communities are the least likely to have home internet, home broadband, mobile connectors and smartphones. This summer’s medical publications, the Journal of the American Medical Association and the Journal of the American Board of Family Medicine, released studies where demographic and socioeconomic data marked the root causes to limited or no access to digital technology, thus hindering the benefits and improved outcomes it can bring to the neediest and most costly populations. Here are the highlights from each study.

Trends in Seniors’ Use of Digital Health Technology in the United States, 2011-2014, a research letter submitted from Harvard Medical School’s Brigham and Women’s Hospital, appeared in the August 2, 2016, JAMA. Authors, David M. Levine, MD, MA, Stuart Lipsitz, ScD, and Jeffrey A. Linder, MD, MPH,FACP made mention that this study, based on the National Health and Aging Trends survey (NHATS), was exempted from the Partners HealthCare Human Research/IRB Committee. The research team included participates to the longitudinal NHATS survey in 2011. The participants were re-surveyed annually on everyday (nonhealth) and digital health use until 2014. The research team acknowledged that this may be the first nationally representative study to examine trends in the adoption of digital health technology by seniors age 65 years and older who are community-dwelling Medicare beneficiaries.

Here are some the reported statistics from the study: (more…)

Connected Health Summit 30 August (updated)

click to enlargeIt’s not too late to visit sunny and historic San Diego to attend Parks Associates’ Connected Health Summit. Click the sidebar advert at right for more information and to register. Read the two latest releases here:

The keynote and presenter lineup is here–plenty of hot topics being presented/discussed by those engaged in the daily business of health tech.

Telehealth & Telecare Aware is a media supporter of the conference for the second year. Their Twitter feeds at #CONNHealth16 @CONN_Health_Smt. 

Summertime, and the ransomware is running wild (updated)

Mashing up our summer ‘tune’ list are the latest reports on ransomware attacks and data breaches:

  • Banner Health’s odd breach of 3.7 million records, first testing their café credit cards then entering their patient information systems, is leading to at least one class-action lawsuit. HealthITOutcomes, Becker’s Hospital Review
  • Bon Secours Health System of Maryland had a exposure of 655,000 records when a business associate of Bon Secours left patient information exposed online for four days while it adjusted its network settings. Healthcare Dive
  • The Locky ransomware has been battering hospitals since the beginning of August, with phishing emails spiking on August 11. Most of this global strike is attacking healthcare, with transportation and telecom running second; countries with the highest frequency of attacks are US, Japan, and South Korea, FireEye reports. ZDNet
  • Solutionary, now NTT Security, which specializes in cybersecurity services, reported last month that 88 percent of all ransomware detections in second quarter 2016 targeted healthcare. However, Cryptowall, not Locky, was the killer ransomware they spotted, accounting for nearly 94 percent of detections. Release
  • Can you anticipate cyber crimes like these? ID Experts has an intriguing blog post on how you can think like a cyber thief. Part One of a promised three-part series. Updated: ID Experts disclosed earlier this week that it spun off RADAR, its two-year-old IT security and compliance company, effective 2 Aug, with a $6.2 million Series A funding. It appears that the CEO wrote the check (CrunchBase).  There’s gold in dem dere cyber varmints! MedCityNews  Release
  • Scared enough? The Federal Trade Commission comes to the rescue with a half-day seminar on ransomware detection and prevention in Washington DC on September 7. The session is free and will be webcast (details to come). FTC release, event page

HRSA sets $16 million fund for 4 rural telehealth grant programs (US)

The Health Resources and Services Administration (HRSA), which is part of the Federal Health and Human Services (HHS) department, is making four grant programs available to support rural telehealth and quality improvement in 60 rural communities within 32 states, including a joint program with the Veterans Affairs Office of Rural Health. The four programs administered by the Federal Office of Rural Health Policy (FORHP) within HRSA are primarily three-year programs and include:

  • The largest amount, $6.3 million, will go to the Telehealth Network Grant Program: $300,000 each annually in a three-year program to 21 community health organizations for telehealth programs and networks in medically underserved areas, with a concentration on child health
  • The Flex Rural Veterans Health Access Program: $300,000 each annually in a three-year program to three organizations providing veteran mental health and other health services. This is a joint program with the VA totalling $900,000.
  • Small Health Care Provider Quality Improvement: $21 million will support 21 organizations over three years in improving care quality for populations with high rates of chronic conditions, and to support rural primary care.
  • Seven Rural Health Research Centers: $700,000 per year for four years, totalling $4.9 million, to support policy research on improving access to healthcare and population health in rural communities. (Funds that more usefully would have gone to veterans health?–Ed. Donna)

HHS releaseMobihealthnews, Healthcare IT News

A ‘desperate’ call for healthcare innovation creates a stir

When you are trying to shake things up in healthcare, sometimes enthusiasm gets mistaken for desperation.

Alex Fair is known to many of our American Readers as one of the Grizzled Pioneers of what eventually became known as Health 2.0. He’s head of a Meetup group in NYC with close to 5,000 members (Health 2.0 NYC, for which this Editor was an event organizer/producer for over a year), founder of health innovation-only crowdfunding platform Medstartr (see ‘Websites We Like’), a successful health tech event producer (MedMomentum 16 coming up 1-2 December) and a few other things in between. In short, Alex Hustles For The Cause.

One of his projects is the Major Depressive Disorder (MDD)/Depression Care Innovation Challenge with Takeda, which closed for applications last Monday. There was a last flurry of promotion via personal notes in social media and emails which is standard–well-known in style for those of us on Alex’s lists. But sometimes enthusiasm gets misinterpreted.

So a funny thing happened to me yesterday on Twitter. Someone told us that we sounded “desperate” in our tweets and posts. At first, my lizard brain said “what, I don’t want to be seen as desperate!” as if I was trying to get a date for the Junior Prom (which I did, thank you very much.) But then my mission-driven, we-have-got-to-fix-this-NOW-so-more-people-like-Jess_Jacobs-Live-longer-and-better-lives brain fired up and said, “Damn Right I’m Desperate!” The fact is that if we want to move the needle on innovation, we need to do something about it and desperate times DO call for desperate measures.

Read all about it here. If you want to change healthcare, especially in the US, you might get a little frustrated! (P.S. Along with the controversy is a calendar of upcoming NYC health tech events).

Chubb expands Community Care into Scandinavia (UK)

click to enlargeChubb Community Care, a UK company which provides home and mobile technology enabled care solutions (TECS) for independent, assisted, sheltered and extra care housing, announced their expansion into Norway, Sweden and Finland, partnering with Norwegian equipment supplier HEPRO which provides local service and market knowledge. Their first project is in HEPRO’s home country with the new Chubb Care Call. Care Call (left) is a colorful wall-mounted mobile-connected unit with simple buttons that connects the resident to onsite staff and remote call centers in case of emergency or need for assistance. HEPRO will be installing the units in seven municipalities. Release. Earlier this summer, Chubb won a contract with Places for People to install their CareUnity at 16 independent living locations across the North West, Hull and Bristol. Care Unity is a PERS/carephone-based system that integrates a wide range of safety and security peripherals. Release

Video Consulting Clinics NHS Scotland pilot — tender due Monday

NHS National Services Scotland (a/k/a The Common Services Agency) is requesting tenders for virtual video clinics. The supplier would furnish software, hosting and support for one year in up to 50 clinics in all of Scotland or in six regions. This ‘video consulting system’ would link NSS, Health Boards and potentially other Scottish public sector Participating Authorities. The tender is due noon UK time on Monday 26 August. Further information may be found here and also at the Public Contracts Scotland website. Hat tip to Suzanne Woodman of BRE.

A brief history of robotics, including Turing and Asimov (weekend reading)

click to enlargeTechWorld gives us a short narrative on robotics history dating back to Asimov’s Three Rules of Robotics (1942), Turing’s Imitation Game (1950) and the pioneering work of several inventors in the late 1940s. There’s a brief tribute to Star Wars’ R2-D2 (Kenny Baker RIP) and C-3PO.  It finishes up with AI-driven IBM Watson and Deep Mind’s AlphaGo. Breezy but informative beach reading! Hat tip to Editor Emeritus and TTA founder Steve Hards; also read his acerbic comment on Dell and Intel’s involvement in Thailand’s Saensuk Smart City

Opportunity for developers – can you help asthma sufferers?

Asthma UK today unveils a key report that tells developers how mHealth could help asthma sufferers better. Entitled “Connected asthma: how technology will transform care”, whilst picking out a few excellent exemplars, it describes how poor the average asthma app currently is – for example only 6% of such apps provide pollution status, and only 8% cover inhaler technique.

Historically CHF, COPD & diabetes have been regarded as the key long term conditions to manage using telehealth. When, as this editor did a few years back, a suggestion was made to try it on asthma, clinicians tended to look askance. Yet as this report shows, mHealth can do a huge amount to improve the management of asthma especially now many people have smartphones. And, bluntly, asthma kills (more…)