The trials of Elizabeth Holmes and ‘Sunny’ Balwani churn on towards a March 2021 court date. Two major revelations have entered the record from last Friday 20 November’s flurry of filings on both sides. The prosecution introduced panicky Holmes/Balwani texts, iMessages, and Skype messages indicating that Theranos was having major trouble with validating its lab technology from 2014 on. One text from Balwani described a lab as a ‘disaster zone’. “The spreadsheets are replete with admissions by defendant and Balwani that demonstrate their knowledge that their statements to investors were false and misleading and that Theranos’s testing was beset with... Continue Reading
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While telehealth virtual office visits flatten, overall up 300-fold; FCC finalizes COVID-19 telehealth funding program (US)
...in the caution of why telehealth has fallen off, other than the obvious of offices reopening. There’s the post-mortem experience of smaller practices which paints an unflattering picture of unreadiness, rocky starts, and unaffordability: Skype and FaceTime are not permanent solutions, as not HIPAA-compliant New telehealth software can cost money. However, this Editor also knows from her business experience that population health software often has a HIPAA-compliant telehealth module which is relatively simple to use and is usually free. It’s the training that costs, more in time than money. If the practice is in a value-based care model, that is... Continue Reading
Telehealth and the response to COVID-19 in Australia, UK, and US: the paper
...HIPAA compliant platforms such as Skype and Facetime for Medicare, retroactive to 6 March. Telehealth mushroomed starting 11 March in hospitals first, reporting 15 and 20-fold increases in telehealth consults. Then CDC and the AARP got on board. The US has an uneven system, between differences in state parity reimbursement, Medicare concentrating on rural health, state Medicaid, private pay, and integrated hospital systems’ approaches. What holds telehealth back are providers and areas in the US that simply do not have the internet connectivity that telehealth consults demand. Good reading. Telehealth in the Context of COVID-19: Changing Perspectives in Australia, the... Continue Reading
10 years in 2 months: prognosticating the longer-term effect of COVID-19 on telehealth, practices, and hospitals
...hackfest, with all sorts of alerts from mobile providers like Verizon on how to secure your phone. (An organization of which this Editor is a member had a panel this week completely disrupted by a hacker in five minutes.) Skype’s problems are well known. The winners here will be telehealth platforms that integrate well with EHRs, population health platforms (or may be part of population health platforms), and have robust security. Primary care practices and specialists, who’ve been surviving on non-F2F visits, will be adjusting their practices to patient demand, and integrating telehealth with physical visits in a way that... Continue Reading
After the COVID Deluge: a Topol-esque view of what (tele)medicine will look like
...users. This Editor’s concern is that easy to use = insecure. Skype and Zoom are inherently insecure–Skype’s user unfriendliness and insecurity outside enterprise platforms and Zoom’s major security problems on its platform and user flaws are well-known (ZDNet). Reimbursement, again! CMS has done a creditable job in broadening reimbursement for telehealth a/v and telephonic services, but coding remains a nightmare for practices struggling to remain open and with some lights on. After COVID, will CMS and HHS get religion, or put it right back in its rural bottle? Covered in the CARES Act passed at the close of March, $200... Continue Reading
CMS clarifies telehealth policy expansion for Medicare in COVID-19 health emergency, including non-HIPAA compliant platforms (US)
...(enforcement discretion again), which enables providers to use Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype–but not public-facing platforms such as Facebook Live, Twitch, or TikTok. Telephones may be used as explicitly stated in the waiver in Section 1135(b) of the Social Security Act. (FAQ #8) More information on HHS’ emergency preparedness page and OCR’s Notification of Enforcement Discretion. On reimbursement, “Medicare coinsurance and deductible would generally apply to these services. However, the HHS Office of Inspector General (OIG) is providing flexibility for healthcare providers to reduce or waive cost-sharing for telehealth visits paid by federal healthcare... Continue Reading
Thinking about a location for your health tech startup? Consider…’virtual’ Estonia!
...in picturesque Tallinn and need a delivery? It may come to your door via Starship robot, founded by one of the former Skype team. (Did you know that former Skypers have funded much of the Estonian tech and investment boom?) They take data security seriously with the Russian Bear growling (and hacking) on the border, so they created a NATO-accredited cyberdefense center in Tallinn and a whole country backup in a Luxembourg ‘data embassy’. Blockchain is a large part of this–and the government is working on using it for mapping the genome data of its 1.3 million citizens and sell... Continue Reading
Debate on Care Quality Commission’s position on online prescription services on Radio 4’s TODAY (UK)
...far preferable to an online service, whereas Mr Lowe maintains that delays in seeing one’s GP creates a need for services where a patient can see a doctor online and receive a prescription if necessary. The quick response allays anxiety in the patient and provides care quickly. Both agreed that a tightening of guidelines is needed, especially in the incorrect prescribing of antibiotics, and that there is no communication between patient records. Mr Lowe notes that GPs have always been comfortable with a telephonic consultation but are far less so with telemedicine consults via Skype. Here’s the BBC Radio 4... Continue Reading
Unintended consequences: American Well loses, loses patent, to Teladoc
...reading this. Surely all these functions are no more than what is in every instant messaging program, dating back to 1990s? Replace the words “medical service provider” by “friends” or “contacts” and “consultation” by “chat” or “call” it seems to me you get … Skype and Face Time and more! [TTA 9 June 15] No matter, the result was yesterday’s double shot of a decision. In addition, three Teladoc complaints against American Well‘s patents to invalidate them are still in progress with the USPTO. A triple, anyone? MedCityNews, Teladoc press release, American Well press release All this is despite the... Continue Reading
Chris Lewis – the hyper-connected individual meets the healthcare system (guest blog)
...visits and reduce the cost of supporting the patient. The aftercare hitherto confined to follow up consultations at the hospitals can increasingly be delivered via video-based services and ideally some more dispersed facilities in the local community. After all, consultation on how well a hip replacement or skin condition has improved can just as easily be done over a Skype link. As with many industry transformations, this requires an organisational, process, financial and cultural shift. If the follow-up consultation is carried out perfectly well by video link, why should it only command a fraction of the fee usually assigned to... Continue Reading
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