Telecare – time to sweat the analogue assets, not dump them

Veteran Editor Charles climbs on his soapbox, one more time.

There must have been a moment, somewhere, when a bronze age warrior realised that iron really cut the mustard (and other things) better. Unfortunately, that resulting genetic preference for new over old has left us open to the blandishments of salespeople through the ages, encouraging us to take every opportunity to buy new and cast out old.

And it costs! A current example is the drive by many telecare companies to use the digitalisation of the telecoms network in the UK to encourage users to ditch their analogue equipment in favour of their new shiny digital kit…when there’s no need. The telecare world has of course an honourable tradition of encouraging box shifting – back when I ran a telecare programme at LB Newham, in 2007 the government was encouraged to offer a Preventive Technology Grant to all local authorities. Perhaps the most memorable campaign though was Three Million Lives which, from the outside, appeared to have that one aim. Indeed there must be few telecare consultants who have not at some point in their career opened a cupboard to find the shelves heaving with unused – and sadly in a few cases unusable – kit.

Wise telecare providers will resist the current pressures though – both BT and Virgin have been provided with a wide range of old analogue telecare kit to test in their digital simulators alongside the appropriate digital/analogue converters and, I am reliably informed, it has worked well every time. Some companies, I am told, may not have taken full advantage of these facilities and only tested their new digital offerings, whilst ignoring analogue; I’ll leave the reader to work out why they might have done that. This is important because telecare kit is built to last and whilst some service users will benefit from the latest tech wizardry, most will be completely happy with the older kit – indeed those with dementia may find it impossible to get used to any new kit, providing one more incentive not to change. The original cost of that analogue kit must conservatively be well over £500 million, so it would seem to be a crying shame just to dump it whilst it still works well – indeed with local authority budgets as they are, it effectively would hugely reduce their ability to provide a service for all who want it.

There is of course one potential issue, as no power comes down the fibre telecoms lines, unlike with copper, so the service could fail in a blackout. However I understand that both BT and Virgin are working on solutions to this. GSM alarms, supposedly the future, are also vulnerable; indeed apparently this already happened a a few weeks back when the country suffered widespread power outages, when mobile networks failed in some areas. I understand that many masts don’t currently have a power back-up for such occasions and those that do only last 30 minutes.

So, if you are responsible for a telecare provision budget and a nice salesperson pops by to encourage you to switch out your old, ask them how their old kit behaved in the network simulations when paired with an appropriate converter.

If they tell you anything other than that it went really well, look askance. If they say they haven’t tested their old kit, ask them why not.

TTA’s Summer Windup: Doro acquires Invicta, PillPack hits data wall, Humana and CTA, CVS-Aetna finally approved, Fitbit, events, more!

 

 

Summer may be winding down but activity is winding up. Doro acquires Invicta, Amazon’s PillPack hits a data wall, Humana first payer to join CTA. Judge Leon finally blesses CVS-Aetna’s merger after 9 months. And events, including Digital Mental Health at the RSM 23 Sept.

News and event roundup: Amazon PillPack, Humana joins CTA, NH’s telemedicine go, Fitbit Lives Healthy in Singapore, supporting Helsinki’s older adults, events
Shock news: the CVS-Aetna merger officially approved after 9 months (Judge Leon’s Final Judgment delivered. But what about future healthcare mergers?)
Doro AB acquires Invicta Telecare from Clarion Housing, increasing to nearly 200,000 users (UK) (Consolidation continues)
Digital Mental Health for Adults – a one day conference at the RSM on 23 September 2019 in London (Sponsored by the RSM)

Being contrarian, we consider that AI and machine learning may be doing real damage both in its workings and in the quality of all that medical data being fed into it. Regrettably, telemedicine in nursing homes looks like a permanent failure. And CMS takes the lead in the PFS with three new telehealth codes on opioid treatment.

A realistic look at why telemedicine isn’t succeeding in nursing homes (It should, but it’s the economics of the business)
Are AI’s unknown workings–fed by humans–creating intellectual debt we can’t pay off? (Building dangerous error upon error with bad data, destroying theoretical thinking–and that’s for starters)
CMS’ three new proposed telehealth codes, changes on inclusions, in 2020 Medicare Physician Fee Schedule (US) (CMS takes initiative in opioid treatment)

Summer is really flying by, but the daystopper of the week is the doubling of breached patient records this year. LIVI adds a lot of patients in the UK, Allscripts settles with DOJ on compliance, and GSK IMPACT opens for UK charitable organization applications.

The Breach Barometer hits a new high for healthcare–and the year isn’t over (The geometric increase in breaches and exposed records)
LIVI telemedicine app expands availability to 1.85 million patients with GPs in Birmingham, Shropshire, Northamptonshire, Southeast (The crowded UK telemedicine field)
Allscripts reaches deal with DOJ on Practice Fusion in compliance settlement for $145 million (Bargains are never bargains)
2020 GSK IMPACT/The King’s Fund Awards now open for applications (UK) (Apply soon!)

Summer is flying by, but rural health connectivity advances at the FCC. Smartphones now set up to detect viruses. Another smartphone enabled ultrasound player–but this time in 3D. A study connects health tech to retaining LTC workers. Connected Health Summit coming up, and Vivify Health acquires a new VP.

Comings and goings, short takes, and in other news…: Vivify’s new SVP Sales, Parks’ Connected Health Summit, $35M for 3D portable ultrasound, Oxford Medical Sim new pilot (Events, products, and more)
Technology will help ease, but not replace, rising workforce demand in long-term care: UCSF study (It’s almost all about the workers and retaining them in the face of technology)
Can a smartphone camera, app, and device detect viruses at low cost? (A University of Tokyo team says yes)
FCC reforming Rural Health Care Program to improve telehealth funding in addition to Connected Care Pilot (US) (About time, but still underfunded)


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News and event roundup: Amazon PillPack, Humana joins CTA, NH’s telemedicine go, Fitbit Lives Healthy in Singapore, supporting Helsinki’s older adults, events

Now that we are past the unofficial end of summer, it’s time to spin that lasso and rope us some news.

Amazon’s PillPack loses a critical data partner. Electronic prescriptions clearinghouse Surescripts terminated their data contract with ReMy Health, which supplied PillPack with information on patients’ prescriptions. Surescripts found fraud in several areas of their relationship with ReMy Health including medication history, drug pricing, and insurance billing. Now PillPack has to obtain it the old-fashioned way–by asking the patient. This can lead to errors and inaccuracies in things like dosages and whether a drug is brand-name or generic. Now PillPack, in the lurch, is seeking a direct relationship with Surescripts. Seeking Alpha, CNBC

Health plan Humana is the first payer to join the Consumer Technology Association (CTA). Humana has been building up his data analytics and digital health capabilities with new ‘studios’ in Boston and hiring USAA’s CTO.  It’s piloting an app for Medicare Advantage patients to connect them with pharmacists and medication management via Aspen RxHealth plus working on a virtual digital primary model with telemedicine provider Doctor on Demand. Fierce Healthcare

New Hampshire is joining the telemedicine reimbursement bandwagon, with its legislature and Gov. Sununu approving primary care providers and pediatricians to bill Medicaid and private insurance for telemedicine visits starting in January 2020. This also ties into rural telehealth. AP, Mobihealthnews

Internationally….Fitbit is partnering with Singapore’s Health Promotion Board (HPB) for the Live Healthy SG behavioral change program, based on the Fitbit Premium program, starting in late October. Mobihealthnews A-P   In Finland, Digital Service Center Helsinki is creating digital tools and virtual care systems to enable older adults to safely and independently live at home, including socialization to prevent loneliness. It’s a significant challenge as over 22 percent of Finland’s population is over 65. Mobihealthnews Europe-UK

Events:

The 9th International Digital Public Health Conference series (#DPH2019), 20-23 November, Marseille, France. This conference is billed as the digital health partner of the 12th European Public Health Conference and brings together the areas of public health, computer and data science, medtech, and NGOs. Conference information here.

Aging 2.0 New York Global Innovation Showcase 4 December, NYC. One of a series of global Aging 2.o events, startups will present aging-focused innovations. Want to pitch? It’s still open–apply here. Register to attend here. Additional information on this and on CREATE’s Design for Older Adults Workshop on 21-22 October at Weill Cornell is here.

 

Shock news: the CVS-Aetna merger officially approved after 9 months

Go away on holiday, Judge Leon finally jumps into the hole. It took two months from the last hearings in mid-July, and nine months in total (delivered after last year’s Thanksgiving turkey) but Judge Richard Leon of the Federal District Court finally–and somewhat unexpectedly–ruled that the CVS-Aetna merger could be at last a Done Deal.

The Final Judgment goes into extensive detail about the Medicare Part D divestiture by Aetna to WellCare, complete with a Monitoring Trustee. On the very last page, Judge Leon admits that the merger is in the Public Interest.

The entire process, which is chronicled here, was unprecedented in the annals of Federally approved mergers. Usually a District Court Tunney Act review of a merger already through the wringer of the DOJ and the states is brief. Judges don’t make headlines, save when their rulings are the coup de grace (see: Aetna-Humana, Anthem-Cigna). Instead, Judge Leon called hearing after hearing, witness after witness from the AMA to PIRG, opining all the way, even turning away five supporting states petitioning (in vain) to be heard.

This high-profile precedent doesn’t bode well for future mergers, especially for healthcare. Fierce Healthcare, Columbus Dispatch

Doro AB acquires Invicta Telecare from Clarion Housing, increasing to nearly 200,000 users (UK)

While this Editor was on holiday, Sweden’s Doro AB increased its presence in the UK with the acquisition of Invicta Telecare, parent of Centra Pulse and Connect. Invicta’s products will join the Welbeing PERS service. which at the time of their acquisition last June had about 75-80,000 users [TTA 7 June 18].

Invicta was sold by Clarion Housing Group, the UK’s largest social housing association, which includes a property development company and a charitable foundation. Invicta’s 2018 revenue was £6.3 million. Like Welbeing, Centra Pulse offers basic and mobile PERS, but also has multi-sensor in-home connected home capability. It is also one of the top three UK monitoring services and is a major provider of after-hours contact services for telecare providers, such as housing associations and local authorities. The sale was effective on 1 September.

The UK remains the largest telecare market in the European region with an estimated 1.8 million telecare connections. It faces a transition to digital from analog systems which affects social care spending and residential service capabilities. Doro operates in the UK and about 40 countries, with a core business in mobile phones specially designed for older adults. Doro announcement, press release

Digital Mental Health for Adults – a one day conference at the RSM on 23 September 2019 in London

The next event run by the Royal Society of Medicine’s Digital Health Council, on 23rd September, focuses on digital mental health for people over 18. There are two main sides in the high level discussion around this topic. There is an increasingly active (and commercially burgeoning) group of companies and individuals who believe that there are a digital tools that can help to screen, manage and in some cases treat people with mental health issues (or who suspect they may have one). Some of these are simply ways of digitally enabling remote conversations between mental health care providers and those that require advice or care. Some are AI driven tools that to some degree replace the human element of care and support. The event will discuss whether this not only addresses workforce issues but also delivers clinical efficacy.

On the other hand, many believe that the use of digital technologies can adversely affect the mental health of people who use them, often to excess. Do the potential benefits outweigh these negative factors, or is a digital detox something that your GP may soon be prescribing?

Come along and get involved! Booking is here – tickets start at £20 (RSM student rate) for the day including a delightful lunch.