Ericsson report: will 5G close the healthcare gap from hospitals into the home?

Ericsson, one of Europe’s leading telecom companies, earlier this month published its latest ConsumerLab report, “From Healthcare to Homecare” on the next generation of healthcare enabled by the greater speed and security of 5G–the fifth generation of wireless mobile. Their key findings among consumers and industry decision makers contained surprises:

  • Growing frustration with hospital wait times. 39 percent prefer an online consult with a doctor versus waiting for the face-to-face.
  • Wearables are perceived as better ways to monitor and even administer medication for chronic conditions–nearly two in three consumers want them. But medical grade wearables will be required.
    • Yet the current state doesn’t lend itself to these wishes. “55 percent of healthcare decision makers from regulatory bodies say these devices are not sufficiently accurate or reliable for diagnosis. In addition, for liability reasons it will be very difficult to rely on patients’ smartphones for connectivity….medical-grade wearables will be required. Such devices could also automatically dispense medicine and offer convenience to those recovering from surgery.”
  • +/- 60 percent of surveyed consumers believe that wearables will improve lifestyles, provide personalized care, and put people in control of their own health.
  • There’s real security concerns that 5G is expected to access: “61 percent of consumers say remote robotic surgery is risky as it relies on the internet….47 percent of telecom decision makers say that secure access to an online central repository [of medical records] is a key challenge and expect 5G to address this.” Surprisingly, only 46 percent of cross-industry decision makers consider data security to be an issue. Battery power is also a significant concern for over half in wearables, a problem that over 40 percent will be helped by 5G.
  • Even more surprising is the lack of desire for consumer access to their medical records–only 35 percent of consumers believe that it will help them easily manage the quality and efficiency of their care. In contrast, 45 percent of cross-industry experts consider the central repository as a breakthrough in healthcare provisioning.

Decentralizing care into the home is seen as worthwhile by a majority of industry decision makers 

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/06/healthcare-to-homecare-fig3_rgb.jpg” thumb_width=”250″ /] (more…)

Tenders closing quickly: Cornwall/Isles of Scilly, Blackpool

Susanne Woodman of BRE, our Eye on Tenders, had sent these earlier but your Editor was at fault in being tardy in reviewing them. But there’s still time!

  • Cornwall/Isles of Scilly: The University of Plymouth and E-health Productivity & Innovation Cornwall & Isles of Scilly (EPIC) are seeking to engage specialist support for the Social Care Sector and Care Homes across Cornwall and the Isles of Scilly to develop their awareness and capability to adopt emerging ehealth products and services. This is closing Wed 14 June so go to the Plymouth website for more information. Gov.UK Contracts Finder
  • Blackpool Council: They are inviting “suitably experienced care organisations to participate in an exploratory exercise to help the Council better understand the market position with regards to supporting individuals with a learning disability and/or autism to live independently through use of assistive technology.” This closes Monday June 19. Tenders Electronic Daily (TED), Due North website

76% of health systems to adopt consumer telemedicine by 2018: Teladoc survey

We normally don’t feature corporate or sponsored surveys, but are making an exception here as it demonstrates two trends: that hospital systems can’t fight consumer telehealth** anymore, and that the future mix of usage is starting to change. Teladoc’s/Becker’s Healthcare Hospital & Health Systems 2016 Consumer Telehealth Benchmark Survey projects that by 2018, 76 percent of health systems will adopt consumer telehealth (vs. site-to-site), double from 2016, and that most who have it will be expanding offerings. As a benchmark survey, it tracks services offered or plan to offer, organizational priorities, and goals.

An interesting part is how the mix of services under telehealth is evolving. Presently, the top three among current users are urgent care, primary care, and psychiatry/mental health. For new users, their priorities are ED/urgent care (45 percent), readmission prevention (42 percent), primary care, including internal medicine and pediatrics (42 percent), chronic condition management (41 percent). Nearly one in five (18 percent) plan to include cardiology services.

As implemented by health systems, telehealth has run into problems that were totally predictable and will provoke the ‘Duh?’ response from our Readers. From the report:

  1. They didn’t measure patient or physician satisfaction with their telehealth programs, even though improving patient satisfaction is a leading motivator for offering telehealth services.
  2. Gaining physician buy-in was cited by 78 percent of respondents, and rated as the #1 lesson learned
  3. The second most important? The importance of aligning telehealth initiatives with organizational goals (75 percent). (more…)

The Nightingale-H2020 project for wireless acute care (UK/EU)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2017/06/nightingale.jpg” thumb_width=”150″ /]Susanne Woodman of BRE, our Eye on Tenders, is following the Nightingale-H2020 project for acute care–and if you are in the wireless or wearable remote monitoring business, you should be too. It is a pre-commercial procurement project (PCP) that invites the European healthcare industry to develop wireless solutions for patient in-hospital and home monitoring. Deriving from the European Commission’s Horizon 2020 grant, the process started last year with a €5 million award and in the spring had two Open Market Consultation meetings. Q&As from these meetings were recently released. The official tender will be released this November on the EU website Tenders Electronic Daily (TED). For more information, consult the Nightingale PCP website and their useful PDF on the process. @Nightingale_EU

Behave, Robot! DARPA researchers teaching them some manners.

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/01/Overrun-by-Robots1-183×108.jpg” thumb_width=”150″ /]Weekend Reading While AI is hotly debated and the Drudge Report features daily the eeriest pictures of humanoid robots, the hard work on determining social norms and programming them into robots continues. DARPA-funded researchers at Brown and Tufts Universities are, in their words, working “to understand and formalize human normative systems and how they guide human behavior, so that we can set guidelines for how to design next-generation AI machines that are able to help and interact effectively with humans,” said Reza Ghanadan, DARPA program manager. ‘Normal’ people determine ‘norm violations’ quickly (they must not live in NYC), so to prevent robots from crashing into walls or behaving towards humans in an unethical manner (see Isaac Asimov’s Three Laws of Robotics), the higher levels of robots will eventually have the capacity to learn, represent, activate, and apply a large number of norms to situational behavior. Armed with Science

This directly relates to self-driving cars, which are supposed to solve all sorts of problems from road rage to traffic jams. It turns out that they cannot live up to the breathless hype of Elon Musk, Google, and their ilk, even taking the longer term. Sequencing on roadways? We don’t have the high-accuracy GPS like the Galileo system yet. Rerouting? Eminently hackable and spoofable as WAZE has been. Does it see obstacles, traffic signals, and people clearly? Can it make split-second decisions? Can it anticipate the behavior of other drivers? Can it cope with mechanical failure? No more so, and often less, at present than humans. And self-drivers will be a bonanza for trial lawyers, as added to the list will be car companies and dealers to insurers and owners. While it will give mobility to the older, vision impaired, and disabled, it could also be used to restrict freedom of movement. Why not simply incorporate many of these assistive features into cars, as some have been already? An intelligent analysis–and read the comments (click by comments at bottom to open). Problems and Pitfalls in Self-Driving Cars (American Thinker)

GreatCall’s acquisition: a big vote for older adult-centered healthcare tech

This midweek’s Big News has been the acquisition of the mobile phone/PERS company GreatCall by Chicago private equity firm GTCR. Cost of the acquisition is not disclosed. GTCR stated that they expect to make capital investments to GreatCall to fund future acquisitions and internal growth. GreatCall has over 800,000 subscribers in the US, generates about $250 million in profitable revenue annually, and employs about 1,000 people mainly in the San Diego area and Nevada. According to press sources, senior management led by CEO David Inns will remain in place and run the company independently. 

Our US Readers know of GreatCall’s long-standing (since 2006), bullseye-targeted appeal to older adults who desire a simple mobile flip phone, the Jitterbug, but has moved along with the age group to a simple smartphone with built-in health and safety apps. Along the way, GreatCall also developed and integrated the 5Star mPERS services on those phones, served by their own 24/7 emergency call center and developed an mPERS with fall detection. Their own acquisitions included the remnants of the Lively telecare home monitoring system in 2015 [TTA 5 Dec 15], adding the Lively Wearable mPERS/fitness tracker to their line; and senior community telecare service Healthsense last December. The original Lively home system and safety watch are sold in the UK (website) but apparently not the Jitterbug. In the UK and EU, the Jitterbug line would be competitive with established providers such as Doro.

What’s different here? GTCR is not a flashy, Silicon Valley PE investing in hot, young startups or a traditional senior health investor like Ziegler. Its portfolio is diversified into distinctly non-cocktail-chatter companies in financial services and technology; technology, media and telecommunications (including an outdoor ad company!); and growth businesses. It has real money, investing over $12 billion in 200 companies since 1980, and strategically prefers leadership companies. Their healthcare businesses have primarily been in life sciences, specialty pharma, dermatology, specialty services such as healthcare in correctional institutions, and device sterilization. Recent acquisitions have been San Diego-based XIFIN, a provider of cloud-based software to diagnostic service providers, RevSpring in billing and communications, and data analytics firm Cedar Gate Technologies. It also has partnered with newly formed medical device companies.

GreatCall crosses over into GTCR’s telecommunications sweet spot, but the older adult market and direct-to-consumer sell are different for them. Because it is unique in their portfolio, this Editor believes that GTCR sees ‘gold’ in the ‘silver’ market. Larry Fey, one of their managing directors, cited its growth and also GreatCall’s recent moves into senior communities with their products. GTCR also has expertise in the security alarm monitoring sector, which along with pharma clinical trials can bolster better utilization and broaden the utilization of GreatCall’s call centers.

However, this Editor would caution that the US senior community market has been having difficult times of late with overbuilding, declining occupancy, resident/labor turnover, and rising expenses–as well as recent coverage of security lapses and resident abuse. Telecare systems like Healthsense are major capital expenses, but the flip side is that communities can use technology to improve care, resident safety, and to differentiate themselves. To make the most of their Healthsense acquisition, GreatCall needs to bring innovation to the V1.0 monitoring/safety/care model that Healthsense is in its current state, and make the case for that innovation in cost/financials, usability and reliability. San Diego Union-Tribune, Mobihealthnews

Tech that assists those with speech impairments, telemedicine for mapping public health

This year’s trend to develop technologies that solve specific but important problems, such as improving navigation for the visually impaired, [TTA 8 June] continues:

  • Voice-controlled assistance systems are becoming commonplace, from improved interactive voice response (IVR) to Siri, Echo, and Alexa. Their limitation is that their recognition systems understand only standard, not impaired or even heavily accented speech. For those with the latter, a Tel Aviv-based startup called Voiceitt has developed Talkitt, an app that learns an individual’s speech based on basic, everyday spoken (or typed input) phrases and after a training period, converts them into normal audio speech or text messages on a tablet or smartphone. This aids with everyday life as well as devices like Echo and Alexa. Voiceitt is out of the Dreamit Health accelerator and was just seed funded with $2 million. This Editor notes from the TechCrunch article that it’s described as ‘the thin edge of the wedge’ and ‘a market with need’. It will be introduced this year to health systems and schools to assist those with speech impairments due to health conditions. Hat tip to Editor Emeritus Steve Hards
  • Diagnosing degenerative diseases such as diabetic retinopathy, which is preventable but if untreated eventually blinds the patient, is doubly difficult when the patient is in a rural, economically disadvantaged, predominantly minority, and medically underserved area of the US. Ophthalmologist Seema Garg has been on a quest since 2009 to have this recognized as a public health threat. The North Carolina Diabetic Retinopathy Telemedicine Network out of University of North Carolina-Chapel Hill, headed by Dr. Garg, collaborated with five NC clinics to recruit patients with diabetes. Her team then trained primary care staff to take digital retinal photographs transmitted over a secure network to be examined for symptoms. The public health study used Geographic Information Systems (GIS)-mapping for patient accessibility to ophthalmologists, demographics, and risk factors such as higher A1C levels, minority race, older age, kidney disease, and stroke. JAMA Ophthalmology, Futurity  Hat tip to Toni Bunting of TASK Ltd. (and former TTA Ireland editor)

Wearable haptic/Braille guidance system for the visually impaired

MIT researchers from their CSAIL (Computer Science and Artificial Intelligence Laboratory) unit have developed a system that is designed to aid the visually impaired in accurately navigating a room, with or without the assistance of a cane. It consists of a 3-D camera worn on the abdomen, a belt that has vibrational (haptic) motors, and an electronically controlled Braille interface worn on the side of the belt. The camera is worn on the chest as the optimum and least interfering body location. The pictures taken are analyzed by algorithms that quickly identify surfaces and their orientations from the planes in the photo, including whether or not a chair is unoccupied. The belt sends different frequency, intensity, and duration tactile vibrations to the wearer to help identify nearness to obstacles or to find a chair. The Braille interface also confirms the object and location through key initials (‘c’ for chair, ‘t’ for table) and directional arrows. According to the MIT study, “In tests, the chair-finding system reduced subjects’ contacts with objects other than the chairs they sought by 80 percent, and the navigation system reduced the number of cane collisions with people loitering around a hallway by 86 percent.” MIT News, Mashable, ‘Wearable Blind Navigation’ paper Hat tip to Toni Bunting of TASK Ltd.

 

VA says goodbye to VistA, hello to Cerner for new EHR–and possible impacts (updated)

The new sheriff just turned the town upside down. Veterans Affairs’ new Secretary, Dr. David J. Shulkin, as expected moved quickly on the VA’s EHR modernization before the July 1 deadline, and moved to the same vendor that the Department of Defense (DoD) chose in 2015 for the Military Health System, Cerner. VA will adapt MHS GENESIS, based on Cerner Millenium. The rationale is seamless interoperability both with DoD and with private sector community providers and vendors, which base their services on commercial EHRs. The goal is to have one record for a service member through his or her lifetime and to eliminate the transition gap after discharge or retirement. (Transition gaps are also repeated when reservists or National Guard are called up for active duty then returned to their former status.) Another priority for VA is preventing the high rate of suicide among vulnerable veterans.

Updates: VA confirmed that Epic and Leidos will keep the development of the online medical appointment scheduling program, awarded in 2015 and currently in pilot, to be completed in 18 months. The contract is worth $624 million over five years. Wisconsin State Journal  The House Appropriations subcommittee on Veterans Affairs likes the Cerner EHR change. The Senate Veterans Affairs Committee is meeting Wednesday to discuss the VA budget sans the EHR transition. The EHR numbers are expected to be sooner rather than later. POLITICO Morning eHealth 

Dr. Shulkin is well acquainted with the extreme need for a modernized, interoperable system serving the Veterans Health Administration (VHA), having been on the US Senate Hot Grill for some years as Undersecretary of Health for VA. The foundation for the move from homegrown VistA to Cerner was laid last year during the prior Administration through an August RFI for a COTS (commercial off the shelf) EHR [TTA 12 Aug 16] and in later hearings. “Software development is not a core competency of VA” and it has been obvious in system breakdowns like scheduling, maintaining cybersecurity and the complex interoperability between two different systems. To move to Cerner immediately without a competition, which took DoD over two years, Dr. Shulkin used his authority to sign a “Determination and Findings” (D&F) which provides for a public health exception to the bidding process. The value of the Cerner contract will not be determined for several months.

For those sentimental about VistA, he acknowledged the pioneering role of the EHR back in the 1970s, but that calls for modernization started in 2000 with seven ‘blue ribbon’ commissions and innumerable Congressional hearings since. He understated the cost in the failed efforts on interoperability with DoD’s own AHLTA system, VA’s own effort at a new architecture, and modernizing the outpatient system. This Editor tallied these three alone at $3 billion in GAO’s reckoning [‘Pondering the Squandering’, TTA 27 July 13]. 

It is still going to take years to implement–no quick fixes in something this massive, despite the urgency.

  • Both MHS and VA will be running two systems at once for years (more…)

Tunstall Americas has a new president/CEO (updated)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”175″ /]Updated Softly, softly. Rumors of a change at the top of Tunstall Americas were confirmed by the appearance in late May of Oscar Meyer as president/CEO on the leadership page of their website. This Editor was tipped earlier that Casey Pittock’s name had disappeared from the page at some point prior to mid-May. Inquiries at that time to their UK press contact were not returned. As of June 6, there is still is no formal press release announcing the change on PRWeb, their usual release site, or posted on the website.

The leadership page gives the barest bones of Mr. Meyer’s background: most recently North America Commercial Operations team for Invacare Corporation, a DME company primarily in the long-term care market, with most of his career at J&J. His LinkedIn page also adds in an adjunct professorship at Xavier University, a brief VP stint at Gambro (acquired by Baxter 2013) and Snow Creations, LLC, giving his location as Ohio. Tunstall Healthcare Group CEO Gordon Sutherland also is a veteran of Invacare (as head of EMEA) and Gambro.

Our Readers will recall the sudden change at Tunstall Americas three years ago when Mr. Pittock was ‘unveiled’ at the Medical Alert Monitoring Association meeting by then Tunstall Group CEO Paul Stobart, replacing Bradley Waugh [TTA 14 Mar 14]. Mr. Pittock was still listed on the Tunstall Group website as CEO North America through May 26, but as of this writing (June 6) the leadership roster has been updated with Mr. Meyer’s picture and brief bio. 

This Editor hopes that Mr. Meyer makes headway in the complex and crowded US PERS and safety market. Tunstall acquired in 2011 one of the most successful PERS/monitoring businesses here, AMAC, but failed to build substantially on their established business. One of the last appearances of Mr. Pittock in the press was in February for the Ripple Network Technologies personal safety device, where Tunstall Americas was providing the 24/7 emergency monitoring [TTA 1 Feb]. A great idea, but by March 3, Ripple had canceled its Kickstarter fundraising and their last Twitter post was March 21, indicating the company has gone dark or out of business. It is another example of how difficult it is to make headway here in the Americas. Is it acquire another company–or go home?