An impressive article written by a young doctor poses the problem of social sharing, data we don’t know we’re generating and how that data is being processed in ways such as tracking programs to predict and analyze our behavior. The example he gives of the Samaritans (a non-profit social services group in UK with a mission to prevent suicide) design of an app to be used with tweets of people we follow to alert you of worsening mood changes so that you could intervene. Some felt it was beneficial, most considered the possibilities for misuse or cyberstalking, and it was pulled. The other, rather chilling example was how a PHR could pick up EHR patient evaluation notes data not meant to be seen by the patient. Data insecurity with devastating consequences. Read the article for what UK family GPs are being asked to do by the Government. When data gets creepy: the secrets we don’t realise we’re giving away (Guardian). Hat tip to reader Mike Clark.
NYeC Digital Health: two diverging visions of a connected future (Part 1)
The New York eHealth Collaborative’s fourth annual Digital Health Conference is increasingly notable for combining both local concerns (NYeC is one of the key coordinators of health IT for the state) and nationally significant content. A major focus of the individual sessions was data in all flavors: big, international, private, shared and ethically used. Another was using this data in coordinating care and empowering patients. Your Editor will focus on this as reflected in sessions she attended, along with thoughts by our two guest contributors, in Part 2 of this roundup.
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/12/Topol-Compressed.jpg” thumb_width=”150″ /]The NYeC Conference was unique in presenting two divergent views of ‘Future IT’ and how it will affect healthcare delivery. One is a heady, optimistic one of powerful patients taking control of their healthcare, personalized ‘democratized medicine” and innovative, genetically-powered ‘on demand medicine’. The other is a future of top-down, regulated, cost-controlled, analyzed and constrained healthcare from top to bottom, with emphasis on standardizing procedures for doctors and hospitals, plus patient compliance.
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/12/Topol-tech-adoption-compressed.jpg” thumb_width=”150″ /]First to Dr Topol in Monday’s keynote. The good side of people ‘wired’ to their phones is that it is symptomatic, not of Short Attention Span Theatre, but of Moore’s Law–the time technology is now taking for adoption by at least 25 percent of the US population is declining by about 50 percent. That means comfort with the eight drivers he itemizes for democratizing medicine and empowering the patient: sensors, labs, imaging, physical examination, records, costs, meds and ‘Uber Doc’.
Data streams of the future analyzed at NYeC Digital Health
Guest columnist Sarianne Gruber (@subtleimpact) also attended the NYeC Digital Health Conference and reflects on what to do with all that data patients and devices are generating–a natural for her as she is a consultant in data analytics for Encore Health Resources.
The New York eHealth Collaborative hosted its fourth annual Digital Health Conference at New York City’s Chelsea Piers on November 17 and 18. There I was joined by 850 health-related professionals to listen, engage and see how life science meets digital technology. No doubt we have become a digital culture. Even seated on an airplane, I noticed the gentleman next to me wearing a Fitbit, and we strike up a conversation on step and sleep data and our dislike of the new dashboard. At the conference, Keynote Speaker Dr. Eric Topol, a Cleveland Clinic cardiologist and a leading practitioner of digital medicine, shared with us his thoughts on what it means be a part of this digital revolution as a patient and a doctor. Technology changes the scope of individual care. Advances in genomics now gives us answers based on our DNA that will genetically determine the success of medications and treatments. Epigenomics, a molecular diagnostics company, can prescreen an unborn baby of a mother with cancer with a simple blood test, sequencing the DNA, to manage her therapy. I was fascinated to hear that a genomic signal sensor can detect heart attacks and warn you of this possibly fatal event, and that necklace for heart failure patients can monitor fluid status averting repeated readmissions for these patients. Dr. Topol believes that digitized 24/7 patient health data will shift the patient–doctor relationship. Bringing in your self-monitored data, eliminates “the how are you feeling questions” and instead the doctor can confirm diagnosis and start treating the patient. “Patient owning data is a foreign concept and the digital revolution ushered this in.“ (more…)
Swasthya Slate: the Indian tricorder?
Why a smartwatch may feel…de trop
De trop —French, adjective, meaning too much, too many, unwanted
Have you noticed that many early adopters have skipped smartwatches? Other wearables such as fitness trackers have taken their place successively on the wrists of your favorite Quantified Selfer or weekend warrior. (A sign: they are now mass market at drug stores like CVS and sports stores for the holiday.) But how many people are looking forward to a special delivery of an Apple Watch, Samsung Gear S or even the well-reviewed and well-priced LG G Watch R in Santa’s pack? Having just returned from the NYeC Digital Health Conference, I saw few on the wrists of DH mavens. Smartwatches (and clothing wearables) also faded out at CES Unveiled [TTA 21 Nov], a complete turnaround from June’s event.
If you’ve been wondering too, you’ll be nodding like a bobblehead at John Nosta’s blog post in Nuvium, The Death of Wearables. (more…)
Care Innovations harmonizes and validates
Updated 27 November
In what seems to be a repackaging and repositioning of their remote care management/telehealth services, Intel-GE Care Innovations is now orchestrating Health Harmony. It appears on their promotional web page to be a bundling into that latest rave, the care continuum, but also a refreshing of separate systems developed since 2011: for the patient, an in-home tablet hub/portal for monitors and PC-based content portal once known as Connect; and for the clinician or caregiver, what was formerly called the Intel-GE Care Innovations Guide (which succeeded the Intel Health Guide). According to the CI website and press release from earlier this month, Health Harmony is an ‘optimized experience” that promotes collaboration among the patient, family, friends and care professionals and will “organize caregiving tasks, coordinate schedules, track medications, monitor vital signs and crucial health information, and quickly share information.” The release gives the impression of a launch but no information on cutting over current clients to the new system.
Update: A test of the Health Harmony system in a hospital environment to reduce readmissions is underway with liver transplant patients at the University of Cincinnati Medical Center. The shocking fact is that 50 percent of transplant readmissions occur within seven days of discharge. Instead of being discharged with a booklet and an exam one week later, the patients daily self-monitor vital signs (blood pressure, glucose, temperature), pain level and answer programmed questions. The clinical team reviews their data for 90 days post-discharge and can also do video consults. Currently eight patients are being monitored in the program with up to 20 projected through April 2015. Liver transplant bundled payments are approximately $250,000 with surgery being $180,000 of it, so there is an immediate benefit to the hospital system.
Another interesting development in Roseville, California is the expansion of the CI Validation Institute, announced in June, (more…)
CES Unveiled New York
11 November, New York
The annual event that is CES Unveiled in New York City is meant to be a nanoparticle-scale preview of International CES in Las Vegas, 6-9 January. It’s a smörgåsbord of what used to be called ‘consumer electronics’ and now is all about innovation–a taste of everything from ever-smarter video and audio to sensors, smarter homes with IoT (the cutely named Internet of Things), Big Data, robotics and (drum roll) Digital Health and the Quantified Self (QS). This Editor regrettably missed the opening briefing by Shawn DuBravac, CEA’s Chief Economist and Senior Director of Research which would likely touch on his areas of the innovation economy and disruption along with the other four 2015 trends to watch: big data analytics, immersive entertainment content, robotics and digital health. (CEA helpfully provides the 30-page white paper here.)
The exhibitors at the Metropolitan Pavilion did not fully represent the trends, however. (more…)
Reforms, restructuring at Veterans Affairs announced (US)
A new Secretary, but the same old process? New Secretary of Veterans Affairs (VA) Robert McDonald is quickly finding out that cleaning house at a government agency is not quite as straightforward as at Procter & Gamble, where he had been CEO. Since being confirmed by the Senate in late July, he has had to fight the fires of multiple scandals, beginning with the Phoenix VA ‘secret’ veterans care wait list leading to uncovering disastrous delays in care at VA regions across the nation. As of this week, and convincingly timed around Veterans Day, McDonald announced a reorganization of the VA to the Washington Post–a restructuring of the VA around the creation of:
- A new customer service organization across the entire VA, headed by a “chief customer service officer” reporting to McDonald
- A standardized regional framework meant to streamline partnering and coordination
- Realignment of internal business processes into a shared services models to improve efficiency, reduce cost and increase productivity
- Collaboration with partners to create a national network of Community Veteran Advisory Councils
Heads are rolling, but slowly. There are pending disciplinary actions affecting at least 35 employees and perhaps as many as 1,000 employees upcoming. (more…)
Short-shorts for an autumn Friday
As we in the US get our first, much too early blast of Polar Vortex this season with New York area temperatures dipping into the 30s F with a snow alert tonight, we should reminisce about what seems only a few weeks ago when the keyword was ‘short’….
Coming up short in the data breach this past Monday was Anthem Blue Cross of California with their TMI emailer–containing in the subject line specific targeting/sorting patient information that direct marketers love, but don’t want you to know they see, such as “Don’t miss out — call your doctor today; PlanState: CA; Segment: Individual; Age: Female Older; Language: EN; CervCancer3yr: N; CervCancer5yr: Y; Mammogram: N; Colonoscopy: N”. Ooops!…Another day, not quite another breakthrough for Mount Sinai Hospital here in NY, which had your typical laptop theft compromising over 10,000 records but fortunately not SSI or insurance information….More alarming were the malware/hacker attacks. In North Carolina, Central Dermatology of Chapel Hill was compromised by malware in a key server. And further south, Jessie Trice Community Health Center of Miami, Florida was hacked by a criminal identity theft operation accessing personal data of almost 8,000 patients. iHealthBeat, also Privacy Rights Clearinghouse, NY Times (Anthem)
A short opinion piece in HealthWorks Collective promisingly leads with:
What if we paid for patient recovery rather than just patient services? What if we paid to treat patients rather than just conditions? What if we paid to personalize care rather just population health quality measures? (more…)
Tunstall adopts new Tactio in patient management
Tunstall Healthcare is partnering with Canadian mHealth developer Tactio Health Group in what is a distinct first for them: creating a mobile care management system that is 1) smartphone-based for the patient and 2) prominently integrates non-Tunstall apps and devices. The patient uses the smartphone and the Tactio-developed mTrax app to collect a wide spectrum of data–everything from activity, sleep, pregnancy, body fat and mood tracking to the traditional constellation of vital signs. This uploads to the care provider’s tablet mPro Clinical App which overviews, details and reports the data for each patient and patient groups in care. The data comes from well-known mHealth apps outside the Tunstall world: BodyMedia, Fitbit, Fitbug, Garmin, Jawbone UP, Medisana and Wahoo Fitness, as well as connected (presumably Bluetooth) medical devices from A&D Medical, Mio, iHealth, Telcare, Withings and Nonin. Tunstall has also added two-way patient coaching and health journal features.
Tunstall’s positioning for what they call Active Health Management or AHM is “supported self-management” and “shift(ing) from reactive care to cost-effective active care.” (more…)
Follow up: Xerox invests in HealthSpot Station kiosks (US)
The day after this Editor posted on telehealth/virtual consult kiosk HealthSpot Station‘s new partnerships with Mayo Clinic and major drug retailer Rite Aid, Xerox announced their investment in the company. Xerox is not a business services organization one immediately associates with healthcare technology, but perhaps not anymore, based on this quote from Connie Harvey, Xerox’ chief operating officer of Commercial Healthcare: “HealthSpot is at the center of healthcare’s shift to a patient-centered model of care, and our investment in the company demonstrates Xerox’s commitment to transforming traditional healthcare into a high-value delivery system for patients, providers and payers.” Xerox will also be supplying BPO–business process outsourcing–services for cloud hosting, system integration, claims eligibility and claims submissions. But there’s more…. (more…)
Telehealth kiosk HealthSpot gains trials with Rite Aid, Mayo Clinic
This follows the October announcement with Mayo Clinic of an in-house pilot in Austin and Albert Lea, Minnesota with approximately 2,000 Mayo Clinic Health System employees (more…)
NYeC Digital Health Conference is one week off
A reminder for those in the US that the two-day NYeC Digital Health Conference at New York City’s Chelsea Piers starts next Monday. Spaces are still available, and for Telehealth & Telecare Aware readers, there’s a bonus of 10 percent off registration using code TTA. Agenda for Monday and Tuesday 17-18 November is here including the Patient Shark Tank on Tuesday afternoon. TTA is a media partner of the 2014 Digital Health Conference.
Concise analysis of mHealth regulatory environment (US)
If you–like most rational people–have some confusion in deciphering the current FDA state of affairs as it applies to mHealth, this summary from major law firm Foley & Lardner will be helpful. Written by special counsel for healthcare/mobile health Monica R. Chmielewski, it defines in few words FDA’s classifications, which mHealth technologies are, and which are not, subject to FDA oversight. In particular, MDDS (medical device data systems) were recently downgraded from Class III (the greatest oversight with pre-market approval) to Class I. FDA has also recently finalized recommendations in a guidance document for medical device manufactures for managing cybersecurity risks. mHealth Technology – Development in an Uncertain Regulatory Climate (Health Care Law Today)
A Canadian view of ‘Healthcare Systems of the Future’
Do we wait for the interconnected, seamless future of consumer-driven healthcare, or work with what we have now? Michael Smit of Canadian virtual consult provider Medeo argues for the latter: “The component pieces for a connected healthcare system exist today. We simply haven’t connected them yet.” He argues that Medeo’s Equinoxe platform, because it uses simple PC equipment, retains patient records securely and creates a health record, is a step more advanced than what Canada has seen in fixed telemedicine settings. Mr Smit also draws a picture of health management, the “3 D’s”–Data, Device, and Decision, integration with telehealth and the increasingly mobile-driven patient group, advocating that the health record should not have to be actively managed by the patient, but be a byproduct of cumulative patient interactions with the healthcare system. The Catalysts Of Virtual Care
Now a (virus) killer robot
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/11/Xenex-robot.jpg” thumb_width=”150″ /]And it’s not a computer virus, either. The US Air Force’s 633rd Medical Group (MDG), based at Langley Air Force Base, Virginia has adopted Saul The Virus Killer Robot. Developed by Xenex Healthcare Services, it zaps viruses human cleaners can’t reach or disinfect. According to the article, Saul sweeps the room with “pulses of high-intensity, high-energy ultraviolet rays 25,000 times brighter than florescent lights to split open bacterial cell walls and kill dangerous pathogens commonly found in hospitals”. The pulses are verified in killing 22 microorganisms including single strand ribonucleic acid (RNA), like that of a virus similar to Ebola, at a range of two meters out in any direction, within five minutes, and at an efficiency rate of 99.9 percent. A useful fighter against more common and nasty MRSA, C.diff and other hospital-borne infections. Armed With Science
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