TTA’s week: PHI risky business, VA’s Cerner award challenged, Microsoft closes digital divide, more

Can population health and data sharing put PHI at risk? Microsoft uses TV to close the digital divide in rural health. VA’s EHR award challenged. Philips indexes Future Health. Tenders and Scottish Challenges. Apple gets sensored for health. And who put the bark in telemedicine?

Last chance to book Connected Health Summit 2017 in San Diego–save 20%. See below.

User consent, security questioned in Higi and Interpreta’s data mix partnership (Risky business with your PHI)
VA EHR award to Cerner contested by CliniComp (They’ve done it before–and won)
Tender Alert: Tameside and Nottingham (East Midlands) (Preliminary info)
Can unused “TV white spaces” close the rural and urban broadband–and telehealth–gap? (The digital divide bridged by Microsoft)
Telemedicine for all creatures great and small? Veterinarians debate. (Consent not same as with humans)
More creepy monitoring: USAA collecting health information from patient portals (But with consent–for now)
Apple’s patent on camera plus sensors for health measurements (Another Apple feint?)
Philips publishes second annual Future Health Index on access, integration and tech adoption (You will need a pot of coffee and several breaks to digest this)
Tender Alert: Scotland CAN DO Challenge, Bootle needs assistive tech (Scotland’s 8 part challenge–and we will skip the Bootle jokes)

Will the doctor’s office go the way of the retail store, even in NJ (the home of the mall)? Can we improve population health through telephone call centers? Will the UK get its mojo back in digital health innovation? Blockchain fund startups? Can the VA implement Cerner by 2019? And will ATA appoint a new CEO before then?

Beyond crowdfunding–startup funding through blockchain cryptocurrency, smart contracts (The Next Big Funding Thing?)
Commonwealth Fund case study on Spanish-speaking telemedicine services (MX, PH, US) (Population health south–and north–of the border)
Tender Alert: Torbay and South Devon NHS Foundation Trust for TECS (Looking for innovative telehealth)
VA’s Shulkin: Cerner rollout start by mid-2019? (The decision was a relief)
Innovate UK’s £35m Digital Health Technology Catalyst competition opens–apply now! (Another opportunity in UK healthcare)
Weekend Big Read: will telemedicine do to retail healthcare what Amazon did to retail? (Except there’s regulation…)
Tender Alerts: NHS Wales, Southend-on-Sea (More for innovative companies in UK)
Analyses of New Jersey’s new telemedicine regulations (Not quite parity, but a forward leap)
Some reflections on ATA and a future CEO–your ‘nominations’ wanted! (Name that CEO!)

Winners and losers…VA implements more telehealth, Israel gets its first aging services venture fund. Charterhouse loses equity in Tunstall, ATA’s Linkous leaves, Siemens delays the Healthineers and Theranos plays for time.

VA unveils several ‘anywhere’ new telehealth services for veterans (VA tech moves fast under Dr. Shulkin)
First aging services tech investment fund debuts in Israel (3rd Age tech)
Change at the top at ATA: CEO Jon Linkous departs after 24 years (Didn’t give notice either)
Charterhouse lost half its equity in Tunstall debt refinancing–Sunday Times report (updated) (Not unexpected)
Siemens plans IPO of Healthineers during 2018, possibly in US: reports (Expectations delayed)
The Theranos Story, ch. 44: Walgreens settles lawsuit, cash box empties further (The spiral to Flat Brokedom continues)


Connected Health Summit: Engaging Consumers analyzes the roles of connected health technologies and innovations in driving changes in consumer behaviors and business models. Now in its fourth year in beautiful San Diego, this event is focused on data-driven, human-centric patient experience and engagement. Keynoters include executives from Aetna, UnitedHealth, ShareCare and Geisinger. Readers save 20 percent! For more information, click on the advert or here.


It’s an IoT Black Hat hackfest, Facebook bots learn argot, AI is debated after a fashion by ‘giants’, and Tunstall gets a partner that opens doors.

It’s all hackable by Black Hats: pacemakers, Amazon Echo, trains, heart monitors, prison cells! (Increasingly easy pickings)
AI good, AI bad (part 2): the Facebook bot dialect scare (Not all that…)
AI good, AI bad. Perhaps a little of both? (Top six effects) 
Tunstall pairing with Inhealthcare digital health for NHS remote monitoring (A shot of digital high-octane for the Big T?)

Recent articles of continued interest….

CTE found in 99% of former, deceased NFL players’ brains: JAMA study (News in both health and sports sections)
Shouldn’t we be concentrating on digital therapeutics rather than ‘health apps’? (A different look at the future of digital health)
The King’s Fund 2017 Digital Health Congress: videos, presentations now posted (Catch up!)
Fitbit’s smartwatch on track; Intel exits the game (Were they ever in?)
Can Google Glass’ enterprise iteration solve the patient documentation crisis? (Hands off help for hands-on workers)
Toyota’s $14 million bet on Intuition Robotics’ social companion robot (JP/IL/US) (ElliQ’s growing up)
TSA appoints new chair (Paul Shead takes the helm)

Creepy data mining on medical conditions run wild: where’s the privacy? (Ethically dubious practices)
“Crazy”: StartUp Health’s 2nd Q digital health funding breaks record (Another round of champs and roses! Can it last?)

‘Record-shattering’ Q2 for digital health deals: Rock Health’s volte-face (Suddenly it’s wine and roses!)
The Nightingale-H2020 project for wireless acute care (UK/EU) (Major initiative, get on it before tender)


Have a job to fill? Seeking a position? Free listings available to match our Readers with the right opportunities. Email Editor Donna.


Read Telehealth and Telecare Aware: http://telecareaware.com/  @telecareaware

Follow our pages on LinkedIn and on Facebook

We thank our present and past advertisers and supporters: Tynetec, Eldercare, UK Telehealthcare, NYeC, PCHAlliance, ATA, The King’s Fund, HIMSS, MedStartr, HealthIMPACT, and Parks Associates.

Reach international leaders in health tech by advertising your company or event/conference in TTA–contact Donna for more information on how we help and who we reach. See our advert information here. 


Telehealth & Telecare Aware: covering the news on latest developments in telecare, telehealth, telemedicine and health tech, worldwide–thoughtfully and from the view of fellow professionals

Subscribe here to receive this Alert as an email on Wednesdays with occasional Weekend Updates. It’s free–and we don’t lend out or sell our list–no spam here!

Donna Cusano, Editor In Chief, donna.cusano@telecareaware.com, @deetelecare

– – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – –

User consent, security questioned in Higi and Interpreta’s data mix partnership

click to enlargeHigi (also higi), which has placed health monitoring kiosks in over 11,000 US retail locations and a 5.5 million signup base, and data cruncher Interpreta announced that they are partnering to blend Higi’s vital signs data with Interpreta’s claims, clinical and genomics data analytics. Based on Mobihealthnews’ article and the joint release, an individual’s health information taken at higi retail stations will be “prioritized within Interpreta in real time”. They also claim that for the first time, insurance payers and providers will be able to leverage biometrics data, clinical, claims and additional genomic information a person may obtain from genetic testing services into a ‘personalized care roadmap’ that closes gaps in care. This is positioned as a big advance in population health and it all sounds great.

Perhaps not so great are the details. What about consent and data security? Aside from absolutely no mention of patient consent and HIPAA compliance in the above news, this Editor suspects that past, current and future Higi users may not be made aware that their vital signs data recorded with Higi will be 1) sent into a non-Higi database and 2) integrated with other information that appears in Interpreta’s database. How is this being done? Is consent obtained? What then happens? Is it used on an identified or de-identified basis? Where is it going? Who is doing what with it? Can it be sold, as 23andme’s genomic information is (with consent, but still…)? “Interpreta works in the realm of precision medicine, continuously interpreting and synchronizing clinical and genomics data in real time to create a personalized roadmap to enable the orchestration of timely care.” but they do this for providers and health plans who are then responsible for privacy and data integrity. Consent for Higi to keep a record of your blood pressure when you drop into your local RiteAid or ShopRite is not consent for Interpreta to use or manipulate it. These questions should have been addressed in the release or an accompanying fact sheet.

And one last and exceedingly ‘gimlety’ observation by this Editor: kiosks get hacked, and here we have not a price to a McDonald’s meal but a portal to deep PHI. Here’s a two-part article in an industry publication, Kiosk Marketplace, if you are skeptical. Part 1, Part 2 

VA EHR award to Cerner contested by CliniComp (updated)

See update below. CliniComp International, a current EHR vendor to some Department of Veterans Affairs locations and to the Department of Defense for clinical documentation since 2009, has filed a bid protest in the US Court of Federal Claims on Friday 18 Aug, saying that VA improperly awarded a contract to Cerner in June [TTA 7 June] without a competitive bidding process.

At the time, VA Secretary David Shulkin moved the award via a “Determination and Findings” (D&F) which provides for a public health exception to the bidding process. Without this, competitive bidding could take six to eight months, as Dr. Shulkin stated to a Congressional committee after the award–or two years, as DoD’s did–and would have further slowed down the already slow adoption process. Even if all goes well, the transition from VistA to Cerner will not begin at earliest until mid-2019 [TTA 14 Aug]. The Cerner MHS Genesis choice was also logical, given the Federal demand for interoperability with DoD.

CliniComp objected to all that, saying in the protest that VA had enough time for an open bidding procedure, that the failure to do so was “predicated on a lack of advance planning,” and that awarding it to Cerner without it was “unreasonable”. “As shown by the nine counts set forth below, the VA’s decision to award a sole-source contract to Cerner is arbitrary, capricious, an abuse of discretion and violates the CICA and Federal Acquisition Regulations,” according to the suit.

According to Healthcare IT News, “CliniComp said it filed an agency-level protest to contest the sole source award shortly after the announcement, according to the complaint. But the VA Deputy Assistant Secretary for Acquisition denied the protest on Aug. 7. In doing so, the VA violated the Competition in Contracting Act of 1978, the company claims.”

This is not CliniComp’s first bid protest. Before one dismisses the bid protest as sour grapes picked by a minor vendor, this Editor discovered via Law360 that CliniComp was successful in a VA bid protest in August 2014. In this case, VA had a $4.5 million contract for computer systems at several intensive care units for saving patient waveform biometrics. The VA’s award to Picis in October 2013 was overturned because the Court of Federal Claims found that in clarifying the CliniComp bid, VA never had official discussions with CliniComp, only informal requests for clarifications. The court found that the two bids were not evaluated the same way–and that likely both were acceptable, with CliniComp’s bid preferable because it was lower.  

Update. Arthur Allen in POLITICO Morning e-Health also did his homework and found the same Law360 article on CliniComp’s 2014 bid protest win, adding the following:

  • DoD and VA officials have complained that CliniComp’s software is not compatible with legacy systems. However, some IT experts have noted that neither DoD nor VA can provide platforms which can be interoperable with Cerner. (Circular firing squad?)
  • Oral arguments are set for 2 October, if necessary, after motions are filed next month. Cerner joined in the defense against the protest as of Monday. 

Will the brakes be put on Cerner’s work while the protest wends its weary way through the Federal Claims Court? The bid protest is high-profile embarrassing for VA, though the D&F is completely legal. Stay tuned. Also Modern Healthcare

Tender Alert: Tameside and Nottingham (East Midlands)

Susanne Woodman, our Eye on Tenders, has another ‘August special’. This is by New Charter for their alarm monitoring service in Tameside and Nottingham. This is for all sheltered housing customers and a significant number of community alarm (Lifeline) customers in Nottingham. Current subscribers are in over 1,500 properties. At this point, New Charter is requesting a preliminary market consultation to replace the current service with one contract for a single service provider to go live in June 2018. More information is on Gov.UK with contacts and an attached brief.

Can unused “TV white spaces” close the rural and urban broadband–and telehealth–gap?

click to enlargeThe digital divide comes one step closer to closing. Microsoft’s release of its white paper proposing an alternative to the expensive build-out of the US broadband network deserved more attention than it received in July. The Rural Broadband Strategy combines TV white spaces spectrum (the unused UHV television band spectrum in the 600 MHz frequency range which can penetrate through walls, hilly topography, and other obstacles) with fixed wireless and satellite coverage to economically deliver coverage to un/under-served areas versus fiber cable (80 percent savings) and LTE fixed wireless (50 percent).

34 million Americans lack broadband connection to the internet. Some of these are voluntary opt-outs, but 23.4 million live in rural areas without access, with huge economic consequences estimated in the hundreds of billions. TV white spaces can also expand coverage in small cities and more densely populated areas, including usages such as within buildings. This effort also presses the FCC, which in turn has pressed for broadband for two decades, to ensure that at least three channels below 700 MHz are kept unlicensed in all markets in the US, with more TV white spaces for rural areas.

The first part, the Rural Airband Initiative, builds on Microsoft’s present 20 programs worldwide, and is planned to connect 2 million people in by July 4, 2022, with 12 projects across the US running in the next 12 months. Much of the connectivity is dedicated to nonprofit efforts like 4-H’s digital literacy program and ‘precision agriculture’ in New York State and Washington. Microsoft is also granting royalty-free access to 39 patents and sample source code related to white spaces spectrum use in rural areas.

A positive move for telehealth’s spread. Rural healthcare providers pay up to three times as much for broadband as their urban counterparts. Telemedicine increasingly connects for consults between hospitals in rural areas and city-based health systems for specialty coverage and to provide assistance in specialized medical procedures. Telemedicine and telehealth remote monitoring has difficulty spreading with poor internet coverage; this has already been a barrier to patients in rural ACOs who can be 1-2 hours from the doctor’s office and notably for the VA in providing rural veterans with home telehealth support. Paramedics increasingly rely on internet connections and dropped connections lead ambulances to go to hospitals at a greater distance. If the FCC cooperates and Microsoft’s partners can find a way to profitably execute, broadband can finally achieve that promise about closing the ‘digital divide’ made back in the Clinton Administration. A Rural Broadband Strategy: Connecting Rural America to New Opportunities  The Verge, mHealth Intelligence, Becker’s Hospital Review

Telemedicine for all creatures great and small? Veterinarians debate.

Will veterinarians be covered by ongoing telemedicine legislation? This surprisingly became an issue with the New Jersey telemedicine bill [TTA 11 Aug] S.291 prior to signature by Governor Christie. The debate was whether “health care providers” covered under the licensing statutes in Title 45 of NJ’s Revised Statutes also included veterinarians in the “including but not limited to” language as well as the nature of the “proper provider-patient relationship” and “patient request”. Reportedly the Governor held his signature in order to sort this out, meeting with healthcare and veterinary representatives. The final bill does not appear to specifically address veterinary practice.

For its part, the American Veterinary Medical Association (AVMA) Practice Advisory Panel (AP) came out solidly in favor of non-inclusion in human laws like New Jersey’s in their January report. Their view of the patient-physician relationship is logically different because the animal patient cannot give consent, but an owner/client can, and that difference is not specified in human medicine laws. In the AP’s view, “telemedicine shall only be conducted within an existing VCPR [veterinarian client patient relationship], with the exception for advice given in an emergency care situation until that patient(s) can be seen by or transported to a veterinarian” which is increasingly not true of human telemedicine. Law firm Fox Rothschild’s animal law practice blog cited instances such as when a Texas veterinarian was found to have violated the state practice act by offering advice over the internet. 

Many veterinarians are calling for AVMA to seek guidance from organizations like the ATA to better codify animal telemedicine practice. ATA, for its part, has stayed apart from state debates while remaining generally supportive. The gap in veterinary practice is especially acute with a declining number of practitioners caring for food animals (livestock) and in rural veterinary practice. But who will care for the unicorns? Seriously, here is a gap that needs to be filled. mHealth Intelligence

More creepy monitoring: USAA collecting health information from patient portals

Veteran health reporter Anne Zieger has uncovered another instance of data mining that could be a benefit–or not. USAA, a financial services company for military and veteran families, has started to collect health data via electronic records from life insurance applicants at the Department of Veterans Affairs and Department of Defense. They have streamlined the health records process in the application by developing with Cerner a feature called HealtheHistory that retrieves the data via the patient portal from the applicant’s EHR after consent. It cuts application time by 30 days, but the implications raise some alarms. In Ms. Zieger’s view, we should consider this carefully before huzzahing this type of data sharing:

  • Is an insurer going to care much about HIPAA compliance on PHI? In her view, not likely.
  • Is it a good idea to give an insurer full access to health data? There is the case of an otherwise healthy woman who tested positive for the BRCA 1 gene which indicates that the carrier has an increased risk of breast and ovarian cancer, who was turned down for insurance by USAA. To not disclose would be fraud, but the nuance is risk, not the condition.
  • Will the information be shared within USAA for judgment on other financial instruments, such as mortgages–regardless of legality?

EMR and EHR  Our previous look at data gathering on medical conditions run amok is here 

Apple’s patent on camera plus sensors for health measurements

9 to 5 Mac, the tip sheet for all things Apple, tracked down a patent granted to Apple (via Patently Apple) for computing health measurements using the iPhone. According to Apple in the patent, “electrical measurements may be used to measure heart function, compute an electrocardiogram, compute a galvanic skin response that may be indicative of emotional state and/or other physiological condition, and/or compute other health data such as body fat, or blood pressure.” It would use the front-facing camera, light sensor and proximity sensor to emit light that would be reflected back to the sensors. Additional sensors mounted in the same area would also generate additional health measurements such as body fat and EKG, which is already measured by the Kardia Mobile/Alivecor attachment. The camera and light sensor alone, based on the patent and the article, would measure oxygen saturation, pulse rate, perfusion index and a photoplethysmogram (which can monitor breathing rate and detect circulatory conditions like hypovolemia). Another demonstration of Apple’s keen interest in the health field, but what features will show up on real phones and apps–and when? 

Philips publishes second annual Future Health Index on access, integration and tech adoption

The Future Health Index–a blockbuster 100-page annual study from Philips with research conducted by IPSOS, Schlesinger, and Braun–reflects findings of over 29,000 consumers and 3,300 healthcare professionals in 19 countries. The survey includes analysis by country and aggregate of perception versus reality (both difficult measures) in access to healthcare, integration between healthcare systems, and adoption of healthcare technology. It is, needless to say, complex and hard to parse into a headline and finding or two or four. The UK press release helpfully discusses particulars of the UK findings which are hard to find in the main report. Overall, it’s positive, but nowhere near a tipping point where connected care is expected and routine.  

  • About half (48%) of (UK) HCPs have seen an increase in the use of connected care technologies by primary care doctors in last 12 months
  • About a third of the (UK) general population (31%) have used connected care technologies to monitor a health indicator in the last 12 months
  • Over half of the (UK) general population (57%) who have used connected care technology to track health indicators have shared their data with an HCP in the last 12 months
  • Six-in-ten (62%) of the (UK) general population think that integration of the health system would make the quality of healthcare better

The appendix with the UK summary results is available online here and the US here. The full study is available for download here. (All countries are in the appendix)

Out of the global results, there’s a disconnect between having the data and making it useful: “Only 23% of the general population surveyed who used connected care technology within the last 12 months claim to completely understand when to share data from connected care technology with a healthcare professional, or the easiest way to do so.” 

A not surprising finding was that quick wins would be found in the home care area and in preventing avoidable readmissions:

  • Connected care was important to healthcare professionals in improving home care and for geriatric care–81 percent and 82 percent respectively  
  • 55 percent of professionals chose home care and related aspects in improving long-term management and tracking of medical issues

Looking forward into the future, the general population group was asked to speculate on artificial intelligence and on what AI technology would have the most impact on improving healthcare if available today. The two leaders were health tracking wearables/apps on smartphones and AI-assisted tools for guidance. Hologram doctors and robots cruised around 10 percent (!)

click to enlarge

Editor’s note: While incredibly comprehensive, this Editor will express a certain disappointment in the researchers’ selection of US and UK experts. This Editor could name five to ten experts and patient advocates in US and UK from personal contacts (including our UK-based Editors) without thinking particularly hard–and with a little homework UAE and Africa–who could have informed their study.

This Editor also had the pleasure to meet two of Philips’ connected health executives at this month’s Health 2.0 NYC/MedStartr meeting on population health and value-based care: Nick Padula, VP of Home Healthcare Monitoring, and Eduardo Da Silva, Strategic Sales Director of Philips Wellcentive. Mr. Padula was a panelist for the evening.

Tender Alert: Scotland CAN DO Challenge, Bootle needs assistive tech

This Editor thought it would be quiet for the rest of the month, but our Eye on Tenders, Susanne Woodman, has alerted us to two freshly posted–and the first is major:

  • Scotland: The tender for the CAN DO Innovation Challenge Fund – Health & Social Care Challenges is so large it is in 10 lots which offer an initial market test, an evaluation by the fund, then a decision made on whether to pursue the potential project further with the public body. There are eight that directly involve healthcare technology:
    • Point of care lab testing
    • Adopting technology for care in the north of Scotland
    • Transforming nursing care processes for the 21st century
    • Creating and driving a clinically and cost effective pathway to improve recovery after critical illness enabled by data from hospital information systems
    • An IT system for care workers and patients for adherence to stroke management plans to enable real time monitoring
    • Transforming management of people with severe COPD to improve patient outcomes and quality of life and reduce healthcare costs
    • Glasgow TECS development to support care and digital cutover
    • Develop and integrate digital services that allow for consent-driven data sharing from patient records

There is no deadline listed. More information and required document links here on Public Contracts Scotland

  • Bootle (Merseyside) and Sovini Ltd are seeking assistive technology for about 1,000 residents of its local One Vision Housing with retirement and dispersed housing. Estimated value £180,000 over 24 months. Deadline is 18 Sept at noon. More information at Delta e-Sourcing and Tenders Electronic Daily.

TTA’s week: pop health en español, ATA’s choice, VA’s Cerner, de-retailing healthcare, more

Will the doctor’s office go the way of the retail store, even in NJ? Can we improve population health through telephone call centers? Will the UK get its mojo back in digital health innovation? Can the VA implement Cerner by 2019? And will ATA appoint a new CEO before then?

Only two weeks to go to Connected Health Summit 2017 in San Diego–save 20%. See below.

Beyond crowdfunding–startup funding through blockchain cryptocurrency, smart contracts (The Next Big Funding Thing?)
Commonwealth Fund case study on Spanish-speaking telemedicine services (MX, PH, US) (Population health south–and north–of the border)
Tender Alert: Torbay and South Devon NHS Foundation Trust for TECS (Looking for innovative telehealth)
VA’s Shulkin: Cerner rollout start by mid-2019? (The decision was a relief)
Innovate UK’s £35m Digital Health Technology Catalyst competition opens–apply now! (Another opportunity in UK healthcare)
Weekend Big Read: will telemedicine do to retail healthcare what Amazon did to retail? (Except there’s regulation…)
Tender Alerts: NHS Wales, Southend-on-Sea (More for innovative companies in UK)
Analyses of New Jersey’s new telemedicine regulations (Not quite parity, but a forward leap)
Some reflections on ATA and a future CEO–your ‘nominations’ wanted! (Name that CEO!)

Winners and losers…VA implements more telehealth, Israel gets its first aging services venture fund. Charterhouse loses equity in Tunstall, ATA’s Linkous leaves, Siemens delays the Healthineers and Theranos plays for time.

VA unveils several ‘anywhere’ new telehealth services for veterans (VA tech moves fast under Dr. Shulkin)
First aging services tech investment fund debuts in Israel (3rd Age tech)
Change at the top at ATA: CEO Jon Linkous departs after 24 years (Didn’t give notice either)
Charterhouse lost half its equity in Tunstall debt refinancing–Sunday Times report (updated) (Not unexpected)
Siemens plans IPO of Healthineers during 2018, possibly in US: reports (Expectations delayed)
The Theranos Story, ch. 44: Walgreens settles lawsuit, cash box empties further (The spiral to Flat Brokedom continues)

It’s an IoT Black Hat hackfest, Facebook bots learn argot, AI is debated after a fashion by ‘giants’, and Tunstall gets a partner that opens doors.

It’s all hackable by Black Hats: pacemakers, Amazon Echo, trains, heart monitors, prison cells! (Increasingly easy pickings)
AI good, AI bad (part 2): the Facebook bot dialect scare (Not all that…)
AI good, AI bad. Perhaps a little of both? (Top six effects) 
Tunstall pairing with Inhealthcare digital health for NHS remote monitoring (A shot of digital high-octane for the Big T?)


Connected Health Summit: Engaging Consumers analyzes the roles of connected health technologies and innovations in driving changes in consumer behaviors and business models. Now in its fourth year in beautiful San Diego, this event is focused on data-driven, human-centric patient experience and engagement. Keynoters include executives from Aetna, UnitedHealth, ShareCare and Geisinger. Readers save 20 percent! For more information, click on the advert or here.


Confirming football CTE, thinking ‘digital therapeutics’. Glass reboots, Fitbit and social robotics back up, TSA changes guard. Mindful (or mind your?) drinking, and catch up with The King’s Fund.

CTE found in 99% of former, deceased NFL players’ brains: JAMA study (News in both health and sports sections)
Shouldn’t we be concentrating on digital therapeutics rather than ‘health apps’? (A different look at the future of digital health)
The King’s Fund 2017 Digital Health Congress: videos, presentations now posted (Catch up!)
Fitbit’s smartwatch on track; Intel exits the game (Were they ever in?)
Can Google Glass’ enterprise iteration solve the patient documentation crisis? (Hands off help for hands-on workers)
Toyota’s $14 million bet on Intuition Robotics’ social companion robot (JP/IL/US) (ElliQ’s growing up)
Come along to London’s first mindful drinking festival! (Hic!)
TSA appoints new chair (Paul Shead takes the helm)

Recent articles of continued interest….

Creepy data mining on medical conditions run wild: where’s the privacy? (Ethically dubious practices)
UDG Healthcare buys American, adds Vynamic, Cambridge BioMarketing for up to $67 million (Acquisition trend for healthcare consultancies and marketing)
“Crazy”: StartUp Health’s 2nd Q digital health funding breaks record (Another round of champs and roses! Can it last?)

‘Record-shattering’ Q2 for digital health deals: Rock Health’s volte-face (Suddenly it’s wine and roses!)
Conference & Tender Alert: Perth & Kinross TEC event, Flintshire (Wales) tender (UK) (TEC event Sept 26, tender Aug 4)
‘Let me die at home’. The human and financial cost of ending telehealth (Cornwall UK) (A familiar, no less wrenching story to those who’ve worked in telehealth–the books don’t balance)

The Nightingale-H2020 project for wireless acute care (UK/EU) (Major initiative, get on it before tender)


Have a job to fill? Seeking a position? Free listings available to match our Readers with the right opportunities. Email Editor Donna.


Read Telehealth and Telecare Aware: http://telecareaware.com/  @telecareaware

Follow our pages on LinkedIn and on Facebook

We thank our present and past advertisers and supporters: Tynetec, Eldercare, UK Telehealthcare, NYeC, PCHAlliance, ATA, The King’s Fund, HIMSS, MedStartr, HealthIMPACT, and Parks Associates.

Reach international leaders in health tech by advertising your company or event/conference in TTA–contact Donna for more information on how we help and who we reach. See our advert information here. 


Telehealth & Telecare Aware: covering the news on latest developments in telecare, telehealth, telemedicine and health tech, worldwide–thoughtfully and from the view of fellow professionals

Subscribe here to receive this Alert as an email on Wednesdays with occasional Weekend Updates. It’s free–and we don’t lend out or sell our list–no spam here!

Donna Cusano, Editor In Chief, donna.cusano@telecareaware.com, @deetelecare

– – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – –

Beyond crowdfunding–startup funding through blockchain cryptocurrency, smart contracts

Bitcoin + Smart Contracts or Bust! A surprise to this Editor was that Bitcoin (on 14 Aug an eye-blinking $4,400) has a host of ‘currency token’ competitors–Ethereum‘s Ether ($286), DCorp‘s DRP, and others in the wings waiting for their initial coin offerings (ICOs). These cryptocurrencies, while still hard to use (don’t try to shop for groceries with them), are demonstrating credible, real-world value despite shady uses in hacking.

The tech behind currency tokens, blockchain, with its distributed data ledger also offers another more intriguing development beyond what this Editor has noted in healthcare [TTA 16 July 165 Apr]–smart contracts. These are built on blockchain that stores, verifies, and executes the terms of an agreement without a middleman. This is proving to be high value–Royal Bank of Scotland is building a distributed clearing house to speed cross-border payments based on Ethereum’s distributed ledger and smart contracts tech. 

The combination of cryptocurrencies and smart contracts could create the next unregulated startup funding vector, according to this article in Forbes. It would more closely resemble an IPO, but using currency tokens. Smart contracts can also assure startup investors that entrepreneurs will be accountable and that investment and loan agreements will be enforced. The nearly unregulated world of crowdfunding has been surprisingly lucrative, with $34 billion invested in 2015. However, startups going this route had a high failure rate, nearly 40 percent, and crowdfunding is now more frequently used to test concepts and cause fundraising. We’ll see if blockchain-enabled funding becomes the Next Big (Funding) Thing. Hat tip to fellow NY Financial Writers Association member Katherine Heires of Mediakat.

Commonwealth Fund case study on Spanish-speaking telemedicine services (MX, PH, US)

Recently released by the New York-based Commonwealth Fund health policy foundation is a case study of a new model for extending medical care in Mexico and with a variant in the US for the Spanish-speaking population. In Mexico, MedicallHome (not a typo) connects subscribers by phone and mobile app to a 24/7 national network of physicians and discounted health resources such as clinics, labs, pharmacies, in-person medical services, and hospitals. The 60-person Healthcare Contact Center, staffed by primary care doctors, psychologists, and nutritionists,  triage emergencies (press 1) to medical advice (press 2) to referrals (press 3). They also arrange in-person visits and emergency services.

MedicallHome’s model is targeted to low and middle-income Mexicans. It is primarily a direct-to-consumer offering, with subscriptions from $2 to $5/month, including travel health (60 cents for a bus trip) and low-cost insurance for students, but they also partner with private insurance, companies, and employers.  With an average of 500,000 calls per year, MedicallHome staff resolve 62 percent of cases by phone and refer the remaining cases for in-person treatment. Prescribing medications without an in-person consult is illegal in Mexico.  

The profitable MedicallHome complements the free (but overwhelmed and with long waits) national health service Seguro Popular. It also benefits from the oversupply of primary care physicians who work at multiple hospitals, clinics and private practices, and find the shift work in a call center convenient. Their parent, Salud Interactiva, built the infrastructure, IT, EHR, and worked with Telmex, the largest phone company in Mexico. They have also extended it to the Philippines as of July 2015 as Konsulta MD, a joint venture between Salud Interactiva and Globe Telecom, the Philippines’ primary telecommunications provider. 

Salud’s joint venture in the US, ConsejoSano (healthy advice) is also profiled in the case study. Since ConsejoSano connects to the Mexico-based call center and not to US doctors, (more…)

Tender Alert: Torbay and South Devon NHS Foundation Trust for TECS

One more from our Eye on Tenders, Susanne Woodman, is from NHS South West which is reviewing their currently in-house delivery of TECS, including monitoring, in Torbay. The Torbay and South Devon NHS Foundation Trust is seeking a fresh look at innovative services from providers who are interested and able to provide the full service from equipment, installation and monitoring, as well as bench-marking information. To review their current services and equipment (Tunstall), they helpfully provided this linkThis was posted today (15 Aug) and closes 1 September, so there’s only a short window. Refer to the Gov.UK Contracts Finder page for contact information and (importantly) document attachments.

VA’s Shulkin: Cerner rollout start by mid-2019?

An interesting short (free) article on POLITICO Morning eHealth today was an interview with VA Secretary David Shulkin, MD on the Cerner transition, stating that if all went well with negotiations later this year, VA clinicians could be using the Cerner system by mid-2019. “There’s a lot of understandable concern about whether the Cerner EHR will have the same functionality as VistA, which has evolved to the physician’s needs over the past 35 years.” One of the problems with VistA was that it wasn’t one system, it was 130 systems, which is echoed in many EHRs. POLITICO goes on to quote Dr. Shulkin: “I don’t hear as many concerns about that as I do relief about finally making a decision because people felt this was the slow death of a system that they have poured their hearts and souls into. Knowing we’re committed to doing a transition as well as we can is reassuring to people.” Sadly, the rest of the interview is paywalled on POLITICO PRO. Earlier analysis: VA says goodbye to VistA, hello to Cerner. We wonder what the involvement and engagement of the four Home Telehealth winners of the 5-year contract will be.

Innovate UK’s £35m Digital Health Technology Catalyst competition opens–apply now!

click to enlargeA new Innovate UK challenge has opened for digital health technology developers. They are seeking subject matter experts (SME) to lead a group in designing digital health innovations which achieve at least one of these objectives: improving patient outcomes, transforming healthcare delivery, and enabling more efficient delivery of healthcare. Total funding is £35m. It appears that each winner will be granted up to £8m as follows: feasibility–£50,000 to £75,000; industrial research and experimental development–£500,000 to £1 million.

This follows on our previously reported £12m Biomedical Catalyst program [TTA 5 Apr]. Innovate UK’s digital health program is being funded by the Industrial Strategy Challenge Fund which is also backing battery power and robotics challenge programs.

Detailed information and application information may be found here. Applications close Wednesday 11 October 2017 at noon. Hat tip to Tynetec via Twitter. (Illustration from Innovate UK and innovation leader Chris Sawyer’s blog.)