Is consumer engagement gaining traction with insurers? (US)

Some encouraging and unusual developments with Aetna and Cigna around weight loss and wellness. In December, Aetna unveiled Passage, a fitness app it developed with Microsoft, which takes the user on virtual tours of running or biking in Barcelona, New York or Rome, with real-time photos of those locations, restaurant recommendations and historical facts along the route. Cigna has bundled four apps for nutrition, exercise, and mind and body relaxation free to the first 20,000 downloaders. For instance, the most popular, Fooducate, helps users grade the nutrition in their groceries and offers more healthy alternatives. The sudden interest in consumer engagement, after languishing for the past year or so, is due to the imminency of the ACA (Accountable Care Act a/k/a ‘ObamaCare’). Prevention increasingly equals savings and is easier to achieve with apps being further along the curve than even last year. Apps latest bid by health insurers to manage wellness (American Medical News)

Patient Portal for New Yorkers Design Challenge (US)

Health 2.0 and the New York eHealth Collaborative invite designers and developers to submit prototypes for a secure portal that will present 19.5 million New Yorkers with their individual PHR while educating them about health data privacy rights. Developers have a chance to win up to $15,000 (first place). Submission deadline is 11 April; New Yorkers will vote on the best prototypes through 21 April. Overview and registration form

EHR misery continues

EHRs are rapidly becoming the Rodney Dangerfield of eHealth (‘I don’t get no respect’). No surprise to any doctor or clinical staff who uses them–but the realization has dawned that it has actually made charts more labor intensive. “I think we’ve sort of made the paper chart electronic, but what we’ve done almost nothing of is automation.” has to be one of the drollest quotes of the past few years (Dr. Donald Rucker, VP and chief medical officer of Siemens Healthcare USA). Instead of using computers to automate, EHRs make records even ‘stickier’. Hospitals like it because it helps capture billing more accurately. MDs aren’t technophobes (a common accusation) but “they’re not going to embrace any technology that makes them less efficient”. Neil Versel takes a ‘gimlety’ look at the subject in his comments on this TEDMED webcast (1 hour recast here) in InformationWeek Healthcare.

And the think tank RAND Corporation adds to the pile-on, with RAND rethinking its optimistic 2005 analysis of $81 million in HIT savings that fed the proliferation of EHR companies and Federal subsidies. Expected savings haven’t materialized, and productivity, interoperability plus quality benefits haven’t been achieved by existing systems, according to Dr. Arthur L. Kellermann, one of the authors of the analysis published in this month’s Health Affairs (abstract only). A list of shortcomings as long as the East River are discussed far more critically in commentary featured in the NY Times, Charles Webster, MD’s EHR blog on how you get to the ‘iron triangle’ of unstable software (hat tip to Vince Kuraitis), and Brian Ahier’s commentary on (this is a first) Google+.

The Health 2.0 Show January podcast

Health 2.0 has now released their January hour-long podcast which previews their 2013 US 7th Annual conference 29 September-3 October which will be at the Santa Clara Convention Center (California), a look forward to Health 2.0 Dubai in two weeks and India in February. It will take you a while to get past the ‘adverts’ to how telehealth and health tech can better work with hospitals to improve care and care transitions (Marco Smit at about 11:00). (Warning, it is also a little kludgy in loading.)

Odds and ends from CES 2013

More CES articles and roundups:

Some ways to put digital health in action at CES: turn the techies into health tech ambassadors by giving them devices to wear during CES and doing a competitive tally of their results, with an award from a prestige panel; test a smoking cessation program (and similar); include in CES the culture change partners such as health systems and data analysts who can actually make that flood of device data into something useful. Interesting POV. How entrepreneurs, execs can take advantage of the techies at CES (MedCityNews)

UnitedHealthGroup is looking to connect its beneficiaries to healthy lifestyles, through tools such as adapting ‘DanceDanceRevolution’ to a classroom setting, mobile apps, cost estimators and rewards programs. Unfortunately, it will need to be more exciting to consumers than as presented at the Digital Health Summit, if this article is to be an indicator. UnitedHealth Group makes waves at CES (mHIMSS) The Forbes article (next) goes into more detail on their 4,000 square foot and more importantly, the global $60,000 Breakthrough Health Tech Challenge prize to help people more effectively manage chronic health conditions.

And finally, the fork making all the news. After you’ve traipsed hundreds of miles of aisles, sat in on your 75th presentation, and have sensory overload to the nth degree, Editor Donna can understand those covering CES for falling all over the HAPIfork from HAPILABS rather than, say, a massage table (legitimate, readers!!) Yes, it was a CES finalist. Yes, it’s a great ‘little engine that could’ story involving a young entrepreneur with a charming French accent. Yes, it’s buzzy because it’s buzzes (literally) if you are eating too fast and uploads your consumption metrics to your smartphone. But it’s a gadget….which still needs funding, which undoubtedly it will get. Launching February on Kickstarter with a Q2 to-market projected (in time for Valentine’s Day?) The Fork That Buzzed CES 2013 (Forbes)

Another five ‘big defining innovations’ for 2013

Writer and Singularity University VP Vivek Wadhwa opines in Venture Beat on the defining technologies we’ll see in 2013. (He was spot on with the cool down of social media, the rising tide of security breaches and cloud-computing failures). All these, but especially the second, are important to healthcare tech. Editor Donna’s comments and opinion follow:

  • Tablet explosion to computing revolution: cheaper, more powerful, but don’t agree that anything decent will ever be given away. And no, tablets will not kill PCs because they are one-way communication tools–great for internet surfing, books, presentations and video, bad for responding to your email, documents or structured creative work. Perhaps the two forms will morph together…..
  • The ‘quantified self’ goes mainstream and creates a new regulatory battlefield: some progress into the educated next segment of early adopters, fitness buffs and the slightly hypochondriac, prices will decline, but the people who could really use the monitoring will continue to be uninterested or not smartphoned. Watch to see adoption trends by young diabetics and asthmatics.
  • Manufacturing jobs continue to return to the US: maybe in tech. And robots are being developed everywhere other than the US.
  • From big baloney to big opportunity in big data: companies will continue to wrestle with this, and the analysis tools keep changing….
  • New user interface paradigms: Leap Motion will be the biggest product of the year and may supplant the mouse and the kludgy touchpad, but don’t dig any graves for keyboards yet. QWERTY keyboards revolutionized mechanical writing starting in 1872 and have carried through to the smartphone; somehow no one has yet found a faster, easier way to communicate the written word. I bet on the 141 year old tech sticking around for awhile.

Kinect’s deployment in physical therapy

The Microsoft Kinect is proving to be a versatile platform for physical therapy and more. Microsoft’s public sector solutions area has been busily developing relationships to pair up off-the-shelf software with Kinect so that injured soldiers, sailors, airmen and Marines can perform their physical therapy effectively at home. The latest is with the US Air Force to define requirements for a Kinect therapy system and with the Army’s Communications-Electronics Research, Development, and Engineering Center (CERDEC). DARPA, the Joint Improvised Explosive Device Defeat Organization, Army Medicine, the Navy’s Bureau of Medicine and contractors Lockheed Martin, SAIC and CACI have all expressed interest in the Kinect. Beyond PT, the Army is seeking proposals for adapting Kinect for pilot training and simulation. Microsoft is also exploring how Kinect could be used in PTSD treatment. This is in addition to West Health Institute’s partnering with the Naval Medical Center of San Diego to conduct clinical trials of the West Health-developed Reflexion Rehabilitation Measurement Tool (RMT) using Kinect [TA 23 Oct]. This is cheering news as Kinect is inexpensive and PC-based, using equipment many soldiers and reservists already have at home. At least there is no FDA to come down on Microsoft for ‘off-label use’ of its electronics. Microsoft Wants to Kinect with Pentagon (Defense News) Can the Kinect Help Heal Wounded Veterans? (MIT Technology News) Hat tip to Toni Bunting of TANN Ireland.

UPDATE 16 Jan: Germany’s Fraunhofer Institute for Open Communication Systems (FOKUS) is also testing a Kinect-based rehabilitation program. This adds a smartphone-lined mobile sensor unit to measures vital signs such as pulse, oxygen saturation levels, and (where applicable) ECG/EKG readings. The physiotherapist sees this data in addition to the Kinect-based information and can tailor therapy to avoid dangerous levels of stress. Gizmag.

‘The pileup of things’: CES highlights

Independa, our first funded health tech company of 2013, saved some news for CES. Not only is partner/investor LG Electronics expanding the use of the Angela telehealth/socialization suite in its commercial market Pro:Centric TVs, but also Samsung Mobile is loading its Galaxy Tab 2 with Angela, available through designated distributors. This combination of TV and tablet technology is a first for the telehealth area, giving care providers in both community and home settings. Independa releases: LG, Samsung. mHIMSS article

The RP-VITA robot developed by iRobot/InTouch is first to gain FDA approval for active patient monitoring in high-acuity environments where immediate clinical actions may be needed (such as ER/ED, pre/post-operative). Available on lease for $6,000 monthly. HealthWorks Collective article

Philips introduced another iteration to Lifeline, called GoSafe. This version is the first Lifeline product that goes outside the home through cellular connectivity provided by AT&T. It features GPS detection on the Skyhook network, AutoAlert fall detection and alarming–but still is a kludgy device which has to be worn around the neck. Its in-home base connector is either connected to POTS or cellular for a better signal. Also different from traditional Lifeline, the device itself will need to be purchased (@ $150) with a $50/monthly monitoring fee. It is targeted for a less frail, more active older adult. Available in March. For those liking metrics, Philips revealed to Mobihealthnews that Lifeline has helped over 7 million people live independently in their own homes–a huge base–and the AutoAlert version has gained 100,000 users. Also Medgadget Whither the overlap with Lifecomm (the Philips/Qualcomm/Hughes Telematics-Verizon JV)? Also will be out early this year, after its beta, according to Mobihealthnews.

Videos Galore. The Digital Health Summit just uploaded multiple interview videos on YouTube, a pick-n-mix as most (as of Friday afternoon NYC time) are not fully labeled. No panel/presentation/keynote interviews yet but here’s another brace of DHS videos. The Wall Street Journal in its CES 2013 ‘Gadgets to look for’ has a video on Scanadu (at 0:37) and in its Thursday highlights, Samsung’s flexible phone/tablet screen (at 1:02)–the WOW of the day.

The HealthSpot Station telemedicine/telehealth walk-in kiosk, which we previewed at CES New York, officially debuted (release) with a kiosk display on the floor, and also announced its partnership with Miami Children’s Hospital on a proposed multi-part project (release). The telemedicine consult portion will be provided by Teladoc (Teladoc release).

ADT Pulse, the home automation division of security giant ADT, and Ideal Life announced a strategic partnership to integrate Ideal Life’s telehealth into the ADT home management system. (release)

Our recently profiled [TA 4 Jan] iPhone/Android med reminder app, MediSafe Project from Israel, claims that its users since November (two months!) have an 81% med adherence rate, versus the WHO 50% average in developing countries. For those on cholesterol statins, the percentage is 84%. Impressive, though early days. MedCityNews

A Series C funding to note is PatientSafe Solutions, a patient workflow and documentation mobile platform. Investors are the Merck Global Health Innovation (GHI) fund and with participation from Camden Partners, TPG Capital, and Psilos Group. Release

What happened to Google Glasses? The Vuzik M100 Smart Glasses only will distract you in one eye. It has built-in Wi-FI, Bluetooth, the ability to record HD video (720p), a compass, an accelerometer and a 16:9, WQVGA, full color display. Perhaps the future for hospital and assisted living care staff? Gizmag

Another recap courtesy of HISTalk Connect [WARNING 31 Aug 2014: linked page may now be infected with malware] (scroll down to CES Week in Review)

And stick-in-the-eye advice from a long-time observer of CES, from the IT perspective but equally applicable to bright eHealth developers: avoid spending time and treasure on ‘solutions in search of problems’ like refrigerators with embedded tablets. The CES cesspool is all our own fault (ZDNet)

The downside of crowdfunding a health app

We haven’t heard from the iMPak JV between Meridian Health system of central New Jersey and Sweden’s Cypak for a while, since their pocket-sized sleep monitor debuted in May 2011. Now iMPak is testing the crowdfunding waters with its ‘Emmett’s Family Vacation’ combination book and mobile phone app for children. Designed to encourage healthy behaviors, it turns tracking everyday movement and steps into a game–pedometer tracking is uploaded onto a mobile phone, and the game works only when ‘energized’ by tracked activity. It also rewards the child with travel facts and history (which gets a big ‘like’ from Ed. Donna). The problem is that its crowdfunding placement on Kickstarter is not gaining traction–since the publication of the Mobihealthnews article on 8 Jan, it’s garnered a measly $50 in funding, totaling an anemic $150 of a distant $25,000 goal–and the deadline is 9 February. Two modest suggestions for iMPak: 1) Get thee over to a healthcare-oriented crowdfunder like Medstartr (contact: Alex Fair) or Health Tech Hatcha concentrated and interested audience, and 2) for the travel facts and history, cross-promote and add sponsored content from American Express, United Airlines, Delta Airlines, British Airways, Virgin, various museums, etc.

Wondering about the ‘Internet of Things’?

Feeling puzzled when the rhapsodized subject matter at your meeting or conference turns to The Internet of Things? Well, it’s what used to be called machine-to-machine, or M2M, which has been around for awhile. ZDNet has helpfully put together a ‘real-world’ information package ranging from a primer to how it affects development globally. There are multiple documents and links to content, plus a vendor guide. Here’s the introductory/index page: 2013’s hot topic: The Internet of Things (and our new way of covering it)

Why Athenahealth bought Epocrates

Normally Editor Donna would append this HIStalk Connect article [WARNING 31 Aug 2014: linked page may now be infected with malware] to our earlier one [TA 8 Jan] but it’s an extremely thorough external analysis of why Epocrates‘ core product–a mobile drug reference–would be worth nearly $300 million (a 22% premium to share value) to Athenahealth. While most have pointed out the mHealth aspects in improving the latter’s mobile offerings, the real reason, according to writer Travis Good, MD, is for Athenahealth to gain exposure to a hard-to-reach group via Epocrates’ ubiquity, and gain more physician users of its core services, practice management and EHR.

What chefs are cooking in the kitchen: FCC adding $400 million to rural telemedicine

Something’s always cooking in the Federal Government kitchen…in this instance the chef is the FCC, and the dish being spiced is the Clinton-era rural broadband scheme for telemedicine. The Rural Healthcare Connect Fund of $400 million will be allocated to rural hospitals, clinics, mental health centers, local health departments and medical/dental schools to connect them with corresponding urban providers and networks, improving quality and immediacy of care. Presumably the money was found in the couch cushions as the debt ceiling is already reached…$400 million FCC fund to bolster rural telemedicine networks (FierceMobileHealthcare)

GE gives entrepreneurial startups a spin with StartUp Health

GE has generated much positive news with its creation, in partnership with accelerator StartUp Health, of a three-year program that will select 10 consumer health startups to become high-growth companies within three years. The announcement, timed during CES, makes much of GE’s contribution to a customized growth curriculum, access to GEs executives including a GE leadership mentor for each company and exposure to GE technology experts. Application is extremely qualified and selective (naturally); the deadline is also short, 8 February–information here. This program is also separate from the existing StartUp Health Academy, although companies in the Academy are eligible to apply. GE joins companies like Nike in a similar setup with TechStars; Qualcomm Ventures has the QPrize in addition to leading the way in funding and partnering with early-stage wireless health companies.

What is not in the release and the MedCityNews article is this, according to Upstart Business Journal: GE Ventures (GE’s investment arm) and the StartUp Health Innovation Fund will negotiate for a 2-10% equity stake in each company. To Editor Donna, what is also notable about GE’s latest foray into ’emerging health innovations’ is that it is Take 2…or perhaps 3. Take 1 was a sub-majority stake, then acquisition of Living Independently Group’s QuietCare in 2008-9, which was to herald an entire Home Health division. Its later relegation into the Care Innovations JV with Intel (Take 2, notably dominated by Intel) was seen by industry observers as a tacit admission of, if not precisely failure, GE’s lack of notable success or confidence in the sector. So we can fairly say that we are cheered that GE has changed its mind–and the accelerator route may be a kinder, gentler way of supporting innovators in consumer healthcare tech.

Saga Homecare (UK) to offer GrandCare Systems

In what Editor Donna believes is its first foray outside the US, remote monitoring/socialization developer GrandCare Systems announced at CES their partnership with Saga Homecare, the largest private provider of domicilary (home) care services in the UK. GrandCare will be providing systems to Saga under the agreement to start in early 2013. The release seems to imply ‘Saga-ization’ as well. For those outside the UK who are unfamiliar with this company, think AARP but rather than growing out of an association and political lobbying group, expanding from travel and tourism to include publishing, financial services and healthcare delivery for 50+. Another move that points to technology integration. UK Home Care Provider, Saga at Home, Partners with GrandCare Systems to power home care services

Further sad confirmation of CTE

Further confirming the prevalence of chronic traumatic encephalopathy (CTE) in the NFL is the recent examination by the US National Institutes of Health (NIH) of linebacker Junior Seau’s brain. Seau, who retired from play after 20 years and was a well-liked, cheerful figure in San Diego, committed suicide unexpectedly at the young age of 43, and his family donated his brain to the NIH for study. It is just further sad confirmation of the Boston University study [TA 6 Dec] that this progressive disorder which occurs as a consequence of repetitive mild traumatic brain injury is the NFL’s scourge. Perhaps it is unavoidable in the game at present, as columnist George Will believes [TA 3 August]. There is now also increasing evidence that even without CTE, living NFL players are at high risk of other brain-related diseases, such as cognitive deficiencies and depression, based on a University of Texas at Dallas study. Seau Suffered From Brain Disease (NY Times) Retired NFL Players at Risk of Brain Deficits (MedPageToday)

For our readers: Do you believe that sensors in helmets and EHRs can mitigate this, which is where the NFL (and Army-NFL) funding is directed? Is this being found in other countries in contact sports such as rugby? Is there evidence, in other countries’ armed forces which have participated in Iraq and Afghanistan action, of suspected high frequencies of brain trauma?

Related: National Football League Readies New EHR System To Boost Care Quality for Players (includes Olympics and NBA) (iHealthBeat audio interview 06:13 and PDF transcript)  NEW: CTE, as cumulative, starts early  Institute of Medicine Studying Concussions in Young Athletes (NY Times)

More troubles in Australian telehealth

The latest news from the southeastern state of Victoria (Melbourne) features a blast from the state’s Health Minister on hundreds of millions in funding cuts, while the Federal minister claims that an additional AU$1 billion over four years is heading Victoria’s way. The debate continues (see TA 29 Dec for a lively reader discussion); is this reality or political blather? Telehealth rebate cut will hurt Vic: Davis Hat tip to reader Ellen ‘Ethical Lens’ Fink-Samnick.