Who’s hiring? Project manager-Simulation for Digital Health (SimDH) (UK)

From the listing posted by London South Bank University, applications close 13 November:

South Bank University Enterprise Ltd, the enterprise company of London South Bank University, is looking for a Project Manager (PM) within its Research, Enterprise and Innovation Department (REI). REI activities cover a range of income generating activities and also support wider entrepreneurial activity and external engagement between business, staff and students.

The current post provides an exciting opportunity to join the newly developed Institute of Health and Wellbeing, an interdisciplinary and inter-professional centre of excellence working towards improving the health and wellbeing status of individuals, communities and regions. The Institute combines a number of expert disciplines across LSBU in a single unit, helping foster novel collaborations, partnerships and innovative research and enterprise activities. The focus of the Institute is to improve the health and wellbeing of populations through impactful interventions, research and policy guidance.

The PM will be responsible for the successful delivery of REI’s recently won European Regional Development Fund (ERDF) project, Simulation for Digital Health (SimDH). The role will require close working with Business Development Managers, academic Schools and external organisations to ensure projects are delivered to contract and achieve all desired objectives.

Complete information on the LSBU website.  SimDH website–this program is intended to assist health SMEs to develop and deliver novel products, processes or services. It will start in January but applications are being taken now here. Hat tip to reader Susanne Woodman

US: Telemedicine to be used during disasters

The American Red Cross has entered into a partnership to pilot the use of telemedicine during periods of disasters in the US. During the pilot a nationwide network of physicians will be available for consultation via video calls.

Through this pilot collaboration, physicians working with Red Cross partner Teladoc will be available to people helped by the Red Cross whose access to health care providers has been limited or is unavailable after large-scale disasters. Teladoc’s virtual physician visit services will be made available via web, Teladoc’s mobile app and phone to address the primary health care needs of individuals affected by disasters.

Teladoc is reported to have donated remote medical care during the recent Hurricane Matthew. This partnership is positioned as an expansion of such disaster relief efforts rather than an expansion of its commercial activities.

Use of telemedicine in disaster relief has been implemented previously in the US by the Department of Veterans Affairs (VA). In 2014 the Office of Emergency Management of the VA awarded a contract to use the JEMS Technology disaster relief telehealth system. Going back much earlier, following the December 1988 earthquake in Armenia and the June 1989 gas explosion near Ufa, a satellite based audio, video and fax link, known as the Telemedicine Spacebridge, between four US and two Armenian and Russian medical centres,  permitted remote American consultants to assist Armenian and Russian physicians in the management of medical problems. Last year NATO tested use of telemedicine in disaster situations in a simulated disaster scenario in Ukraine.

Another system, Emergency Telehealth and Navigation, is deployed in Houston for helping with 911 calls. The Houston Fire Department has agreements with doctors so they have access to a doctor at any time to take calls from crew at emergency sites. They find that this avoids having to take some people to hospital when a doctor is able to determine that a condition is non-emergency where a paramedic may well have taken the patient to an Emergency Department.

The cybersecurity black hole–and bad flashback–that is the Internet of Things

click to enlargeOne week after the Dyn DDoS attack, the post-mortems get more alarming. Our Readers knew they were coming in 2014-2015 (our ‘Is IoT really necessary–and dangerous?)

IoT devices, and a lot of older networked medical devices, have been proven to be easy to hack, as even this non-ITer, non-codegeek realized then. But those in tech have been to this movie before–with Bluetooth circa 2002! Now shouldn’t designers have learned? From ZDNet:

“It’s almost like we’ve learned nothing from Bluetooth” says Justin Dolly, CISO at cybersecurity firm Malwarebytes.

“Seeing what these IoT vendors are doing, it just blows me away because they haven’t learned from history,” says Steve Manzuik, director of security research at Duo Security’s Duo Labs. “They’ve completely ignored everything that’s ever had bad vulnerabilities”.

Many of these devices, according to these experts, have default log in credentials, if they have them at all. IoT devices are also allegedly findable on a snoop site called Shodan. Reason why: the financial and market need to get products out fast and cheaply.

Over at data security company Varonis’ blog, with the great title in part, “Revenge of the Internet of Things”, another succinct and telling quote:

Once upon a time in early 2016, we were talking with pen tester Ken Munro about the security of IoT gadgetry — everything from wireless doorbells to coffee makers and other household appliances. I remember his answer when I asked about basic security in these devices. His reply: “You’re making a big step there, which is assuming that the manufacturer gave any thought to an attack from a hacker at all.”

Privacy by Design is not part of the vocabulary of the makers of these IoT gadgets

Varonis also gives a how-to on changing settings in your router so you don’t become a victim, and how to secure your gadgets.

Bottom line: when Hackermania is Running Wild, do you, or anyone, really need to be an early adopter of an internet- connected coffee maker or fridge? And if you need internet-connected home security, telemedicine virtual consults, telehealth/remote patient monitoring or telecare….best heed Varonis and secure it!

Earlier in TTA: Friday’s cyberattack is a shot-over-bow for healthcare 

Zimmer Biomet acquires telehealth company RespondWell

Orthopedic device maker Zimmer Biomet today (27 Oct) announced the acquisition of St Louis-based telerehabilitation + telehealth company RespondWell. RespondWell provides several facets of post-surgical physical therapy: telerehabilitation with clinically prescribed exercise routines, virtual doctor-patient consults, tablet-based personalized care plan delivery and data collection/RPM, and ‘gamified’ patient engagement tools. Up to the acquisition, according to Xconomy, RespondWell had raised $2 million from investors and had been seeking another raise of $8 million. Zimmer’s purchase price was not disclosed, but the changeover was swift, with the RespondWell website already copyrighted and top-bar tagged with Zimmer’s information.

Based on the release, RespondWell will be integrated into Zimmer Biomet Signature Solutions, using the brands Therapy@Home and presumably their original Fitness@Home. RespondWell’s former CEO Ted Spooner has been named VP of Connected Health at Zimmer Biomet; in his interview with MedCityNews, he was pleased at the exit and the acquisition by a company which wants to scale his solution.

Signature Solutions was formed from related Zimmer programs a few months ago as essentially a specialized value-based care consultancy and service provider. The combination of the two–VBC consultancy integrating with a health tech service provider–appears to be a nascent trend–and perhaps finally a path for telehealth providers. Hat tip to reader David Lee Scher MD via Twitter

Care Innovations gets into the behavior change training business

An under-the-radar move by Intel-owned Care Innovations, which markets the Health Harmony telehealth and the QuietCare behavioral telemonitoring systems, is their entrance in the behavior change training business.

Care Innovations developed an accredited (CE eligible) training course for nurses to effect behavior change in patient beyond what may be a limited telehealth engagement. According to their release, the training will help them with coaching patients to increase their engagement with their health and identifying areas for improvement, along with the appropriate technology.

The three-hour course work, designed primarily for telehealth nurses but open to all, has three key learning sections:

  1. Six steps to take to achieve behavior change in healthcare
  2. Learning four coaching skills: crafting open-ended questions, sharing words of affirmation, demonstrating reflective listening and crafting summary statements
  3. Discussing the most common challenges associated with acting as the coach, which are avoidance, ambivalence, resistance and compliance.

There are three sessions before the end of the year, priced at a relatively modest below $300 rate, with group discounts. Information is on their website here.

It’s an interesting move in that the training seemingly is not exclusive to CI clients, although this Editor would expect that 1) it would fit best with CI’s system and 2) is a way of cultivating prospective clients in an academic, value-added way.

For CI, it is another association with the ‘intersection of behavior change and technology’ (more…)

The Theranos Story, ch. 22: the human cost of lab error (updated)

click to enlargeSave this one for the coffee or lunch break. What is the cost of a lab error on the human psyche? It can be mildly upsetting to you and your doctor, warning of a developing condition and some changes have to be made–or make for a very bad day/week/months. It can be falsely reassuring or simply confusing.

We know that in April, Theranos flunked a CMS review, and in May voided all test results from its proprietary Edison devices from 2014 and 2015, as well as some other tests it ran on conventional machines. The results were not only off, but way off, according to the WSJ. “Notes from the CMS inspection show that 834 out of 2,890 quality-control checks run on the Edison in October 2014, or 29%, exceeded the company’s threshold of two standard deviations from its average result. Standard deviation is a statistical measurement of variation. In addition, 80% of the 834 quality-control checks that raised a red flag under Theranos’s internal standards were more than three standard deviations from its average result, the inspection notes show.”

They also failed to notify patients for weeks or months, and often not until forced to. At least 10 lawsuits have been filed in Arizona and California. Some of the human stories of Theranos’ improbable lab results, which included tens of thousands of patients, with the cost of retesting, repeated doctor visits and agonizing suspense :

  • After five widely different Theranos blood coagulation tests in six weeks, a retired marketer living in Arizona and his doctor so distrusted the results that the latter recommended that he stop taking warfarin and switch to a milder medication. This patient found out only last Friday that Theranos had corrected a September 2015 test showing his blood taking more than six times longer than normal to clot. The other four tests showed the warfarin wasn’t thinning his blood enough. Contradictory results confusing both doctor and patient on treatment.
  • A thyroid cancer survivor got thyroxine results (T4) from three tests conducted in October 2014. The extremely high results could have indicated hyperthyroidism at the least, or a more serious condition. The results–false after retesting failed to confirm.
  • A breast cancer survivor had extremely high levels of estradiol, which could have been produced by a rare adrenal tumor that can secrete estradiol or an elevated risk of breast-cancer recurrence. Again, false results but found only after retesting.

The comments under the article are worth the long scroll. (They are running 98 percent in favor of Holmes for Prison 2017. Also there are a few shots at Walgreens’ role in legitimatizing Theranos by putting their centers in store; this embarrassing part of the story isn’t over, in this Editor’s opinion.) What is evident–fraud perpetrated on patients and doctors–and anyone who invested. David Boies, their legal supremo and board member, is gonna have a full docket between this and the various legal actions taken by the Alphabet Agencies.

Agony, Alarm and Anger for People Hurt by Theranos’s Botched Blood Tests. If the WSJ is paywalled, search under the headline text.

See here for the agony of TTA’s 21 previous Theranos chapters. We hope that John Carreyrou and the WSJ investigative team, which we’d assume includes Mr Weaver, this article’s author, are awarded the Pulitzer Prize.

MedStartr Momentum 2016–28-29 November (NYC)

28-29 November 28
Gerald Lynch Theater (John Jay College-Lincoln Center), 524 West 59th Street, New York, NY

click to enlargeMedStartr Momentum is a conference with two full days focused on finding, partnering, piloting, and investing in the best new ideas in healthcare. With 9 Momentum talks, 7 discussion panels, 5 pitch contests with over $500,000 in prizes, and performances that will inspire, MedMo16 promises to be among the best events of the year for everyone involved in healthcare innovation. Speakers include John Nosta, Ben Chodor and from Northwell Health, Memorial Sloan-Kettering, NYU, Mount Sinai and Mad*Pow. It is also the kickoff for the MedStartr Venture Fund which adds to the crowdfunding impact of MedStartr–now up to 94 health projects. Find out more and register on the Momentum website. TTA is a supporter of MedStartr and Editor Donna is a MedMo16 event host. Hat tip to Alex Fair of MedMo16 and MedStartr.

The King’s Fund Digital Health Congress 2017–call for showcase projects (updated)

click to enlargeDespite the colorful (and falling) leaves of autumn, The King’s Fund is looking forward to the Digital Health Congress on 11–12 Jul 2017. What’s up? First, they are looking for innovative digital health projects to feature. Contact Caroline at c.viac@kingsfund.org.uk for more information. The deadline to submit is Friday 9 December.

The 2017 Congress will focus on progress and improvements in:

1. enabling citizens to take an active role in their health and care
2. improving data sharing and interoperability across the health and social care economy
3. demonstrating the benefits and improving productivity
4. using technology and data to improve user experience and quality of care.

Editor Charles was, of course, first out of the gate earlier this month, and has informative guidelines on this here.

The King’s Fund’s event page is here; the Digital Health Congress fact sheet is here including information on sponsoring or exhibiting. To make the event more accessible, there are new reduced rates for groups and students, plus bursary spots available for patients and carers.  Hat tip to KF’s Claire Taylor for the information and the update. TTA will be a media partner of the Digital Health Congress 2017. Updates on Twitter @kfdigital17

Who’s getting what!

Denny Hatch, the master direct mail copywriter and creative thinker, for decades had a private direct mail marketing newsletter called ‘Who’s Mailing What!’ This came to mind with some very big funding rounds in the past few weeks:

  • Omada Health’s Series C $48 million raise in September to boost validation, enhance its Prevention program and expand to state Medicaid for low-income patients. Current clients include Humana and Costco. Forbes attributed the size of the round to Omada’s approach in tying participant outcomes to over 50 percent of its compensation. MedCityNews.
  • Propeller Health‘s Series C of $21.5 million. This is a sensor on asthma meds such as inhalers that connects to an app. With 45 programs and clients like Dignity Health and Molina Healthcare, Propeller has been growing intensively since this Editor last saw them at the 2014 NYeC Digital Health Conference. Their total funding is now $45 million. TechCrunch.
    • And now that we mention it–don’t forget that TTA Readers receive a 10% registration discount on this year’s conference 6-7 December–use code TTA when registering. Click on the advert in the right sidebar to enter registration or view their event website.
  • Spain’s biotech sector got a boost when Ysios BioFund II Innvierte exceeded the initial fund target of €100 million (US$110 million), closing at €126.4 million (US$140 million). It recruited existing investors and multiple Spanish and European economic interest groups. With their Biofund I, Ysios has €191.4 million (US$220 million) in assets under management. MedCityNews
  • iRhythm closed its IPO on Tuesday with an over-allotment. Shares from last Thursday’s offering of 6.3 million shares at $17 on NASDAQ initially soared 65 percent to $28 before closing at $26.05. iRhythm’s Zio service is a cardiac monitor patch and long-term monitoring to determine whether a patient has an arrhythmia or atrial fibrillation. WSJ, Reuters
  • And before you have that AFib, if you are living in California, Heal can provide you with an in-person doctor house call from your smartphone for $99, which may be covered by a participating insurer. Series A round of $26.9 million. VentureBeat

‘Deconstructing the telehealth industry’ (Ziegler report, US)

A recently published white paper from Ziegler, a specialty healthcare investment bank, that actually does what it says –deconstruct the US telehealth (and telemedicine) industry. It also constructs a framework of ‘who does what’. Good graphic and text (but not infographic, mercifully) detail on the shareholders, barriers, tailwinds and future state, plus financial/acquisition participants and a compact growth history. Article here on Benzinga, or go directly to Ziegler to download.

When is an app not an app? (When it’s a conundrum)

It all started so simply. In DHACA under the leadership of Rob Turpin (BSI) we produced the definitive guide to app regulation in the UK. Sure it was 44 pages long (and will shortly need updating) however we all knew that an app was standalone software and that none other than MEDDEV 2.1/6, the ultimate definitive guide to when an app is a medical device defined software as:

…a set of instructions that processes input data and creates output data.

However doubts began to creep into this editor’s mind when he heard that app developers in the US were avoiding (US/FDA) medical device classification as that would rule them out as service providers, which can reduce future  reimbursement benefits – as we quoted Ralph-Gordon Jahns of research2guidance in 2014 “profitable developers… rely on service sales as their primary source of revenue.”

Things got more complicated when it emerged at the UK Health Show this autumn that PHE was considering listing digital GP services as (more…)

Friday’s cyberattack is a shot-over-bow for healthcare (updated)

click to enlargeFriday’s multiple distributed denial-of-service (DDoS) attacks on Dyn, the domain name system provider for hundreds of major websites, also hit close to home. Both Athenahealth and Allscripts went down briefly during the attack period. Athenahealth reported that only their patient-facing website was affected, not their EHRs, according to Modern Healthcare. However, a security expert from CynergisTek, CEO Mac McMillan, said that Athenahealth EHRs were affected, albeit only a few–all small hospitals.

A researcher/spokesman from Dyn had hours before the attack presented a talk on DDoS attacks at a meeting of the North American Network Operators Group (NANOG)

The culprit is a bit of malware called Mirai that targets IoT–Internet of Things–devices. It also took down the (Brian)KrebsOnSecurity.com blog which had been working with Dyn on information around DDoS attacks and some of those promoting ‘cures’. According to Krebs, the malware first looks through millions of poorly secured internet-connected devices (those innocent looking DVRs, smart home devices and even security devices that look out on your front door) and servers, then pounces via using botnets to convert a huge number of them to send tsunamis of traffic to the target to crash it. According to the Krebs website, it’s also entwined with extortion–read, ransomware demands. (Click ‘read more’ for additional analysis on the attack)

Here we have another warning for healthcare, if ransomware wasn’t enough. According to MH, “even for those hospitals with so-called “legacy” EHRs that run on the hospital’s own computers, an average of about 30 percent of their information technology infrastructure is hosted (more…)

Accelerated Access Review published – well worth a read

The Accelerated Access Review is published today. Readers with long memories will recall that it kicked off in the Spring of 2015 aimed at accelerating the uptake of innovation in to the NHS. It had three technical streams – pharma, medtech & digital health, plus a patient stream. This editor, as Managing Director of DHACA, was the digital health champion.

DHACA members were heavily engaged in the consultation, so it is gratifying to see that all DHACA recommendations were accepted. Most important were recommendations that:

  • NICE broaden its reach to include more medtech & digital health recommendations, and consider other means of funding;
  • there be closer alignment of regulatory and NICE data requirements and processes (currently, there can be duplication);
  • a strategic commercial unit is established in the NHS;
  • a small amount of funding is offered to support the commercialisation of disruptive innovative technologies that significantly change care pathways;
  • products not referred to NICE should be assessed only once by NHSE;
  • the route for digital products should build on the “Paperless 2020” simplified app assessment process;
  • the Crown Commercial Service, in partnership with NHS Digital, NHS England, the Department of Health and other system and technology partners, should consider how best to develop an accessible, simple and swift competitive process for procuring digital products from SMEs;
  • NHS England, working with NHS Digital, should develop a generic framework for app prescription.

When implemented, these and all the other recommendations in the report will go a long way to (more…)

An assistive robotic glove for those with hand disabilities

click to enlarge There are many people who have lost hand mobility due to injury, stroke and other neurological conditions. Exoskeletons are a great idea, but for a small area far too bulky. At Seoul National University, research director Kyujin Cho and a group of SNU Biorobotics Lab students, working with disabled people, have developed the Exo-Glove Poly, a soft wearable robot ‘glove’ that is capable of grasping objects. Three soft, tactile fingers fit over the wearer’s thumb, index finger and middle finger, with a tendon-like routing system of wires connected to a motor which opens and closes the hand. It is waterproof, washable and reasonable looking. According to the article in AtlasoftheFuture.org, this assistive technology is scheduled for commercialization in late 2017. Exo-Glove Poly website. Hat tip to contributor Sarianne Gruber via LinkedIn.

Weapons in the Perpetual Battle of Stalingrad that is diabetes management

A major area for both medicine and for healthcare technology is managing diabetes–Type 1, Type 2 and also pre-diabetes, which is the term used to describe those who are on the path to Type 2 diabetes. Type 1 diabetics, because they have had it for years, usually since youth, have one battle and are fighting that Perpetual Battle of Stalingrad. As this Editor has noted previously, technological tools such as closed-loop systems that combine glucose sensors with insulin pumps take much of the constant monitoring load off the Type 1 person. [TTA 20 Aug, 5 Oct]

But the panel at MedCityNews’ ENGAGE touched on a point that rankles most pre-diabetics and Type 2 diabetics–the lack of empathy both healthcare and most people they know, including family, have for their chronic condition. Many feel personal shame. And digital health ‘solutions’ (a tired term, let’s retire it!–Ed. Donna) either drown the patient in data or send out, as Frank Westermann of Austria’s mySugr said, a lot of negative messaging. Adam Brickman of Omada Health, whose ‘Prevent’ programs are mainly through payers and employers, noted it was a real challenge to get people to change their lifestyle, but also change their state of mind. Their model includes peer support and health coaching, specifically to include that empathy. Home support also makes all ther difference between those who successfully manage their condition and those who don’t, according to Susan Guzman of the Behavioral Diabetes Institute. The approach is certainly not one-size-fits-all.  MedCityNews  In September, Omada received a sizable approval on its approach via a Series C round of $48 million. Current clients include Humana and Costco. Forbes attributes the size of the round to Omada’s approach in tying participant outcomes to over 50 percent of its compensation.

 

Connected Health Symposium to merge with PCHAlliance conference

One of the earliest conferences in healthcare tech, the Connected Health Symposium organized annually in Boston by Partners HealthCare, is merging with the Personal Connected Health Alliance (PCHAlliance)‘s Connected Health Conference to stage one conference in 2017. Joseph C. Kvedar, MD,  who is VP Connected Health at Partners HealthCare, will be a senior advisor to PCHAlliance, a featured speaker at this year’s PCHA CHC in December and will be the Program Chair for the newly combined event. To this Editor, it’s a logical move as when both of these conferences were pioneering nearly a decade ago, there were few venues beyond the traditional (and boring) Big Health meetings. Now there are multiple meetings, large and small, expensive and popularly priced, every month in many cities. In the release there is no information on when and where the joint event will be. The Symposium was in October and the 2016 PCHA CHC will be 11-14 December at the Gaylord National Harbor near Washington DC. TTA is a media partner of the PCHA CHC for the 8th year, starting in 2009 when it was the brand new mHealth Summit.