Tunstall Goes Hawaiian with Kupuna Monitoring acquisition

June 11, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /] Tunstall Americas is acquiring Kupuna Monitoring Systems of Aiea (northwest of Honolulu), Hawaii, a medical alarm and medication manager provider. In the press release, CEO Casey Pittock confirmed that Tunstall Americas’ strategy is to acquire regional monitoring services, as we noted in their Mountain Home (Denver) purchase last year. Locally owned (kama’aina) and serving the four major islands, Kupuna (‘elder’) is currently using Philips Lifeline monitors and Philips med dispensers. We hope they are welcomed with warmest aloha. (Hawaii as a market and culture is like no other in the US, and in this Editor’s experience in a totally different industry, can be fiercely local.)

What’s news at the end of the week

June 11, 2015 | by

Care Innovations harmonizes seniors, Panasonic adds diabetes, Jawbone and Fitbit bite, the first EHR/PHR Hack and Concussion in Cleveland. Converging its interests in remote patient monitoring with its long-time footprint in senior housing resident monitoring (QuietCare), Intel-GE Care Innovations is testing its Health Harmony remote patient monitoring system, partnering with two California-located Front Porch communities and the Front Porch Center for Innovation and Wellbeing. The residents selected have poor chronic condition management or have returned after a discharge from a skilled nursing facility. No disclosure on projected number or duration–and it doesn’t appear that QuietCare is part of the monitoring. Release….Panasonic just bought Bayer Healthcare’s diabetes/blood glucose monitoring device unit for $1.13 billion as Bayer continues to shed non-life science businesses. While old-school prick-and-bleed monitors are being eclipsed by continuous glucose monitors (CGMs) and mobile-based devices such as Telcare in the US and in Europe, there’s plenty of market remaining in the West, and new ones in Asia and the Middle East for simple devices. It joins Panasonic’s existing blood pressure monitors. MedCityNews….Jawbone and Fitbit continue to snap at each other in court, with the former on Wednesday filing a second lawsuit on patent infringement, specifically “a wellness application using data from a data-capable band”, with the added fillip of going to the International Trade Commission, which could ban the import of Fitbit products or component parts. The 28 May lawsuit was about Fitbit’s hiring of five former Jawbone employees who allegedly stole IP. The companies between them have hundreds of patents, and as this Editor has noted in previous IP and patent troll articles, the US Patent and Trademark Office (USPTO) is not especially rigorous in ensuring that patents are not overbroad. Wonderful for the IP attorneys, but not exactly what Fitbit wants as a runup to their expected IPO next week. Wall Street Journal….Now an EHR and PHR join Hackermania Running Wild. Medical Informatics Engineering reported Tuesday that in May their server was cyberattacked, exposing PHI of patients in five clients and separately information contained in the NoMoreClipboard PHR subsidiary. POLITICO reports that this is the first recorded instance of an EHR compromise. MIE Release, POLITICO Morning eHealth….If you are in the Cleveland, Ohio area and have an interest, Concussion: A National Challenge is a free, two-day event on detection and diagnosis sponsored by the National Academy of Engineering, the Institute of Medicine, Case Western Reserve University, Metro Health and Taipei Medical University. Advance registration required.

Health Datapalooza 2015: more data, better health

June 10, 2015 | by

Guest columnist and data analytics whiz Sarianne Gruber (@subtleimpact) sat in on the Health Data Consortium’s 2015 edition of Health Datapalooza last week in Washington, DC. It was all about the data that Medicare has been diligently harvesting. Also see the US-UK connection on obesity.

Health Datapalooza 2015, now in its sixth year, welcomed more than 2,000 innovators, healthcare industry executives, policymakers, venture capitalists, startups, developers, researchers, providers, consumers and patient advocates. Health Datapalooza brings together stakeholders to discuss how best to work the advance health and healthcare,” said Susan Dentzer, senior policy adviser to the Robert Wood Johnson Foundation and a member of the Health Data Consortium. The Consortium promotes health data best practices and information sharing; and works with businesses, entrepreneurs, and academia to help them understand how to use data to develop new products, services, apps and research insights. This year’s conference was held on May 31 through June 3 in Washington, DC. And how best to celebrate is with the gift of more data!

New Medicare Data Means More Transparency
The Centers of Medicare and Medicaid Services (CMS) released its third annual update to the Medicare hospital inpatient and outpatient charge data on June 1, 2013. (more…)

Medtronic favoring early-stage acquisitions, diabetes; American Well and Teva

June 4, 2015 | by

Medtronic plc, now firmly planted in the Auld Sod of Ireland, reported a tidy $7.304 bn in its 4th quarter global revenue closing 24 April versus a prior year of $7.257 bn, with a net loss of $1 million. Their report yesterday (2 June) was primarily centered around the integration of Covidien and the foreign currency loss. Results were especially strong in the US with an 8 percent gain in fourth quarter. Earlier speculation that the major Covidien acquisition in addition to Corventis, Zephyr Technologies (through Covidien) and telehealth provider Cardiocom would slow future investments seems to be the direction CEO Omar Ishrak is taking, based on his comments during the analyst call. The Covidien strategy of making early-stage company acquisitions is to his liking and with new revenues from Covidien (and a more favorable tax domicile) certainly there is not a lack of funds despite a small loss in fourth quarter revenues. Another change from being a cardiac-centric device company is apparent in the growth area of global diabetes, shifting from pumps to diabetes management. They have a minority investment in diabetes manager Glooko, a partnership with IBM Watson Health for diabetes management, and acquired a Dutch clinic and research center, Diabeter. Jonah Comstock at Mobihealthnews has more on that call.

In a surprising move, Israel’s Teva Pharmaceuticals is putting a reported ‘tens of millions of dollars’ into American Well and their telemedicine (virtual consult) platform. The pharma interest at once may be narrow in utilizing these consults in clinical trials, but as we have seen with Merck’s telemedicine clinics in Kenya, there’s also a focus on monitoring critical medication at long distances. Late last year American Well completed an $81 million Series C, but it is not clear whether Teva is a part of this and the news is just now catching up. MedCityNews, Globes (Israeli business website)

The leaky roof of healthcare data (in)security–DARPA to the rescue?

June 4, 2015 | by

This week’s priceless quote:

“A lot of the response was, ‘We live in a cornfield in the middle of Minnesota,’” he said. “’Who wants to hurt us? Who can even find us here?’”–Jim Nelms, Mayo Clinic’s first chief information security officer, 

We know where you are and what you do! The precarious state of healthcare data security at facilities and with insurers, plus increased external threats from hacking has been getting noticed by Congress–when you see it in POLITICO, you know finally it’s made it into the Rotunda. It was over the horizon late last summer with the FBI alert and legislators in high dudgeon over the Community Health Systems China hack [TTA 22 Aug 14]. It’s a roof that leaks, that costs a lot to fix, doesn’t have immediate benefit (cost avoidance never does) but when it does leak it’s disastrous.

This article rounds up much of what these pages have pointed out for several years, including the Ponemon Institute/IBM study from earlier this week, the Chinese/Russian connections behind Big Hacks not only for selling data, but also IP [TTA 26 Aug 14] and how decidedly easy it is to hack devices and equipment [TTA 10 May 14]. Acknowledgement that healthcare data security is about 20 years behind finance and defense deserves a ‘hooray!’, but when you realize that on average only 3 percent of HIT spend is on security when it should be a minimum of 10 percent (HIMSS) or higher…yet the choice may be better security or uncompensated patient care particularly in rural areas, what will it be for many healthcare organizations?

The article also doesn’t go far enough in the devil’s dilemma–that the Federal Government with Medicare, HITECH, meaningful use, rural telehealth and programs like Medicare Shared Savings demand more and more data tracking, sharing and response mechanisms, stretching HIT 15 ways from sundown. At the cutely named Health Datapalooza presently going on in Washington DC, data sharing is It for Quality Care, or else. Yet the costs to smaller healthcare providers to prevent that ER readmission scenario through new care models such as PCMHs and ACOs is stunning. And the consequences may be more consolidated, less available healthcare. We are already seeing merger rumors in the insurer area and scaledowns/shutdowns/buyouts of community health organizations including smaller hospitals and clinics. Also iHealthBeat.

DARPA to the rescue? The folks who brought you the Internet may develop a solution, but it won’t be tomorrow or even the day after. The Brandeis Program is a several stage project over 4.5 years to determine how “to enable information systems that would allow individuals, enterprises and U.S. government agencies to keep personal and/or proprietary information private.” It discards the current methodology of filtering data (de-identification) or trusting third-parties to secure. Armed With Science  FedBizOpps has the broad agency announcement in addition to vendor solicitation information.

Healthcare vulnerability in a concatenation of data breaches

June 2, 2015 | by

Concatenation is one of those lovely English words that express far more than its simpler synonyms: sequence, series or chain of events. Perhaps we have experienced that concatenation of data breaches which connect and demonstrate a critical mass that motivate healthcare organizations, including insurers, to ensure that data security and privacy gets primacy in HIT. Our Readers know we’ve been on the case since 2010; we’ve been noting Ponemon Institute and ID Experts studies since then.

While simple, straightforward theft can be the cause of smaller breaches and not part of a Big Hack, it’s not as Three Stooges or Benny Hill-esque as perhaps the JAMA study earlier this year made it out to be, especially if it’s your personal record, or your patient’s, which is breached, identity and financials damaged. (See this Security Intelligence article on a minor health breach and how it affected an individual who happens to be in IBM’s security arm.)

Just in the past few weeks, in the US we have experienced the following major and minor breaches:

  • CareFirst BlueCross BlueShield in Maryland–an insurer, not a hospital or practice–had a Big Hack of 1.1 million health records, with names, birth dates, email addresses and insurance identification numbers (but not SSI or credit card numbers) revealed.
  • Beacon Health Systems (Indiana) had a phishing attack into employee email boxes dating back to 2013. This was a Medium Hack that affected about 220,000 patients. Data taken included SSI and driver’s license. Health Data Management today.
  • Advantage Dental in Redmond, Washington had a 152,000 patient hack during three days in February.
  • Also in February, a New York City Health and Hospitals Corporation employee transferred patient files to her personal and new work email. 90,000 patients may have compromised data as a result. Becker’s

More breaches are listed today in iHealthBeat and the ever-growing list on Privacy Rights Clearinghouse.

Ponemon Institute’s 2015 Cost of a Data Breach Study: Global Analysis, with IBM, was published last week. (more…)

Tunstall adds services for Australian veterans, upgrades US call centers

May 29, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /]Tunstall has been quiet on the newsfront lately, so these two items from Australia and the US are to be noted. In Australia, the Department of Veterans Affairs (DVA) rehabilitation appliances program (RAP), which provides subsidized personal response systems to veterans, now includes Tunstall’s PERS, iVi fall detector pendant, PIR movement sensor and GPS watch. The program requires that veterans be evaluated for need by a qualified health provider. Tunstall has participated in the RAP program since 2002. Pulse+IT (Australasia) In the US, a significant part of Tunstall’s purchase of AMAC were medical answering service operations in Long Island City, NY, Pawtucket, RI, and Newington, CT. A $10 million upgrade of their 24/7 service includes CRM for healthcare providers for after-hours, overflow support, appointment reminders, insurance verification and help desk services. Release

Telehealth reimbursement makes legislative progress in Texas, US House

May 29, 2015 | by

In Texas, telehealth reimbursement as part of the state Medicaid program passed their House resoundingly (120 to 5!) and moved to the state Senate. (In Texas, if your bill makes it through the scrum that is their House, the Senate moves expeditiously.)  HB (House Bill) 2641 would authorize Texas’ Health & Human Services Commission (HHSC) to extend reimbursement for home telemonitoring (telehealth) services under the state Medicaid program from September this year for four years. Health care providers in Medicaid would be reimbursed for review and transmission of electronic health information. The caveat of course is that it is ‘feasible and cost effective’–it is designed to be expenditure neutral. The bill also includes extensive stipulations on health information exchanges based on national standards (ANSI) as well as amending the health and safety code for immunizations and other health conditions. The ‘criminal offense’ pertains to protected health information breaches as a misdemeanor. Telehealth inclusion in Medicaid is positive as this state insurance plan serves the poorest and often sickest, as well as many federal Medicare ‘dual eligibles’. Texas, being a large state, also sets trends (including the most reluctant to adopt cross-state telemedicine licensure.)  Text of HB2641

Would that telehealth reimbursement have the same chance in that large, exceedingly deliberative body called the US House of Representatives. HR2066, the Telehealth Enhancement Act of 2015, is similar to a bill that expired in committee in the last session. It was introduced (more…)

Home telehealth now focused on the ‘superusers’ of healthcare

May 28, 2015 | by

A noticeable trend in telehealth has to do with focusing less on the generic virtues of at-home vital signs monitoring for routine patient care and more on managing specific high-cost populations to avoid or reduce costs. Some of the impetus in the US has come from new regulations by CMS (Center for Medicare and Medicaid Services) intended to move Medicare fee-for-service (FFS) patients into a reimbursed chronic care management (CCM) model. Banner Health is Arizona’s largest private employer (which does say something about Arizona as a retirement haven) and since 2006 has been experimenting with remote monitoring since 2006. Starting in 2013 Banner piloted Philips‘ post-discharge program now called ‘Hospital to Home’ as Banner iCare, combined with Philips Lifeline PERS, but made it available to those only with a stunning five+ chronic conditions–the top 5 percent that is reputed to account for 50 percent of healthcare spend. Banner combined the tech with intense support by a multi-layered care team. At ATA they announced the following results with the initial cohort of 135 patients, now up to 500:

  • 27% reduction in cost of care
  • 32% reduction in acute and long term care costs
  • 45% reduction in hospitalizations

The article in Forbes is a bit breathless in profiling the program and the ‘superusers’ of healthcare (with a windy but false analogy from John Sculley) but provides a level of detail in the program that most articles do not. One wonders how Philips makes money on supplying what is at least $2,500 worth of kit, with peripherals that must all be Bluetooth LE. It’s also not stated, but the TeleICU and TeleAcute programs also appear to be Philips’. Video

The potential of engaging ‘safety net’ patients via mHealth: study (US)

May 27, 2015 | by

The Commonwealth Fund‘s just-published study on mHealth usage in a national sample of urban and rural community health centers and clinics (in US termed ‘safety net providers’ for low-income and uninsured) indicates the potential of mobile health for patient engagement in care, but yet to be achieved. Their patient population has high levels of mobile phone adoption, including text and internet. About 27 percent of the 181 providers who participated currently use mHealth in care delivery, but in basic applications such as appointment reminders. The potential observed is in chronic disease management support, health education and specific programs such as smoking cessation, weight management and medication adherence. Mobile Health and Patient Engagement in the Safety Net: A Survey of Community Health Centers and Clinics    Also FierceMobileHealthcare.

Undermining the system an unintended consequence of telemedicine?

May 27, 2015 | by | 1 Comment

Telemedicine’s doctor-patient virtual consults may undermine the healthcare system, if Mass General neurologist Dr Lee Schwamm is to be believed from his comments at last week’s iHT2 Health IT Summit in Boston. Urgent care delivered by telemedicine not only commits the mortal sin of siloing data, not ‘doing an adequate job’ of passing to the primary care physician, but attracts dissatisfied doctors who want to set their own hours. And the cardinal sin: telemedicine attracts wealthier patients, paying cash, who by using these services are “…pulling dollars out of the healthcare system that are desperately needed to care for poorer patients.”

Quite a leap of logic here, when his real concern should be quick availability of patient care–not having to wait hours in a doctor’s office or ER/ED because you’re triaged as not bleeding-on-the-floor urgent. Virtual consult rates at least for now also tend to be low–$40-45 per visit–and appealing to those without insurance, not seeing a doctor on a regular basis (no chronic conditions) or anyone with a high deductible. Doctors are still also free, despite Dr Schwamm’s snark, to better utilize their time–and yes, make additional income–through signing on to telemedicine as part of their practice. So is this a lash back on a factor that’s undermining the establishment which Dr Schwamm is part of? Perhaps Dr Schwamm can explain? Stephanie Baum takes a puzzled view over at MedCityNews.

The dilemma of design for older people

May 22, 2015 | by

Is the best design for older people and the disabled not specifically designed for them, but an adaptation of basic good design? Laurie Orlov in one of her apt Aging In Place Technology Watch articles questions the market viability of all those specially designed products we’ve seen since, say 2008. We recall ‘smart homes’, senior desktop computers, simplified phones and the robot caregivers which never seem to get past the prototype stage [TTA 25 July 14]. Her POV is that in most cases ‘designing for all ages is feasible today’ except for healthcare–durable medical equipment (DME) and healthcare delivery (and,this Editor would add, monitoring). One of her commenters points out that not everything can be designed ‘universally’, linking to this excellent article from Smashing on guidelines for designing tech to be used by those over 50. The section on blue color perception was especially interesting, as blue is healthcare’s #1 color. I would also point out that design which avoids stigma (as in ‘it screams OLD’) and has good aesthetics also wins.

Is AARP admitting that ‘tech designed for seniors’ is not a winning notion, as this May’s Life@50+ National Event in Miami is likely the last national event they sponsor? And it would be interesting to go back to the previous ‘Live Pitches’ to see how they are doing. Ms Orlov profiles this year’s five.

Call for presentation proposals: mHealth Summit (US)

May 22, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/05/mHealth2014_logo4c_FINAL-thumb.jpg” thumb_width=”150″ /]You have till 8 June to submit a proposal for a presentation at one of the largest digital health conferences in the US, the mHealth Summit (which is same place–near Washington D.C.–but a month earlier than usual–8-11 November). This year’s theme is “Anytime, Anywhere: Engaging Providers and Patients” and centered around one of five topics: clinical care, technology, patients and consumers, research, policy or business. The co-located Global mHealth Forum has a separate submittal process. Information and submittal link. Telehealth & Telecare Aware has been a media partner of the mHealth Summit US since 2010 and the 2015 Global mHealth App Developer Economics Study presented earlier this month at mHealth Summit Europe in Riga.

‘Internet Plus’ nurturing China’s nascent digital health market

May 21, 2015 | by

Back in April this Editor was surprised by the interest Chinese investment companies had in Scanadu–and vice versa. Two of the three, Tencent Holdings and Fosun International, led the $35 million Series B round. Scanadu in return reportedly is developing products primarily for the China market, such as a urine analyzer.

Somewhat surprising, but it should not be, is the extent that private money tacks to the winds of official Chinese government policy. Ecns.com, the online site of the state China News Service, reports that part of the government ‘Internet Plus’ initiative will be targeted to the health and social care needs of 212 million people over 60 in China–a surprising 15.5 percent of the population. The civil affairs vice-minister has publicly advocated the use of the Internet, cloud computing and big data to transform care for the aged. Oddly, this also includes the development of ‘e-commerce’ for seniors.The language is also interesting and very careful–“The country’s population also features a large number of elderly people who are disabled and who are faced with empty nests and poverty” and a similar to the West shortage of carers. (more…)

Aetna may ‘buy into’ more analytics, digital health

May 20, 2015 | by

Rumors now mainstreamed into press surround Aetna’s apparent interest in fellow insurers Humana and Cigna. Forbes last Friday started the ball rolling with an article last Friday focusing on the main event driving insurance payer consolidation: the transition of Medicare from fee-for-service to value-based bundled payments and accountable care organization (ACO) models. Humana has substantial Medicare business and a foot in home care (SeniorBridge), but has innovated in digital health: partnerships (Healthsense, TTA 20 Dec 13), purchases (what remained of Healthrageous, TTA 16 Oct 13), employee wellness (Vitality) and app development. Cigna is a major insurer with corporate business, but has struggled a bit in the digital health arena with the flashy-but-flopped patient engagement platform GoYou. It’s piloted telehealth to reduce readmissions with Care Innovations [TTA 7 Oct 14]  and Coach by Cigna, a mobile health platform in conjunction with Samsung for the Galaxy S5 and S6 phones.

Aetna has had some success with working with ACOs, with 62 contracts covering about 1 million lives, but this Editor counts over 400 practice-based ACOs in the Medicare Shared Savings incentive program alone. Their experiment in consumer app aggregation, CarePass, came to a quiet end last August and Healthagen, their ’emerging businesses’ unit, has had some swerves in rationale including iTriage and even ActiveHealth Management, their long-time population health analytics arm. While digital health is part of it (see Mobihealthnews), (more…)

Do startups truly threaten the ‘healthcare establishment’?

May 19, 2015 | by

Or are successful startups fitting into their game? Chris Seper in MedCityNews paints the picture of one side of a quandary. The ‘healthcare establishment’ fundamentally and to its detriment does not understand and is threatened by the startup and innovation process. A startup may begin with an idea which is, in his words, ‘almost always flawed, sometimes deeply’. If the founders are smart, they will test their ideas, validate them and change them appropriately. If not, they will fail. But it is easier for the Establishment to point at the most egregious of the bad ideas and use them to rationalize the status quo.

But being congenital contrarians, we paint the house on the other side of the street. Has the Establishment caught up with–or in some cases, co-opted startups, making them and their funders ‘do their diligence’ and be more cautious before emerging? This Editor would argue yes, and largely for the better.

**The ‘Wild West’ days are over. A few years ago, a truly bad or deeply flawed health tech idea or could easily find funding, because it was all blank slate, new and ‘transformative’.The sexiest hooks were Quantified Self, sleep, employer health incentives, interactive coaching, genomics, app prescribing and (last) wearables. A lot of founders imagined themselves as the Steve Jobs of Healthcare, down to the black turtleneck. Now there is a history of success and failure. The railroads reached the dusty frontier towns.

**There’s now a ‘Startup Establishment’. National accelerators (more…)