Telecare Soapbox: Is mHealth/eHealth becoming a ‘Field of Dreams’?

Editor Donna muses on the link in the telecare chain where it can all fall down – the person who is expected to use the device.

“If you build it, they will come”–misattributed to the film Field of Dreams, 1989

We can get telehealth and mhealth into the home care or healthcare provider, payer, ‘app store’ or ‘ecosystem’ (the ‘push’), but you cannot force the client or patient to use it.

The buzz may be about how slick a system or app is, how to sell it to the C-suite or even the Four Big Questions, but have we forgotten someone? We assume that end users/clients/patients will be delighted to use our wonderful devices, in the way they should be used–consistently, correctly, continuously until they… expire. Step back and think about human behavior, however, and you realize…that cannot be true. (more…)

Connected Health Symposium 2011: reviews and recaps

We’ll reserve this space for various articles, blog postings, Tweetstreams and insights about the Connected Health Symposium, held 20-21 October, sponsored by the Center for Connected Health. With regrets once again, Ed. Donna was otherwise engaged and was unable to take that not-too-long train ride north. Your comments/reflections invited.

Connected Health Symposium looks for answers to healthcare’s troubling questions. HealthcareITNews

The official CHS Tweetstream (#chs11)

Dr. Joseph Kvedar’s cHealth Blog on the MIT Media Lab presence at CHS, representing the objective assessment of patient via reactions to emotional stimuli, ‘affective computing’, and the role of ‘relational agents‘ (who can help to deliver healthcare).

From the HIT perspective, Melody Smith Jones attending from the Perficient technology consulting firm on Meeting patients halfway reduces costs. “Everyone is discussing ways to best engage patients and, not surprisingly, what the price tag of such ambitious efforts will amount to.”

Connected Health Symposium offers pitfalls and possibilities for wireless innovation. MobileHealthWatch reports that there was an emphasis on low-cost innovations in wireless health, specifically “pilot projects that look really great at conferences but that no one ever uses,” as well as projects that look great when they’re launched, then die out when the money runs out.”

Telecare Soapbox: Telehealth for the intellectually disabled

About the author: Andrea Swayne is a gerontologist who received her M.A. from Bethel University (Minnesota). She possesses 25 years of experience serving seniors at all levels of the care continuum. Starting with a B.A. in music therapy from Western Illinois University, Andrea worked with the intellectually disabled along with many other populations in need. She first became familiar with telehealth while piloting remote sensor-based behavioral monitoring in the early 2000’s for Volunteers of America. Currently, Andrea is a Director of Partner Services for WellAWARE Systems, which proactively identifies variations in key wellness indicators such as sleep quality, bathroom usage and activity level.

In our short history, telehealth has primarily concentrated efforts on individuals who are aged and who are attempting to remain as independent as possible for as long as possible in their least restrictive environments. Least restrictive environments for the aged include (but are not limited to) assisted living facilities, independent living apartments or the client’s primary residence with services provided by a home health agency.

I believe that another population could significantly benefit from telehealth: the intellectually disabled (ID). (more…)

Health 2.0 NYC: Healthcare Kickstarter

Health 2.0 NYC, Healthcare Kickstarter

New York, NYU Stern 17 August 2011

Your reporter: Donna Cusano

Ed. Donna attended this three-hour event which was a ‘reverse pitch’-eight New York City-based early-stage financing people (and one provider/corporate venture) presented to an audience of nearly 200, including representatives of 80 startups. They represented an interesting cross-section of assistance and funding.

 

The ‘Connector’

StartupHealth

Presenters: co-founders Steve Krein and Unity Stoakes

A connector-type or collaborative organization which is intended to create an ‘ecosystem’ for healthcare startups, and designed to improve access to capital, education and resources for health and wellness entrepreneurs. It originated as part of the White House’s current (June) entrepreneurial support effort called Startup America Partnership. As presented in the meeting, their goal is to create a campus for healthcare entrepreneurs in NYC to shepherd companies through the idea, startup, rampup and speedup phases of development past the traps of expertise, services, talent, customers and capital. Steve and Unity are also co-founders of OrganizedWisdom which enables doctors to set up a web presences ‘in minutes’.

 

The VC

Milestone Venture Partners

Todd Pietri, co-founder

Milestone Venture Partners is a digital health investor group which currently manages 13 companies in healthcare with about a $25 million investment, but specifically avoids therapeutic devices. Their investments include MedPageToday (sold), dLife (diabetes management), Medidata and GenomeQuest.

 

The Challenge

Health 2.0 Challenge

Jean-Luc (JL) Neptune, Director

This offshoot of Health 2.0 is all about ‘problem solving for a prize’-coding, applications-for specific sponsors.

 

The Angel

Life Sciences Angel Network (LSAN)

Milena Adamian, MD, PhD, Director

 

This offshoot of the New York Academy of Sciences started nine months ago and claims to be the first angel group in NYC investing in life sciences. In a relatively short, 9 months of existence, they have already funded 3 companies and there are at least 3 strong candidates until the end of this year. It fills the gap between Technology Transfer Offices and venture funding, and also educates entrepreneurs and investors.

 

The Corporate Venture

Visiting Nurse Service of NY (VNSNY)

Michael Monson, SVP Performance and Innovation

VNSNY is in the unusual position of being both a payer (Medicare Advantage) and a service provider in long-term care. His major points to developers:

  • any device or service MUST fit into clinical workflow, doesn’t depend on changing consumer behavior and ideally should be disposable!
  • especially do not make it dependent on a smartphone which requires a level of dexterity and visual acuity that many older people simply do not possess.

However, in seeming contradiction of above, Mike is especially interested in systems which can positively impact individual behavior, especially in compliance, disease management and in workflow productivity.

 

The Mentor

Blueprint Health

Matt Farkash, Founding Partner

Blueprint Health is a NYC-based startup accelerator that will be offering (January 2012) an intensive three-month program to NY-based entrepreneurs. It provides $20,000 of seed capital, extensive mentorship and a shared work environment to help entrepreneurs go from idea to prototype and provide access to angel and venture capital investors. Already 65 mentors-VCs, payers, providers-are affiliated.

 

The Incubator

NYU Innovation Venture Fund

Frank Rimalovski, Managing Director

The NYU Innovation Venture Fund is a seed-stage ($100K level) venture capital fund created to invest in startups built upon NYU technologies and intellectual property. It helps in developing product commercialization and patentable inventions.

 

The burning questions:

1) How do entrepreneurs get investors’ attention?

  • Referrals-or a 1-2 line pitch in a highly targeted email. Know the bios of the principals and the portfolio to get the fit, and figure out a connection (Pietri)
  • Develop a kicka** product where people pay you (JL Neptune)
  • Solve a real world problem (Monson)
  • Partnership plays with insurance companies (payers)
  • Understand that this is not a friendly process (Krein)
  • Confidentiality, at least prior to investment, is impossible (Pietri)
  • Overall, there’s a problem in backing of NYC-based healthcare startups (although online doctor appointment scheduler ZocDoc got another $50 million in Series C funding from Russian billionaire Yuri Milner’s DST Global earlier this month.)

2) How do entrepreneurs deal with providers who are ‘stuck in the mud’? These are especially hospitals but can be doctors, payers.

  • Put together a ‘dream team’-people with expertise in business, tech and a designer (Krein)
  • Understand that for providers, ‘improving outcomes’ is not that desirable of a benefit (!). For payers, it is a big plus (e.g. WellDoc’s Diabetes Manager) (Monson)
  • The changes in healthcare delivery are slow in coming

3) Opportunities-and not

There is an opportunity to build a model for integrated health (Monson)

  • A favorable model would concentrate on data and software, have a recurring revenue model and show distinct signs of acceleration (Pietri)
  • Delivering a lower cost model
  • Not favored-media businesses, EHRs (all)

 

Video on Livestream, multiple clips (wait a bit to get the videos to play after the interminable commercials)

Many thanks to Health 2.0 NYC organizer Alex Fair (FairCareMD, which allows consumers to shop openly for healthcare pricing and matches patients and providers) and the sponsors for hosting!

 

 

MHX 2011 Conference Report

A highlights report on Day 2 of the recent Mobile Health Expo (MHX) 2011 in NYC. Some points:

  • mHealth as the convergence of social media (SM) and healthcare (HC) or wellness care (WC)
  • 7,000–or 2%–of Apple AppStore apps are clinically related
  • Need safeguards for such mHealth apps as diabetic insulin dose calculators;  doctors very wary due to risk and liability, not to mention significant implications for HIPAA privacy and security
  • social support a key motivator

Many thanks to reader Bill Oravecz of EHR and health management consultancy WTO Associates.  Report

The ATA 2011 virtual conference report

While New York-based Ed. Donna were not in Tampa for ATA 2011, Eds. Donna and Steve kept up with conference news from various sources and Tweetstreams galore. Starting Friday/Saturday with pre-show news, this area will be updated continuously starting Monday through end of week. Most recent information will be first.

**Updated 6 May**

Friday 6 May: Editor, Donna Cusano

  • The next generation of telehealth cometh–or RIP, Intel Health Guide PHS6000: Raising some surprise on the ATA show floor was the demise of intel-health-guide-blood-pressure-monitoringone of the pioneers–the stand-alone Intel Health Guide PHS6000 which Intel formally introduced in 2008 after testing since 2005. Intel-GE Care Innovations representatives told our sources that sales of the ‘white box’ were concluded and current installations would be transitioning over to the PC platform, now called the Intel-GE Care Innovations Guide, no longer the ‘Health Guide Express’ of only two months ago [TA 5 Mar]. The 2 May release plumps the new Guide as ‘commercially available’ without mentioning any of this of course, along with the first customer, Virtual Health, a new concierge-style health and wellness service provider for a dual audience–seniors and new mothers–which will deploy it starting in May. Confirming that the PHS6000 is moving into the history books is the device’s absence from the ‘Intel Health Guide’ tab on the website and the depiction of the Care Innovations Guide–although the scrubbing is incomplete, as the PHS6000 lives on in the tech specs and a solution brief. It’s another indicator that the technology is moving on to different and more usable forms, even though the (paying) markets are still scarce on the ground. And the other early ’00s pioneer in their stable–GE QuietCare–if and when will be their next gen?

More information on the CI Guide from the release: it’s platformed on Windows 7, requires an SD card slot and webcam, and is available on notebooks, tablets, netbooks, desktops, and all-in-one devices, preferably with a touch screen. Connectivity is to specific models of peripheral medical devices such as weight scales, blood pressure monitors etc. Also mentioned is synchronization of their data with ‘existing IT infrastructure’ but not specifically EHRs.

  • Where’s Waldo (Health)? For their second ATA and ready to market with the 510(k) in hand, Waldo Health is adding ECG to its peripherals connecting to its touchscreen PC-type monitor –a combination of a Zephyr heart rate belt with Monebo cardiac ECG software. It is probably a first in telehealth and certainly in the portable monitor type–and with a big benefit: reading and recording discrepancies in the heart scan which are even earlier indicators of congestive heart failure (CHF), before the telltale weight gain or breathing difficulties that presage greater trouble. Our source visiting their booth had his ‘socks blown off’ by this. Press announcement scheduled later this month. Hat tip to reader John Boden of ElderIssues.
  • Cisco’s telehealth head Kaveh Safavi on the possibilities, challenges and opportunities for telehealth: replacing and doing more of what you do today, plus things you couldn’t even think of. Destination ATA.
  • Scottish Development International (SDI) had a major presence on the ATA floor, marketing the research power of their universities like GCU plus their success stories with companies like Celestor, Mobile Health Care Networks, Emotional Sciences, Robomotics and Antara Consulting. The enthusiasm of their representatives really comes through on their seven videos from the show floor on SDI’s YouTube channel (right up there with David Pogue); nevertheless some American viewers may feel the need for subtitles.
  • Who pays (one of our Four Big Questions)…remains difficult. There may be some opportunities in the ‘reform’ Federal legislation, in HITECH with the Beacon Community Program, and California is looking into updating its 1996 bill to include current practice (’bout time, dudes!). While 34 other states have some Medicaid reimbursement, it is so restrictive it hardly makes sense for providers to attempt it. ACOs and Medicaid Health Homes may be other options but certainly not cure-alls. At ATA show, telemedicine reimbursement takes center stage Search HealthIT
  • And wrapping up…Destination ATA show floor video (05:38): Referenced by Ed. Steve below. Companies featured are MedVision, SDI, MinXRay, VoCare, VGo and concluding with a steel band for a festive finish.

Thursday 5 May: Editor, Steve Hards

Some more videos from the conference, courtesy of Healthcare IT News in addition to the Martin Cooper/David Pogue one and the Exhibit Hall Highlights referenced by Donna previously. For a bit of levity, readers may also want to see ‘David Pogue wants an iPhone’.

Tuesday 3 May: Editor, Donna Cusano

  • More on Bosch Healthcare’s enhanced clinical web application for care management which is being previewed at ATA. The new platform has been in use in Europe and the UK for the past year, and integrates data from both Health Buddy and the ViTelCare T400 in greater depth and detail than is currently featured. According to Skip Coleman, Bosch’s Account and Implementation manager, it is designed for ease of use by care managers, administrators, nurses and physicians who can selectively look at individuals and populations as needed; the architecture will also permit expansion to mobile. The plan is for current US Health Buddy and ViTelCare clients to migrate to the new platform by end of year. Thanks to Skip, Melanie Fagen of Bosch’s marketing department and Julie Zappelli of GCI.
  • Vidyo, the Hackensack, New Jersey video conferencing company, and American Well announced their agreement to incorporate Vidyo’s HD communications platform into American Well’s Online Care Suite for video/audio physician-patient consults. American Well taps Vidyo for enhanced video conferencing, Destination ATA. Prior to ATA, Boston-based Partners Healthcare announced they were upgrading its current telestroke program to Vidyo’s platform to create a more mobile, secure network that allows doctors to consult with patients and community hospitals far more flexibly–from the exam room, a computer at home, or a mobile application on the go, as long as they have a webcam and a basic internet connection. And patients would pay out of pocket for the service. Boston Globe
  • On Monday, University of Pittsburgh Medical Center (UPMC) announced that they have named Alcatel-Lucent (plus their Bell Labs subsidiary) to create a single platform for all its 16 telemedicine service lines, including a secure web portal from which patients can access scheduled and emergency care through a number of mobile devices, using real-time audio and video. Destination ATA
  • CMS announced a final rule streamlining physician credentialing for telemedicine. The hospital receiving the telemedicine services “may rely upon” information provided by the consulting hospital when making privileging decisions for physicians offering the consultations. Health Data Management
  • InTouch Health premiered the RP-Xpress, a portable telemedicine device using standard 802.11 Wi-Fi for video consults in clinical environments. Release.

Monday 2 May: Editor, Donna Cusano

  • At the Sunday afternoon plenary:
    • ATA’s president Dale Alverson, M.D. called current conditions the ‘perfect storm’ for telemedicine and the transformation of healthcare delivery. Factors: economic downturn, aging population, the critical shortage of healthcare providers. Health information and new technologies will facilitate transformation and get us through these challenges. ‘Health diplomacy’ is needed: “We need to work together. And the reason we need to do that is that most health issues are global. And we can share knowledge and information in meaningful ways that you couldn’t before.”
    • **Updated 6 May** Jitterbug founder and inventor of the modern mobile phone circa 1972, the legendary Dr. Martin Cooper was interviewed by New York Times personal technology columnist (songwriter, keyboardist and singer) David Pogue. Dr. Cooper’s future vision lies in “personalization and customization” around how individuals prefer to use their devices. See an original Motorola StarTac (a/k/a The Brick) Video. (04:25) Mobihealthnews‘ interview with Dr. Cooper, focusing on mobile health, is notable for two quotes:
      • Health apps are superficial and incomplete. It’s so easy to come up with an app that attacks the surface or the easy stuff. To create something that people will really use is hard.”
      • “People think of technology as being science and engineering, but technology doesn’t mean anything if it doesn’t involve people. Technology is the application of science to create products, services, and devices that make people’s lives better. You can’t separate the two.”
    • ATA’s annual awards presented to Dena Puskin, ScD of HHS, Hubble Telemedical, Michael D. Abramoff, MD, PhD, Alice Borrelli of Intel, University of Arkansas for Medical Science,and the ATA Telehealth Nursing SIG. The 2011 ATA College of Fellows were inducted. At opening plenary, ATA speakers tout growth and change, Healthcare IT News
  • Sunday also showcased global connected health at the International Telemedicine Forum, with speakers from Latin America, India, Australia and China describing how telemedicine is used–from texting to connecting distant clinics with hospitals or patients directly to specialists. It concluded with a signing ceremony for the ATA’s new MoU partners: the eHealth Association of Pakistan, the Telemedicine Society of India, the Armenian Association of Telemedicine, the UK’s Telecare Services Association and the Telemedicine Society of Nepal. ATA’s international delegates display global power of telemedicine
  • A Monday executive roundtable lamented lack of standards for remote monitoring will slow growth, but conceded that ‘medical reform’s’ ACOs, medical networks and documenting better outcomes will help to drive telehealth and telemedicine. Particpants: Louis J. Burns, CEO of Intel-GE Care Innovations: Allen Izadpanah, president and CEO of ViTel Net, Daniel L. Cosentino, MBA, CEO and president of Cardiocom; Jasper zu Putlitz, M.D. of Bosch Healthcare.
  • Robert Bosch Healthcare announced both an improved clinical web application for patient assessment and workflow for Health Buddy and ViTelCare to integrate both platforms, as well as a new advanced weight scale peripheral for Health Buddy. This press release is oddly limited in its information; your editor is angling for more.
  • Short takes from the Tweetstream:

A roundup of press announcements and news coverage prior to the start of ATA 2011. Your editor is Donna Cusano:

  • ATA calling on CMS and Donald Berwick in an open letter to rewrite the ‘restriction-riddled’ Medicare telemedicine statute for ACOs. The restriction on telehealth usage in urban areas alone is absurd. TA 28 April Further commentary in FierceMobileHealthcare.
  • Philips is introducing a cellular modem–confusingly called a ‘cellular accessory’–to connect patient home telehealth data to Philips’ secure server and thereon to a home health provider. Philips is also introducing a steady scale for the home that is designed for frail patients: wireless transmission, measurement up to 440 lbs., integrated handle bars and multilingual audio prompts. Release. Booth #1633.
  • MedApps is interestingly pairing with kiosk designer/builder PhoenixKiosk to create a Personal Health Station, with a blood pressure cuff, weight scale and printer. It is then connected by MedApps’ CloudCare platform and stored to a SmartCard ID or to the patient’s EHR. Release. Booth #1317.
  • Lifecomm–the partnership between Hughes Telematics, Qualcomm and AMAC–just published a study on ‘critical design factors for MPERS’. Older adults want a wearable device that does not ‘stigmatize’ them and integrates into their lives. Release. Booth #1532 (with AMAC)
  • Diabetes monitoring continues to add systems: PositiveID will be demonstrating their iglucose mobile health solution for diabetes management. The device (not yet FDA-approved) wirelessly connects glucometer readings to their database. Booth #1340. Release.
  • Affecting rural telemedicine: Certain to be discussed at ATA is HHS/Health Resources and Services Administration funding of $12 million for up to 40 grants for rural health IT adoption, focusing on EHR meaningful use criteria . iHealthBeat.
  • And as they enter the market with their 510(k) approval in hand, Waldo Health is seeking a VP of Sales. If you are a member of the ATA group on LinkedIn, here is the job posting from COO Alan Weiss. Otherwise, see Alan during ATA at Booth #1125.

Telecare Soapbox: Turning back time with Fast Company and Care Innovations

Wondering what the GE-contributed part of Care Innovations has been up to? This short article in Fast Company online should have been far more informative. Instead, it skids into the journalistic equivalent of a brick wall. Its sole subject: QuietCare–originally developed by another company and acquired by GE. Its tone: recycled from 2006-7. And sadly filled with inaccuracies. It’s making Ed. Donna itching to rant, because she was quite close to QuietCare as it developed from 2006 into early 2009 as part of the founding company, Living Independently Group through the early days of the GE acquisition, and knows better. (more…)

Mobile Healthcare Communications: Case Studies and Roundtables

Presented by the Business Development Institute (BDI)

New York City, Wednesday 19 Jan 2011

Your reporter is Donna Cusano

The content of this semiannual half-day conference on mobile healthcare was oriented primarily for pharmaceutical marketers and communicators. Thus most of the case studies presented were from the pharmaceutical sector, with an emphasis on patient (primary) and physician information delivered via smartphones. Leavening this was a discussion of texting in an adolescent health program here in NYC. A lively tweetstream, projected on a small screen stage right, kept a running commentary and also outside links to videos and other source material.  It is available at #BDI with a transcript of the day’s activity provided by Bridge 6. (Ed. Donna is @deetelecare) 

 

Highlights:
Pfizer and health management.
No exception to the cautious approach pharmaceutical companies tend to (or must) take with social media and partnerships, the heart of Kate Bird’s (Director of Digital Communications Policy) presentation centered on four apps, two outside the US: the partnership with Epocrates enabling direct contact with medical professionals to report adverse events; Smidge in Canada, a behavioral modification app to encourage healthier habits; Protonix mobile co-pay and refills, using designated text codes; and in Hong Kong, Pfizer Nutrition and Yahoo!‘s educational app that lets parents create flash cards for children, using preloaded forms.  What’s surprising is that all these apps are for iPhone only, with no plans to add Android and (ex US) Symbian—but 70% of their searches are from Apple devices (one tweet: Android users don’t get sick)
Ms. Bird is forecasting that apps are becoming saturated anyway, with which many in the audience, including this editor, concurred.) Another surprise: despite quadrupling in traffic recently, Pfizer’s website has only just been redone for mobile, which will enable the current 1% of their website impressions to grow and to benefit on what they have found is a lower cost per click cost. (Memo to Pfizer: your patients are not only using Android phones, but many will be buying tablets (and not just iPads.)

 

Joe Grigsby (Director, Emerging Media) from agency VML presented the case history on Text4Baby, the nearly two year old prenatal health reminder SMS for mothers [TA 8 Nov] which is 6 million texts to date; with 100,000+ users T4B is projecting an eventual 1 million.  Among future professionals, 25% of nursing students use iPhones, 70% of medical students have iPhone/iPod. But his points were strategic, reminding the audience that even though mobile is the ‘new norm’ for a younger age group, it doesn’t change marketing fundamentals and the need to develop a marketing strategy.  If anything, mobile has enhanced consumer control (as long as their information is secure). Smart marketers have to think even more about the end user and their individual goals as shaping the value proposition, not what app to make; what they are doing and how to add value. (Slideshow available at Slideshare)

 

Helping ACCU-CHECK diabetes monitor users better understand their condition and how to manage it is Roche Diabetes Care’s ‘Glucose Buddies’ iPhone app (again, no mention of Android). This free app also gathers general demographic information for Roche which is a secondary business goal, in addition to patient education. This information sparked a Twitter commentary on tradeoffs on privacy for ‘value’ although the data is ‘de-identified’.  The lack of a Spanish-language version that would be targeted to Hispanics who have, as a population, an above-average incidence of diabetes, also prompted a few choice tweets. Presented by Todd Siesky, PR Manager, Roche Diabetes Care.

 

Monique Levy’s review of Manhattan Research’s recent mobile-related studies touched on some points already made on Telecare Aware. Key highlights:

Physicians and mobile
* Doctors are abandoning the mainstay BlackBerry for the iPhone, with Android down the list (for now)
* MR projects that currently 72% of physicians have smartphones, projecting that 81% of doctors will have a smartphone by end of year, accelerating their year-ago projection by a year. [TA 3 Mar]   25% will have iPads and/or tablets (note the Dell Streak is targeting healthcare enterprise: TA 15 Sept ).
* Health info outpoints health tools. Visiting websites is as common as using apps like Epocrates, Medscape Mobile and Skyscape—doctors are seeking information (note to pharma companies, publications and references—time to get mobile versions of your websites)
* 65% of physicians use smartphones to check e-mails, but 41% are using mobile Websites and 38% apps.
* The greatest uses of smartphones (@50% in descending order): drug reference databases, clinical/medical references, reading medical journals, treatment guidelines, prescription dosage calculator)
* Remote patient monitoring is underdeveloped at 10%–same as writing medical notes

Consumers and mobile
* Again, health info outpoints health ‘tools’ or apps
* And it won’t come from pharma companies: 71% of those age 35+ are “not interested” in mobile services from a pharma company. (What will pharma do to win them over?)

 

Leaving the lofty heights of pharma-land for the streets of the South Bronx and East Harlem, Dr. Katherine Malbon of the Mount Sinai Adolescent Health Center (MSAHC) shared how her idea to connect young patients with their ‘health home’ at MSAHC via text messaging and social media turned into a six-month successful program, ‘Text in the City’.  Teens opt-in for information, individual answers to their questions (within 24 hours, birth control reminders (most requested) and weekly ‘HealthBytes’ of advice.  Texting and often unlimited plans are ubiquitous (95%) in this population and age group—an amusing example was a teenaged girl texting non-stop as she received a physical exam! But privacy is a concern—users are reminded to delete their perhaps sensitive texts. Dr. Malbon’s passion is clearly serving teens—trained as a paediatrician and working in several Central London hospitals, she moved to the US as adolescent medicine is not a recognized sub-specialty in the UK.

 

Rounding out the conference was more on marketing and communications from Porter Novelli’s EVP Social Media, John Havens.  One memorable quote:  “If you want to speak doctor – speak mobile.” With the PwC findings of 56% of Americans liking the idea of remote healthcare and 41% via mobile phone—he focused on the less conventional as ‘pointers to the future’, such as earplugs that gauge your eating and wirelessly report activity (U. of WA), the Kaiser WeightMate app acting like a Chinese mother after you brought home a B, Frontline SMS: Medic (now Medic Mobile) in developing countries and goggles that prompt with speech and images. “Why is mobile so important for healthcare? Because it saves lives.”  Just a reminder why we are in the field…and that mobile technology is changing so quickly that unless we are otherwise funded (non-profit) developers and marketers need to focus on business case, goals and usage/ROI.

Many thanks to Maria Feola and Steve Etzler of BDI and Mario Nacinovich of AXON plus the Journal of Communication in Healthcare.

Robotic roundup at CES 2011

Perhaps overshadowed by ten jillion tablets, 3D TVs and Motorola’s Atrix, robots were also at CES, many of course from Japan and in their own TechZone. Many had something to do with cleaning, but these had applicability to healthcare: Israeli company DreamBots with their WheeMe robotic masseur that won’t fall off your back–at $69 may be next Christmas’ hit item; iRobot’s AVA self-navigating, tablet-controlled droid; Pleo RB, the cuddly dinosaur with a personality that evolves with human interaction and even knows to shiver in a cold room; the Anybot telepresence droid with a laser pointer (keep away from airports); Soft Robots from Quality of Life Technology Center to assist with activities of daily living such as feeding, dressing and transfer; and Autom, the googly-eyed robot diet mentor who tells you if you’ve been dieting or splurging. PARO, our cuddly and vocal harp seal, was also there but wandered off from this roundup. TechRepublic rounds up the robots for you.

CES 2011 telehealth highlights

Rounding up the CES news on telehealth (updated 11 Jan):

  • Mobihealthnews has a preview slideshow of what they rated as the most interesting telehealth-related items at CES.  Our top picks from theirs:
    1. the long-awaited Lifecomm mPERS from Hughes Telematics with minority partners Qualcomm and AMAC. Available end of 2011. Release. Website.
    2. AliveCor’s iPhone ECG: a case for the iPhone 4 that pairs with an app to create a clinical-quality ECG. This is probably a 2012 Game Changer (see below) if it gains FDA and CE approvals–and keeps its pricing around the rumored sub-$100 price point. Check out MedGadget and the Dr. David Albert video.
    3. iHealth Lab’s Blood Pressure Monitoring system for the iPhone (iPad and iPod): a dock and cuff combination, in release shortly
    4. Withings’ latest: the Blood Pressure Monitor cuff with a transmitter at the end that connects to an iPhone, iPad or iPod and feeds information into respective apps. This also made CNN’s top CES devices .
    5. The Ideal Life Health Tablet:  a proprietary device that claims it is ‘the first tablet that automatically synchronizes with data systems used by providers, patients or caregivers.’  Photo not available. Release.
    6. Diabetes monitoring remains hot; perhaps because of this, the devices and apps are beginning to resemble others plus variations. Consumer Cellular, a wireless provider to AARP members, is adding lifestyle apps, including diabetes monitoring. along with a GPS tracker. Release. Telcare displayed its 3GM blood glucose meter, still in prototype and with no FDA approvals, at Qualcomm’s exhibit as it utilizes Qualcomm’s M2M ‘Internet of Everything Module.’ Release.
  • The Digital Health Summit wound up its Friday conference with a panel of ‘The Game Changers of 2011’: PhiloMetron (a biotech incubator most recently known for a smart patch for diet tracking), Proteus Biomedical (smart pills), Healthsense (sensor-based telecare and security) and RSLSteeper’s BeBionic amazing prosthetic hand [TA 24 June].  [Disclosure: Telecare Aware was a media partner of the 2011 Digital Health Summit]
  • Acknowledging that not all older people want or need a high perceived level of tech in the home, Independa launched its phone-based Smart Reminders system. The family member/caregiver calendars events, appointments, activities and medication reminders online–the older person receives telephone reminders that must be confirmed. Free trial offer for six weeks, $19.95/month thereafter. Release.
  • AgeTek–the Aging Technology Alliance–had its own booth in the SilversSummit/Digital Health Summit area, plus its first annual AgeTek member meeting. Peter Radsliff, Presto CEO and AgeTek Chair, reported to this editor [Donna] tremendous interest: AgeTek is up to 47 paid members, including new members AARP, Flipper Remote, Telekin and distribution players Home Controls and HealthTech Marketing Group; 10 additional probable from interested companies. Traffic in the area (North Hall) was high, based on a live video feed I saw on Thursday. Peter also reported ‘fantastic ideas from members for 2011 initiatives’ plus an all new website to launch in a few weeks–now designed as a portal for consumers to find products and services for aging in place from AgeTek members.
  • BBC video report (2min) on the Sonamba device. Previous ZDNet report. [Steve] This table-top ‘wellbeing monitor’ from pomdevices was displayed at the i-Stage TechZone. It is designed for an older person who needs some assistance and social connectivity. It is M2M cellular and combines basicsonamba motion/sound sensors (wellbeing monitoring), med reminders, a PERS, text messaging, games and a digital photo frame (!) with an iPhone app for caregiver monitoring and adjustment. Not inexpensive (‘pure’ unit cost is $549.99 direct from the manufacturer–no retail announced yet) but with plans moderating the actual cost including monthly data charges ranging from $39-$69, it becomes 1) comparable to PERS and other devices and 2) roughly comparable to a higher end cell phone. Company is based in North Carolina, founder ex-Intel and eFusion. [Donna] Updated 11 Jan: Popular Science included Sonamba in their ‘Best of CES 2011: Products of the Future.’ Also included was the Motorola Atrix 4G [TA 7 Jan]

Connected Healthcare: MIT Enterprise Forum 17 Nov 2010

MIT Enterprise Forum of NYC

Wednesday, 17 November 2010

Reporter/Attendee:  Donna Cusano–Editor, North America

Is this a perfect storm for healthcare IT and consumer health? Panel moderator Raymond Falci (Managing Director, Cain Brothers) set out a ‘storm map’—a hospital IT spaghetti chart that represented ‘streamlined process’.

  • Business models in consumer health are fractured—whether payors seeking the next gen in disease management; pharmaceutical companies trying to increase falling sales; healthcare providers attempting to measure and manage risk (and will accountable care really work?); and consumers reluctant to pay for anything.
  • Prospect areas:  Monitoring chronic diseases, other remote monitoring, acute care post-discharge management, member health status and wellness monitoring.

Panel question #1: What are the obstacles and enablers to connected healthcare adoption?

Nick van Terheyden, M.D. (Chief Medical Officer, Nuance):  Prior experiments in paperless hospitals in 1990s unworkable because inability to transfer records and information.  Current EMRs and tablets take too much time.

Rob Dhoble (President, Diversified Agency Services Healthcare):  WebMD in 1990s opened up torrent of information, not always correct.  Understanding it is a problem for average person.  Video e.g. YouTube the most persuasive (and often incorrect) medium—video is ‘surrogate’ for information needed.  People gravitate to ‘authorities’ who make health information simple (Dr. Oz, Dr. Sanjay Gupta)

Rachel Block (Deputy Commissioner for HIT, NY State Dept. of Health):  State Health Information Exchanges (HIE or HIX) have been useful in delivering health information; most are getting tools (e.g. EHRs) to doctors.  Now emphasis on programs—care coordination, public health, mHealth.  Two factors supporting adoption—systems that are patient-centered, policies in standards and payments.

Teo Dagi, M.D. (HLM Venture Partners): 
The big question:  Do we really know if prevention, monitoring and information (data synthesized) make a difference in outcomes?
Adapting to change:  Physicians find adapting to change like connected health very difficult because of the way they are trained: to take care of patients, provide good technical care, take responsibility for patients, not populations.  Comparison:  NHS short visit system versus longer consult and options in individual care (US).  Other questions:  current comfort level in technology and transferring skills to technology.

Gopal K. Chopra, M.D. (CEO, Dauphin Health):  The system is so broken we have to reconstruct it.  IT is colliding with care—‘we built it so that we could bill.’  For instance:  we have not figured out how to make data actionable in workflow; we have looming shortages of time (e.g. pediatricians where many doctors are not full time through careers), versus demand (birth rate). Can we succeed in taking healthcare out of the enterprise (hospital)?

Panel question #2:  What is the revenue model for advanced technology?

Mr. Dhoble:  Accelerant will be the CMS non-reimbursement for preventable readmissions in 30 days in October 2011.  ‘Expert patient’ key factor (and can patients be ‘experts’?)  Leveraging media to increase learning of healthy behaviors and increase understanding.
Ms. Block:  Disincentive in healthcare reform.  Health may well become a ‘regulated utility’ that is based on scale.  (This was a surprising answer)
Dr. Dagi:  Questioned ‘scale’ paradigm.  We may wind up with a two tier system like the UK or a ‘shadow system’ e.g. privately paid concierge medicine because ‘scale’ does not work.

Panel question #3:  Will EHR adoptions fulfill the ‘vision’ of better quality healthcare in the short term?  (Answers here were especially surprising)

Dr. Chopra:  There is NO WAY that the January 2011 start of adoption and qualifying for meaningful use works.  If he were in private practice, he would run away from it!
Dr. van Terheyden:  Systems can’t extract information from the EHR and put into patient records as needed.
Ms. Block:  System is in overload because of other demands, such as transition to new coding standard (ICD-10).  Meaningful use is a distraction (!)
Mr. Dhoble:  All the stakeholders (pharma, imaging companies, etc.) are lobbying for too much to be included.
Dr. Chopra:  Right now, we are not practicing ‘clean healthcare’ and EHRs aren’t going to change this.
Dr. Dagi:  What is the standard of care?  This is a population question not an individual care question.  (Not clear from his remarks or my notes where EHRs fit in this comparison, though.)

More on Dauphin Health:  After the panel concluded, I spoke with Dr. Gopal Chopra who is their CEO. The early-stage company has designed a system, currently in test, that allows a parent to transmit information on an ill child via phone or web to a ‘virtual resident’ which compiles it and connects to the family pediatrician.  Treatment instructions are returned in 10-15 minutes.  The call is essentially triaged but speeds response back to the parent.  It is in test: their two basic websites are at www.dauphinhealth.com and www.dauphinmd.com.

Not all the questions in the session notes were answered…are they ever?…but an excellent evening (and any event at 30 Rockefeller Plaza is a treat!)

 

‘Economist’ on mHealth Summit

The Economist summarizes the mHealth Summit in a brief but meaty article that summarizes the massive detail presented.  Gates:  beyond the pilots, technology has to be replicable and scale up. Anta (Inter-American Development Bank): ‘We know little about impact and nothing about business models’.  Business interest is stimulated by 1) cloud computing applications, 2) US adoption of EHRs, 3) developing countries’ mHealth ideas and business models (such as mobile banking), 4) substituting technology for medical labor (Healthpoint Services and P&G support).  M-powered:  the convergence of mobile telephony and health care is underway.

News from mHealth Summit: Wednesday

Check this space for updates and links. As this will be a short day ending at 3pm, most news will be summarized in the afternoon (ET).

Breaking news from mHealth Summit (Tuesday)

Running coverage of the mHealth Summit. Check this space for updates and links.

Tuesday

Insight on what’s next from Bill Gates: mHealth, mCommerce and robots. Excellent summary of the Bill Gates afternoon keynote (no live video feed). Tip of the hat to Alex Howard of Gov20.govfresh.

HIStalk for Day 2 (and last for him): the keynotes and supersession plus a small session that included Vitality GlowCaps, PhiloMetron’s PMTS sensor patch and UCLA’s Dr. Ozcan’s LUCAS microscope [TA 21 May]. A must read for a contrarian, witty POV. Hat tip to the (anonymous) author, whom we hope finally got something decent to eat. We will miss him tomorrow.

In other news:

  • Norad (Norwegian Agency for Development Cooperation) is providing $1 million in support for the mHealth Alliance’s Maternal mHealth Initiative. Release. Announced by the Alliance’s chairman Tom Wheeler during the morning keynote. [Unfortunately, the best part of a somewhat comical morning keynote by Ted Turner expounding on his notions of world peace policy, wandering over the plains like one of his buffalo, with Mr Wheeler politely trying to corral him back to the mHealth point and his support on the UN Foundation’s work on eradication of malaria, polio and measles. After the umpteenth blatant plug of CNN and Cartoon Network, I ‘turnered’ the audio off.–Ed. Donna]
  • Healthpoint Services Global, Inc. announced this morning a partnership with The Procter & Gamble Company aimed at advancing a scalable, self-sustaining model for delivery of water, healthcare, and other benefits to underserved rural communities in developing countries. Healthpoint is a for-profit active in India, provides in rural clinics safe drinking water, access to qualified doctors via telemedicine, advanced on-site diagnostics and an on-site licensed pharmacy. In addition they equip and deploy village health workers with mobile phones.  P&G’s FutureWorks will provide financial support, people and in-kind services.  PR Newswire release
  • MedApps and CardioNet are forming a strategic alliance ‘to advance their positions in the mobile wireless medical market’.  What they are doing together is not clear from the release except for this from CardioNet’s CEO Joseph Capper:  ‘We are looking to MedApps to help accelerate our entry into additional areas of monitoring, and to extend our platform utilizing MedApps’ CloudCare™ technology.’  Terms not disclosed. BusinessWire. Related news: CardioNet yesterday announced a definitive merger agreement with Biotel, to close by 31 Dec.  This had been postponed since last year.  BusinessWire
  • More Text4Baby news: a multi-million dollar commitment from Johnson & Johnson to the National Healthy Mothers, Healthy Babies (HMHB) Coalition to expand the program both numerically and to add new features; Department of Defense and HRSA (Health Resources and Services Administration) are evaluating the program for the underserved and military families.  PR Newswire.

Neil Versel’s roundup today on FierceMobileHealthcare themed as highlights from the ‘Lollapalooza’ (annual US rock festival) of mHealth. Inspiring but sober. Dr. Louis Hochheiser’s (Humana) hopes on learning patient behaviors via mHealth and as a means of changing behaviors.   Prof. David Gustavson (Univ. WI)  on shortening the long timelines of pharma clinical trials (average 5 years) and other health/science breakthroughs (17 years!).  At Fierce’s executive breakfast, Centers for Medicare & Medicaid Services’ Medical Director Dr. Barry Straube on telehealth and HIT being ‘ripe for change’ and very important in the cultural change of bringing healthcare to the individual and away from ‘brick-and-mortar’.  Cell phones being used for maternal and child health and reducing mortality.  (Dr. Straube to retire 31 Jan 2011 after six years at CMS.  MassDevice)

Blog coverage of Day Two: Brannon Cullum in the Alliance for Youth Movements blog, Day Two highlights (including more on Mr Turner’s musings).  Do read down to Theresa Cullen of the Indian Health Service on how in health, our Native American citizens have attributes of both the developed and developing worlds, and Patricia Mechael’s ‘Top Ten Lessons for mHealth’.

Healthcare IT News hosted live blogging of Tuesday only. CoverIt Live replay (direct link to page):  keynotes by Ted Turner, the AM supersession and the Bill Gates luncheon, concluding with Aneesh Chopra’s hyperbolic pep talk.  They also picked up the tweetstream from #mHS10 after midday.

Breaking news from mHealth Summit (Monday)

Running coverage of the mHealth Summit.  Check this space for updates and links.

Monday

HIStalk conference summary.  Observant–and not above poking fun. Compared to others’ (HIMSS) focus on population health; heavy on the academics, NGOs, global health people–‘serious people getting serious education mostly working for noble causes underwritten by government money.’  See his points about 75% down on the mHealth business model or lack thereof; the general supposition is that mHealth will never be profitable.  Too extensive to excerpt here–they deserve extensive discussion.

  • Diversinet awarded a five-year contract to support expansion of the U.S. Army’s mCare telehealth-outreach program for members of the military recovering from mild traumatic brain injuries (TBI) and other wounds.  This follows the one-year pilot that started with the now-defunct AllOne Mobile that transitioned to Diversinet, the developer of the MobiSecure Health platform.  Release.   Diversinet booth #202-12, in the Qualcomm pavilion.  [Flashback to findings presented at ATA:  TA 21 May]
  • West Wireless Health Institute announced its first engineering prototype, Sense4Baby, a non-invasive fetal and maternal monitor that is portable and uploads data to the internet.  It incorporates cardiotocography, standard technology for measuring fetal heart rate and uterine contractions, which is typically administered in a clinical setting for 20-30 minutes per visit and is used in high-risk pregnancies.  Demo at their booth #205.  Release.
  • mHealth Alliance to receive a two-year, $1 million donation from HP.  This funding will assist the Health UnBound (HUB) online community and the Maternal mHealthInitiative.  Release.
  • Text4Baby has passed 100,000 subscribers–101,962–announced by Dr. Todd Park, CTO of Health & Human Services, which has also created a Text4Health taskforce on how to apply lessons learned from Text4Baby to smoking cessation, obesity and childhood health issues.  Mobihealthnews.  Park also announced ‘detailed plans for the government to launch a website featuring health data harvested from across HHS – a wealth of easily accessible, standardized, structured, downloadable data on health care at the national, state, and county levels, as well as by age, gender, race/ethnicity, and income.’ mHealth Alliance release  

Blog coverage of Day One:  Alliance for Youth Movements blog (Brannon Cullum) 1st day highlights

Mobihealthnews on morning keynote speaker Dr. Francis Collins:  increasing number of grants for mobile health research, highlights of NIH-funded applications and devices, the difference between developed and developing markets.