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.

Telehealth the way forward for chronic disease treatment – Australian report

  1. Telehealth has been confirmed as the way forward for sustainably treating the leading chronic diseases in Australia says a report published following a scientific study. The study, which analysed the effects of monitoring a mixed group of patients with chronic conditions using home-based telehealth equipment, concludes that use of home-based telehealth will not only reduce the hospital admissions but will also reduce the length of stay when admitted. The analysis of the data from the trial has shown that for chronically ill patients, an annual expenditure of AU$2,760 could generate a saving of between AU$16,383 and AU$19,263 representing a rate of return on investment of between 4.9 and 6. This is equivalent to a saving of AU$3 billion a year, says the report.

The Australian study, carried out by the Commonwealth Scientific and Industrial Research Organisation (CSIRO) is reminiscent of UK’s Whole System Demonstrator (WSD), the world’s largest randomised control trial of telehealth. Although the Australian study is much smaller with a total of 287 participants over 5 sites (covering the 5 States) compared with over 6,000 in the WSD, the principles are similar. Due to the smaller sample sizes and the need to have patients connected to the National Broadband Network (NBN) the selection of patients was not random but other techniques were used to obtain statistically significant results. Patients selected had unplanned acute hospital admissions indicationg one or more of Chronic Obstructive Pulmonary Disease (COPD), Coronary Artery Disease, Hypertensive Diseases, Congestive Heart Failure, Diabetes and Asthma.

The TeleMedCare Systems Clinical Monitoring Unit (CMU) was used as the home-based unit although not all features offered by the device were utilised in this study. The CMU system deployed in this study was developed in Australia, registered with TGA (Therapeutic Goods Administration) and has been extensively used and tested in previous trials.

Typically patients would have some or all vital signs measurements scheduled at a convenient time, typically in the morning. These measurements were blood pressure, pulse oximetry to measure arterial blood oxygen saturation, ECG (single channel), lung capacity, body temperature, body weight and blood glucose concentration. In addition to scheduled times, patients could take their vital signs at any time. A full suite of clinical questionnaires was also available.

The full report Home Monitoring of Chronic Diseases for Aged Care is available to download here.

Broadband and health in USA

The Federal Communications Commission (FCC) has been investigating [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/08/C2H-BroadbandMap_Gaps-America.png” thumb_width=”150″ /]the relationship between broadband and health in the US through their Connect2Health Task Force and this week it has released an online tool “Mapping Broadband Health in America”.
It is an interactive map that allows users to visualise, overlay and analyse broadband and health data at the national, state and county levels.

This tool allows easy access to existing health and broadband access data to anyone who wants to look at the possible influence of broadband access on health over a period of time or to identify gaps which may provide opportunities to develop or expand online health services.

The interactive tool allows the user change the broadband availability measure (by say proportion of coverage or download speed for example) and select a health measure such as say obesity rate or preventable hospitalisation days and shows where the selected broadband measure is satisfied, where the selected health measure is satisfied and where both are satisfied. The types of health measures are currently limited but if users find the tool useful and feedback to the FCC there may well be further expansion.

Have a play with the map here.

Tech savvy ageing

Future technologies are expected to play an important role in supporting independence in later life says one of the main findings [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/08/How-tech-savvy-are-we.jpg” thumb_width=”150″ /]from research published this week in the UK. People aged 65 and over who have not grown up with technology around them, perhaps unsurprisingly, find it more difficult to master the latest technologies initially than younger groups do and there are concerns that society could become more inactive and too reliant on technology. This are some of the other main findings given in the report ‘How Tech Savvy are We?’  from the Institution of Engineering and Technology (IET) in the UK.

Although the research was not focused on just the older age group there are some aspects which are particularly looking at this group of people.

There is no clear consensus on which of the six proposed technologies in the research would be most useful in later life – smart healthcare devices are rated most useful by 27%, whilst driver-less cars and robot help are deemed the most useful by only 10%. This suggests a possible disconnect between what industry is developing and what the public actually wants says the IET.

Commenting on the report’s findings, Chris Cartwright, Chair of the IET Information and Communications Sector, is quoted as saying: “It’s great to see strong public support and understanding for the potential benefits new technologies offer an ageing population. But it’s less encouraging that this support is still hindered by concerns around cost, lack of physical activity and loss of human contact. There is also a lack of clarity about which technologies people will find most useful, probably because they are unclear of the benefits.

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Danger in switching to pill organisers

Have you ever had one of those days when you get home from work and can’t remember anything about the drive back? I certainly have. [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/07/Pill-box-file8421285496858.jpg” thumb_width=”150″ /]Your mind is so engrossed on that knotty problem or you’re busy with a conference call.  Being on auto-pilot, we call it.

Now, we all probably know one or more people who take regular medication and use a pill organiser to help remember whether they took their medicines. When one is taking regular medication it becomes so second nature that one is sometimes on auto-pilot and without some means of checking like using a pill organiser it is so easy to lose track of whether one had the tablets at lunchtime.

Yesterday a report was published in the British newspaper, The Telegraph, about research carried out on the impact of using pill organisers and the results were rather surprising. When people who had not previously used pill organisers were switched to use organisers researchers observed that patients using the organisers were having more medical problems than a control group. Problems such as falls and hypoglycaemic episodes. What was going on? (more…)

Philips publishes new report on connected tech

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/06/Future-health-index-e1465426741815.jpg” thumb_width=”150″ /]A report published by Philips today claims that 78% of healthcare professionals believe their patients need to take a more active role in managing their health while 20% of UK patients admit to not managing their health, according to a press release. The report suggests that the result of people not paying attention to their health is increased illnesses (or “lifestyle related conditions” as the report calls them) such as heart failure and type 2 diabetes. The report then goes on to suggest that the use of “connected technology” to help manage their health should be made mandatory for some patients. Connected technology is defined as technology that enables sharing of information throughout all parts of the health system (e.g. doctors, nurses, community nurses, patients, hospitals, specialists, insurers and government) that can range from computer software that allows secure communication between doctors and hospitals, to a watch that tracks a person’s heartbeat. However, the connected technology in a case study highlighted in the press release is home based monitoring systems supplied by Philips for a classic UK telehealth trial for COPD, diabetes and heart failure.

Philips say they commissioned the Future Health Index (FHI) report to globally gauge (more…)

Telemedicine device wins Africa Prize for Engineering Innovation

A telemedicine invention called Cardio Pad developed by an engineer from Cameroon has been selected as the winning entry for [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/05/Cardio-Pad-2.jpg” thumb_width=”150″ /]the 2016 Africa Prize for Engineering Innovation, according to news reports  (BBC, Forbes, TechTrends, Business in Cameroon).

The winner, 24-year-old Arthur Zang (pictured with a Cardio Pad), who won the £25,000 ($37,000) on offer from the Royal Academy of Engineering in the UK,  was awarded his prize at a ceremony in Dar es Salaam, Tanzania, on the 26th of May, 2016. Zang previously won a Rolex Award for Enterprise in 2014 for the device. (more…)

Telecare Awareness Day (UK) – June 1st 2016

This Wednesday, June 1st, is National Telecare Awareness Day in the UK for 2016. This is promoted by the industry body [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/05/UKTelehealthcare-Awareness.png” thumb_width=”150″ /]UK Telehealthcare.

To mark the day, CAIR, the UK based telecare products supply company, is holding an event at their headquarters in West Yorkshire. According to information available from the Telecare Services Association, twelve of the region’s leading voices in Telecare will gather to “tackle some of the challenges facing the industry”.

Last year several activities took place to mark the day, then called National Telehealthcare Awareness Day, with events being held by CAIR, University of East Anglia’s Norwich Electronic Assistive Technology Centre (NEAT), Welbeing (an independent-living service provider) and many others.

A summary of last year’s events is available via the UK Telehealthcare website here.

State by State report on telehealth laws and policies (US)

A comprehensive scan of telehealth laws and Medicaid [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/05/State-telehealth-laws.jpg” thumb_width=”150″ /]program policies is available from the recently released report from the Center for Connected Health Policy, part of the Public Health Institute, a California based non-profit. This fourth annual review, State Telehealth Laws and Medicaid Program Policies,  provides a current summary of telehealth policies and laws in all the states and the District of Columbia.

As we have covered in many previous articles, states are actively pursuing legislation to implement their own set of telehealth policies. This report is supposedly an up to date summary of these laws and regulations as of March 2016.

Some significant findings highlighted by the authors are
– 47 states and Washington DC provide reimbursements for some form of telemedicine video conferencing. This number is unchanged from last year.
– 9 states reimburse for store and forward services (e.g. medical images, documents and pre-recorded videos. Primarily sent between medical professionals)
– 16 states offer reimbursement for remote patient monitoring, unchanged from last year

The report is complemented by an interactive map located here.

Australia: Most of the benefit of NBN comes from Telehealth and Teleworking

A study has concluded that most of the benefit from the National Broadband Network in Australia comes from two sources, telehealth and teleworking. Economic Benefit of the National Broadband Network (NBN) is a report partially summarising a study by the Centre for Energy Efficient Telecommunications (CEET) at the University of Melbourne. The study analyses the potential economic impact of Australia’s NBN.

Assuming that eventual access speeds will reach 10-25 Mbps, the model used by CEET predicts long-term GDP increase of 1.8% and a 2% increase in real-term household consumption. Of six categories of services considered, cloud computing, e-commerce, online higher education, telehealth, teleworking and entertainment, it is telehealth and teleworking that have come up as the services that will generate the most benefit from the NBN.

The average annual household benefit is estimated to be around $3,800 by 2020. Recognising the significant investment being made in broadband in Australia, the paper attempts to describe how the NBN will influence the national economy through the adoption of new services and new ways of working.

The short summary report is in easily accessible language and well presented and is available here.

Insurer launches telemedicine for Australian travelers

An Australian health insurance underwriter has announced that it is offering a telemedicine service for its traveling and expatriate policyholders, according to today’s Insurance Business. [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/04/Docto-logo.png” thumb_width=”150″ /] Accident and Health International (AHI) is offering access to Australian-trained emergency physicians via video, phone call, email or text 24 hours a day for these customers.

The service is being offered through Docto, which describes itself as “Australia’s first on-line telemedicine hospital”. CEO of AHI, Peter Banks, is reported to have said “the policy holder simply clicks a button on the AHI App or the Docto website and they can see a doctor from the comfort of their home or hotel room. Often when you are travelling in an unfamiliar place, it is the simple questions you want answers to. They can simply text, email, video or voice call AHI’s TeleHealth for an immediate answer.”

Dr John Field, founder of Docto, offers another scenario: “it is preventing a mother from having to go to a foreign hospital in the middle of the night with sick kids. She can press a button and see a doctor in real time, without leaving the house.” Docto website claims that its “Emergency Department” is staffed 24-hours a day by fully trained Australian Emergency Physicians. Access to medical specialist covering a wide range of areas are arranged via Telemedicine consultations on the next business day.

If the traveler requires repatriation back to Australia that is arranged via Dynamiq, a global emergency management company.

Mississippi to get VA telemed pilot amid controversy

Mississippi has led the way in telemedicine projects in southern USA for some time with the University of Mississippi Medical Center’s various successful projects [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/10/Dept-of-VA-logo.jpg” thumb_width=”150″ /]attracting well deserved funding. Now the US Secretary of Veteran’s Affairs has announced that a new pilot programme to use telemedicine to reduce wait times for new patients at VA hospitals will take place in Mississippi.

This pilot programme comes in the wake of the highly criticised wait times reported for new patients at VA hospitals in 2014. A CNN report based on internal VA documents claimed that thousands of veterans had to wait more than three months to see a specialist.

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IBM automates diagnostic image analysis

“Most smart software in use today specialises on one type of data, be that interpreting text or guessing at the content [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/02/Avicenna.jpg” thumb_width=”150″ /]of photos. Software in development at IBM has to do all that at once. It’s in training to become a radiologist’s assistant” writes Tom Simonite in MIT Technology Review.

According to Simonite, the IBM software, named Avicenna, analyses diagnostic images like CT scans and the associated data such as a patient’s medical record and suggests possible diagnoses.

An example quoted was the case of a 28-year old with shortness of breath whose pulmonary angiogram images and medical history were analysed by the software. Using a family history which showed a tendency to form blood clots the software diagnosed a pulmonary embolism which was the same diagnosis an independent radiologist reached.

Simonite reports that IBM have thus far used annonymised data and are now working on commercialising the software although an independent researcher is quoted as saying that the accuracy needs to be increased before it would be a useful diagnostic tool.

Read the full article here.

NHS England announces 7 “Test Beds”

NHS England has announced a series of “Innovation Test Beds” that will be used to “harness technology to address some of the most complex issues facing patients and the health service”.

“Front-line health and care workers in seven areas will pioneer and evaluate the use of novel combinations of interconnected devices such as wearable monitors, data analysis and ways of working which will help patients stay well and monitor their conditions themselves at home”, according to the NHS press release. (more…)

Australian healthcare fund takes stake in telemedicine startup

HCF, the oldest of the “Big Four” Australian health funds, has bought a 15% stake in telemedicine online doctor service startup GP2U. [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/01/HCF-logo.jpg” thumb_width=”150″ /]GP2U provide systems which helps to make remote consultations via video conferencing possible.

According to yesterday’s press release HCF will run a pilot to “ensure the service is scaled to the wider HCF membership as smoothly as possible”. In addition to providing the video conferencing platform, [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/01/GP2U-logo.png” thumb_width=”150″ /]GP2U also provides a prescription service that sends prescriptions directly from the GP office to pharmacy once the GP approves it. GP2U has agreements with three Australian pharmacy chains, Terry White Chemist, Chempro and Priceline.

HCF is a not-for-profit organisation founded 80 years ago and provides health cover for 1.5 million Australians and has a turnover in excess of AUD 2 billion. GP2U is very fortunate that such a large fund has taken a serious interest in it

Dubai starts telemedicine pilot

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/01/rp-vita-1-e1453251179139.png” thumb_width=”150″ /]I am somewhat baffled by the news this week of a telemedicine trial in Dubai. One of the seven emirates making up UAE, Dubai has an area of less than 1,600 square miles, which amounts to a square of about 40 miles – so not exactly far to travel from any place to any place else if you are in Dubai. Not the obvious place to benefit greatly from telemedicine. The press release two days ago said that the pilot will “significantly enhance the manner in which healthcare is delivered in the emirate”.

According to the release the project will use “robots” from In Touch Health (referred to as “RoboDoc” in the release). These are self-propelled six-foot tall units (similar to the one shown, I expect, which is from the In Touch Health website) with video conferencing capability so that staff in one hospital can consult experts in one or more other hospitals in real time at the patient’s bedside.

The full press release is available here.