Optum’s Utopia of proactive patient care–without telehealth

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/10/question_mark.jpg” thumb_width=”150″ /]And we wonder why telehealth patient monitoring is floundering and telemedicine is only starting to take off? In this Editor’s reading today, up came this rather glossy, beautifully designed advertorial web page in The Atlantic sponsored by healthcare services provider/holding company Optum. It describes a proactive, highly supportive care process that starts with the diagnosis of a chronic condition (in this case developing CHF) through a ‘health scare’ handled at an urgent care versus a hospital ED, then to care at home (from a highly engaged nurse-practitioner no less) and a patient who, suitably engaged, is “responsibly managing her condition through a wellness approach” and has an improved lifestyle.

Other than an EMR (integrated between provider and urgent care–but EHR is the more current term), no other technology other than telephonic is mentioned in this rosy picture. Where’s the telehealth app that touches our patient, letting her chart her weight, breathing and general wellness, sending it to her EHR and alerting that nurse so she can truly be proactive in seeing changes in her patient’s health? Where’s the telemedicine virtual visit capability, especially if our patient’s out of breath outside of normal office hours, or there’s a blizzard and that nurse can’t visit? Here’s all the infrastructure built up for integrated care, but where’s the technology assistance and savings on home health visits and transportation for the patient?

It can’t be that Optum doesn’t know about what telehealth/telemedicine can do and the role it already plays in care? It can’t be that it doesn’t fit in the integrated care infrastructure? Or does it have to do with reimbursement? (Optum is the parent of giant insurer United HealthcareReaders’ thoughts?

Rock Health announces its Top 50 in digital health (US)

This Editor observes that digital health is at the state of maturity (so to speak) where entities assemble a Top 50 list and host a dinner to pass out awards. Rock Health, Fenwick & West, Goldman Sachs and Square 1 Bank cast a wide net from investment to startups in their just-released list. (Of course there will be a glitzy dinner, soon, at the kickoff of the JP Morgan Healthcare Conference, 9 – 12 January 2017 in San Francisco. Want an invite?)

Of great delight is an award to John Carreyrou of the Wall Street Journal as Reporter of the Year for his investigative work on Theranos. Other highlights are Validic (clinical/wellness data integrator) as Fastest Growing Company, Evolent Health for Best Performing IPO and BSX Technologies‘ LVL hydration monitor as Crowdfunding Hero (having raised $1.1 million when goal was $50,000). Rock Health website

What is increasingly curious to this Editor is that digital health companies, in nearly all cases, aren’t crossing borders and oceans. Every one seems to stick and be unique to its own country of origin, creatures of their own unique petri dish.

Also in other Rock Health news, having evolved a position as a venture fund/business support provider, they have added to their list of prominent partners kidney care and medical group operator DaVita. Rock Health release.

Over £15,000 for Dementia Dog in memory of Tynetec’s Billy and Lisa Graham (UK) (updated)

Updated Tynetec has announced via Twitter that the £15,000 goal has been exceeded for Dementia Dog. Thanks to our Readers who donated on our 9 Nov article and retweets, Tynetec and all donors!

Local fundraisers in Perthshire have raised £11,000 (as of 5 Dec, £15,000) for dementia assistance dogs in memory of Billy and Lisa Graham, who while on holiday were tragically killed in the June 2015 Tunisia beach shooting. As Editor Charles wrote then, “Billy was well loved and respected in the industry, working in Scotland as Business Development Manager for Tynetec, and previously with Chubb. As such, even if readers did not know him personally, there is a high probability that they will have attended many conferences and exhibitions where he was also present.”

The beneficiary is Dementia Dog, which funds specially trained dogs to help and support people living with dementia in their activities of daily living, such as taking their medicine. Former colleagues and friends of the Grahams helped to raise the money as a permanent tribute to the couple by combining two things close to them–to help those with dementia and their love of dogs. The fundraising site is open to all and located on JustGiving, with all donations going to Alzheimer Scotland. A worthy cause indeed and a lovely way to remember the Grahams. More information and the story behind the fundraisers is in the Scottish Daily Record. Hat tip to Tynetec on Twitter; Tynetec has been a long time supporter of this publication.

The Theranos Story, ch. 28: when the SecDef nominee is on the Board of Directors

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/12/jim_mattis.jpg” thumb_width=”150″ /]Does ‘Mad Dog’ ‘Warrior Monk’ James Mattis, General, USMC (ret.) have a blind spot when it comes to Theranos? President-Elect Donald J. Trump has selected him as the next Administration’s nominee for Secretary of Defense. A remarkable leader and, yes, scholar (check his background in various sources), but he has some ‘splaining to do, in this Editor’s opinion.

This Editor leads with this question because those who have been following the Continuing Saga (which, like the Nordics, seems never-ending) know that Theranos stuffed its Board of Directors (BOD), prior to last October, with a selection of Washington Luminaries, often of a great age: Henry Kissinger, George Shultz, Sen. Sam Nunn, Sen. Bill Frist (the only one with an MD), William Perry and Gary Roughead, a retired U.S. Navy admiral. It also reads like a roster of Hoover Institution Fellows except for Sen. Frist, who sticks to the East Coast. Another interesting point: Hoover is based at Stanford University, an institution from which Elizabeth Holmes dropped out to Follow Her Vision. Obviously, there was an accompanying Vision of Washington Pull.

Also joining the BOD as of July 2013, well before The Troubles, and shortly after his retirement, was Gen. Jim Mattis (also a Hoover Fellow, photo above). When the Washington Luminaries were shuffled off to a ‘board of counselors’ after the Wall Street Journal exposé hit in October, Gen. Mattis remained on the governing BOD. Unlike his fellow Fellows, he had actually been involved with a potential deployment of the lab testing equipment. As we previously noted, as commandant of US Central Command (CENTCOM is Middle East, North Africa and Central Asia), he advocated tests of the Theranos labs under in-theatre medicine conditions in 2012-13. Leaked emails cited by the Washington Post (in Gizmodo) and also in the Wall Street Journal indicate the opposition from the US Army Medical Research and Materiel Command at health-intensive Fort Detrick MD, which oversees medical research, based on the undeniable fact that the equipment and the tests weren’t FDA-cleared, which remained true two years later…and which Gen. Mattis tried to get around, being a good Marine. Nonetheless, the procurement of Theranos equipment was halted. DOD permitted him to join the BOD after retirement as long as he was not involved in any representations to DOD or the services. (Wikipedia bio)

Yesterday, Theranos also announced that it is dissolving (draining?) the ‘board of counselors’. They led with a BOD shuffle, with Daniel J. Warmenhoven, retired chairman of NetApp, replacing director Riley P. Bechtel, who is withdrawing for health reasons. (Warmenhoven also serves on the Bechtel board, so they are keeping an eye on the estimated $100 million they invested). Gizmodo and Inc. While effective January 1, the Theranos website has already scrubbed the counselors and updated the BOD.

However, Gen. Mattis remains a director, until such time as he actually becomes Secretary of Defense, which is not a lock for Senate approval by a long shot. First, he requires a Congressionally approved waiver demanded by the National Security Act of 1947, as he has been retired only four years (as of 2017) not the required seven. Second, his involvement with Theranos has already been questioned in the media. After all, it is a Federal Poster Child of Silicon Valley Bad Behavior: censured by CMS, under investigation by SEC and DOJ. It is a handy, easily understandable club with which to beat him bloody (sic). WSJ’s wrapup.

In this Editor’s opinion, the good General should have left in October, but certainly by April when CMS laid the sanctions down, banning Ms Holmes and Mr Balwani from running labs for two years in July. What is going on in the ‘Warrior Monk’s’ mind in sticking around? Is there anything to save? 

If the WSJ articles are paywalled, search on ‘Gen. James Mattis Has Ties to Theranos’ and ‘Recent Retirement, Theranos Ties Pose Possible Obstacles for Mattis Confirmation’.  Oh yes…see here for the 27 previous TTA chapters in this Continuing, Consistently Amazing Saga.

Telemedicine’s ‘missing link’ found? American Well adds Tyto Care remote diagnostics. (US)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/11/Mom_using_on_child_ear.jpg” thumb_width=”150″ /]Telemedicine leader American Well and telehealth newcomer Tyto Care announced a new partnership that (finally) pairs up remote diagnostics to the virtual doctor visit. Patients (or parents) can use the Tyto Care device before or during the online visit to take guided exams of the heart, lungs, abdomen, ears, throat, skin and temperature which is then shared with the doctor. The releases indicate that the American Well-Tyto Care combination will be introduced first to health systems and employers. The Tyto Care examination platform and clinical data are being integrated into American Well’s telehealth platform. Timing and pricing are not disclosed, but the retail price of Tyto Care’s home model is $299.  Tyto Care, American Well releases.

Tyto Care recently obtained FDA 510(k) Class II clearance for its digital stethoscope snap-on to the main device to monitor heart and lung sounds. [TTA 2 Nov] The all-in-one type device also includes attachments for a digital imaging otoscope for ear exams, a throat scope, a skin camera and thermometer swipe. A new and quite comprehensive demo video of Tyto Care on its own platform is viewable on YouTube, which includes how a doctor can review the information during a live video visit, or as a store-and-forward exam. Tyto Care is also introducing a professional version of its device and platform.

Tyto Care has also made it to the finals of The Best of Baby Tech (a/k/a The Bump) Awards, which include a new version of the awww-worthy Owlet smart sock baby monitor, the Edwin the Duck child learning tool, TempTraq’s continuous temperature monitor and the SNOO smart sleeper. They will be exhibited with 13 other finalists at CES 2017 in the Bump Pavilion at the Baby Tech Showcase 5-8 January, with winners in six categories on the 5th. #babytechces

PCHA Connected Health Conference in Washington–book soon!

11-14 December, Gaylord National, National Harbor MD (Washington DC area)

Hosted by the Personal Connected Health Alliance, the Connected Health Conference was renamed in 2015 to reflect an increasingly consumer-centered, technology-enabled and collaborative approach to improving health, and builds on the success of the mHealth Summit. There are three days of programming with over 300 speakers, four tracks, a new and innovative exhibit floor, and specialty events. Each component — from keynotes, panel discussions, interactive sessions, roundtables and the dynamic exhibit floor — focuses on new research and actionable knowledge such as best practices, lessons learned and conclusive case studies.

  • Pre-conference sessions providing a deep dive into key topics
  • Four content tracks bringing diverse perspectives, sparking meaningful discussion and advancing new solutions around key issues such as behavior change, real time intervention, design, collaboration, data science, disparities, policy, interoperability, ethics, privacy and security, and more
  • Numerous opportunities for networking

Co-located at the Conference is the Global Digital Health Forum, which addresses digital health in low- and middle-income countries.

Click on the advert in the right hand sidebar or the link above to learn more. When you register, use code TELE100 for $100 off registration. TTA is a media partner of the PCHA Connected Health Conference.

What are the true costs of analogue care?

With current approaches to Scotland’s social services labelled unsustainable, and health care similarly under pressure, this guest article by Tom Morton of Communicare247 argues that the potential for digital technology to address health and care needs should be realised now, rather than waiting for the limitations and costs of existing analogue solutions to become ever more apparent.

Health and care provision across the globe is under pressure to provide the best in care to a growing population, in the most efficient way possible. Different countries are responding in different ways.

In Scotland, rising demand and costs for public services mean that, “by 2020, the country’s 32 councils will have to spend an extra £700m on top of the £3.1bn per year spent now”, Accounts Commission chairman, Douglas Sinclair told BBC Scotland. He also called current approaches “not sustainable”.

Health is also facing significant financial pressures, with Audit Scotland reporting that Scottish NHS boards will have to make unprecedented savings of £492m in the current final year. Some may not be able to achieve financial balance, as all struggle to meet the needs of a growing and ageing population.

Health and care providers are looking to address these issues by delivering more person-centred services within the citizen’s home. For many this means wider use of telecare or technology enabled care (TEC) to provide remote monitoring, responsive alarms, and round-the-clock support for these individuals.

Telecare is delivering benefits; one report found that widespread, targeted use of telecare could create potential savings of between £3m to £7.8m for a typical council, equating to 7.4% to 19.4% of the total older peoples’ social care budget. Savings for the NHS have also been identified, with reductions in unnecessary hospital admissions and healthcare appointments.

So with such evidence of impact, it is disconcerting to know that only around one in seven of the over 65s have access to telecare services. Such technology could help address many of the issues affecting health and care provision, but it needs investment if it is to make its contribution.

Current analogue approaches are not fit for purpose
[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/12/1950s-bakelite-md4.jpg” thumb_width=”125″ /]The UK needs to invest wisely. Currently most telecare systems are reliant on phone landlines – this is called ‘analogue’ telecare. But we need to invest in digital telecare if we want to maintain a society where our senior and vulnerable citizens can be cared for in an acceptable way.

The analogue delivery system is unsustainable due to increasing demands, with often tragic communication failures emerging that could be avoided. Current analogue services already report around 3% of failed call attempts between the home and response services, because they cannot communicate effectively over the new digital telephone network systems. (more…)