A useful White House study released: ‘Emerging Technologies to Support an Aging Population’

Just released is the 40 page Executive Branch report on technologies with the potential to better support aging in place. Emerging Technologies to Support an Aging Population was developed by the Task Force on Research and Development for Technology to Support Aging Adults organized by the National Science and Technology Council (NSTC) and the Office of Science and Technology Policy (OSTP).

The Trump Administration has made finding solutions for an aging population–now over 15 percent of the American population–a research and development (R&D) priority to enhance the functional independence and continued safety, well-being, and health of older Americans, while reducing overall economic costs and the stress on the Nation’s healthcare infrastructure. The report identifies six primary functional areas which are critical to aging adults and which should be addressed by technology:

  1. Key activities of independent living 
  2. Cognition
  3. Communication and social connectivity
  4. Personal mobility
  5. Transportation
  6. Access to healthcare

Added to this are cross-cutting themes across two or more of these functional areas.

Each of these areas are broken down into focus areas with key functional needs. From each need, the study identifies R&D topics for developing solutions. For instance, a key functional need under both independent living and healthcare is oral hygiene, and one solution is  developing systems to support personalized dental regimens.

What is attractive about this study is that it cuts to the chase in identifying the themes and the analysis leading to the R&D–and a great deal here that’s useful for developers and healthcare organizations. Hat tip to Laurie Orlov of Aging In Place Technologies, who this week also released her 2019 Technology Market Overview

 

Hackermania ‘bigger than government itself’–and 25% of healthcare organizations report mobile breaches

To quote reporter Andy Rooney, ‘why is that?’ Everyone in healthcare (with our Readers well ahead of the curve) has known for years that our organizations are special targets, indeed–by hackers (activists or not), spammers, ransomwarers, criminals, bad guys in China, North Korea, and Eastern Europe, plus an assortment of malicious insiders and the simply klutzy. Why? Healthcare organizations, payers, and service companies have a treasure trove of PHI and PII with Big Value. 

So to read in Healthcare IT News that Christopher Wray, the new director of the FBI, is saying that today’s cyberthreats are bigger than any one agency, and in fact bigger than the government itself, it gives you the feeling that the steamroller has not only run over us, but is on the second pass.

According to one reporting company, Bitglass, breach incidents were year-over-year flat (290), but the number of records affected in 2018 nearly tripled from 4.7 million to 11.5 million. Hacking finally became the top cause (45.9 percent) versus unauthorized access and disclosure (35.9 percent). Loss and theft is down to about 15 percent.

And mobile feels like that second pass. Verizon’s Mobile Security Index 2019 reports that 25 percent of healthcare organizations have had a mobile-related compromise. Nearly all hospitals are investing in mobile. In the field, doctors and other clinicians are either using issued devices or BYOD, whether authorized or not. Whether or not their organizations are using app security systems like Blue Cedar [TTA 17 Feb 18] or work with companies like DataArt on securing proprietary systems is entirely another question. Apparently it’s not a priority. According to the Verizon study, nearly half of all organizations sacrificed mobile security in the past year to “get the job done.” Healthcare Dive.

Back to Director Wray, who is urging public-private cooperation especially with the FBI, which itself has not hesitated to break encryption (e.g. Apple’s) in going after criminals’ phones.

Smartphone-based ECG urged for EDs to screen for heart rhythm problems: UK study

A UK study of patients reporting heart palpitations at Emergency Departments (EDs) compared the use of standard care at the ED versus standard care plus the use of a smartphone-based ECG (EKG) event recorder (the AliveCor KardiaMobile) to determine whether symptomatic heart rhythms were present. Often heart palpitations are transitory and triggered by stress or too much coffee, but may indicate a larger problem such as atrial fibrillation which can cause stroke, or other types of cardiac disease.

Researchers from the University of Edinburgh and NHS Lothian conducted the trial over 18 months in 10 UK hospital EDs, with a total patient group of 243. The intervention group was given a KardiaMobile and told to activate it if palpitations were felt, with results sent to a doctor. 69 of 124 reported symptomatic rhythm using the AliveCor device over 90 days versus 11 in the control group of 116. Reporting was over four times faster: the mean detection time was 9.5  days in the intervention group versus 42.9 days in the control group.

The study was funded by research awards from Chest, Heart and Stroke Scotland (CHSS) and British Heart Foundation (BHF) which included funding for purchasing the AliveCor devices. NHS England has issued statements included in the BBC News article on how they have issued AliveCor devices to “GP practices across the country as part of the Long Term Plan commitment to prevent 15,000 heart attacks, strokes and cases of dementia.” Retail pricing is US $99 and UK £99. EClinical Medicine (study) Hat tip to the always dapper David Albert, MD of AliveCor

Listening to music impairs verbal creativity: UK/Sweden university study

Take those headphones off, and think more clearly. The conventional view that music enhances creativity is being refuted by a University of Central Lancashire, University of Gävle in Sweden and Lancaster University study that has found the opposite.

When matched against respondents in library or relatively quiet natural ambient noise conditions, music listening “significantly impaired” the completion of simple but creative/problem-solving verbal tasks classified as Compound Remote Associate Tasks (CRATs), such as associating three words (e.g., dress, dial, flower), with another word (in this case “sun”) that can be combined to make a common word or phrase (i.e., sundress, sundial and sunflower). It apparently didn’t matter whether the music was instrumental or with foreign-language familiar lyrics.

It’s not a surprise as this Editor cannot work with music on for any length of time since her attention goes to the music versus what she’s working on. This is despite a misspent girlhood where she studied for exams listening to WABC’s Cousin Brucie and Scott Muni hosting New York’s Top 40 pop music. (Maybe teen brains are different?)

It’s mentioned here because music is frequently used in tech applications–in the design of music therapy in cognitive treatment and with memory-impaired seniors–and devices like Alexa at home and music in work environments are becoming pervasive. Thinking clearly and music listening may not be compatible for most people. But active listening to music alone can be quite pleasant, rather than as a background to multitasking. How listening to music ‘significantly impairs’ creativity (AAAS EurekAlert!), Lancaster University release/videos here, research study (Wiley) 

TTA’s Week: NHS loses the pagers, digital health ethical talk-talk, back to chronic condition monitoring, consumers driving health design–whatta notion!

 

 

Chronic condition telehealth monitoring is suddenly hot–again. When will digital health ethics be more than talk-talk? No more faxes, no more pagers in the NHS. Surprise! Consumer behavior should drive health tech. Plus late spring events + Connected Health Summit speaking opportunities.

And scroll below for news of The King’s Fund’s Digital Health and Care Congress, including Matt Hancock as keynote speaker on day 2. Plus 10% off registration for our Readers!

Suddenly hot: chronic condition management in telehealth initiatives at University of Virginia and Doctor on Demand (We’ve been here before)
Events, dear friends: MedTech London, Aging 2.0 Philadelphia, speakers wanted for Connected Health Summit (More for your calendar from late winter into late summer)
First they came for the fax machines….now NHS is coming for the pagers (Pretty soon it will be the stethoscopes, the furniture…)
The King’s Fund Digital Health and Care Conference announces Matt Hancock as Day 2 keynoter (He’s everywhere!)
About time: digital health grows a set of ethical guidelines (But how to put it into action beyond the nice meetings and draft principles?)
A short but canny look at consumer behavior as a driver of health technology (Design that fits into life–what a notion!)

Rounding up HIMSS and the millennial/Gen Z healthcare mindset. It’s wall-to-wall Theranos for the next few weeks. And we bid farewell to a fine (if over-parodied) actor with our video advert.

News roundup: of logos and HIMSS roundups, Rock Health’s Digital Health Consumer Adoption survey, and the millennial/Gen Z walkaway from primary care (Increasingly not trad, dad)
The Theranos Story, ch. 58: with HBO and ABC, let the mythmaking and psychiatric profiling begin! (updated) (A deluge of Theranos Analysis)
From our archives: a long buried advert (RIP Bruno Ganz) (Editors Steve and Donna salute a fine actor and fine movie–remembered, humorously)

The Topol Review’s relationship to reality explored by Roy Lilley. Robotics effects in therapy for children with autism and CP. The wind’s even more at the back of telehealth–but there are caveats. Plus Editor Charles is back with a UK digital health roundup.

Roy Lilley’s tart-to-the-max view of The Topol Review on the digital future of the NHS (This week’s Must Read)
Robots’ largely positive, somewhat equivocal role in therapy for children with autism and cerebral palsy (HIMSS)
The wind may be even stronger at the back of telehealth this year–but not without a bit of chill (VA, Virginia as indicators–and the hurdles when you get there )
A selection of short digital health items of potential interest (Editor Charles is back with views on AI and events)

The telehealth entrepreneur and the $5 million fraud = 15 years in prison. Scotland’s Current Health wins FDA clearance, Latin America telemedicine’s uncertain state, women in eHealth, and studies on digital health in health systems.

News roundup: Current Health’s Class II, Healthware Italy’s €10 million boost, the low state of Latin America telemedicine, weekend reading on digital health in health systems
Digital health versus eHealth: ‘here we go again’ with the confusion and the differences. Plus Women in eHealth (JISfTeH) (Reviving the terminology discussion)
The telehealth ‘entrepreneur’ whose $5 million funding bought stays at the Ritz and portfolios at Bottega Veneta (And 15 years in the Federal pen. Tell your mum or uncle to be wary of good stories)

Our lead this week is the sale of Tunstall’s US operation. Unicorns need to hype less and publish studies more. The King’s Fund’s two events in March and May, Bayer’s accelerator winners, and news from Apple to teledermatology for São’s spotted!

Short takes: Livongo buys myStrength, Apple Watch cozies with insurers, Lively hears telehealth and $16 million
Tunstall Americas sold to Connect America
(Tunstall conceding their business is outside the US)
Where’s the evidence? Healthcare unicorns lack the proof and credibility of peer-reviewed studies. (Unicorns need to add substance to the sparkle)
News roundup: Virginia includes RPM in telehealth, Chichester Careline changes, Sensyne AI allies with Oxford, Tunstall partners in Scotland, teledermatology in São Paolo
The King’s Fund ‘Digital Health and Care Explained’ 27 March
(Readers also get a 10% discount at the 22-23 May Congress)
Bayer’s G4A accelerator awards agreements with KinAptic, Agamon, Cyclica (DE) (A truly international accelerator program)

Latest through the revolving door is NHS’ chief digital officer, digital health may be more ‘bubbly’ than you would like, telemedicine and telehealth gain important consumer and Medicare facing ground, and fill your calendar some more!

NHS England digital head Bauer exits for Swedish medical app Kry, but not without controversy (The revolving door reveals a self-made cloud over her head)
Events, Dear Friends, Events: UK Telehealthcare, Mad*Pow HXD, dHealth Summit (Get out the calendars–and the checkbooks/app)
Telemedicine virtual visits preferred by majority in Massachusetts General Hospital survey (Over 94% loved the convenience alone)
Medicare Advantage model covering telehealth for certain in-person visits starting in 2020 (The needle moves–slowly)
It’s not a bubble, really! Or developing? Analysis of Rock Health’s verdict on 2018’s digital health funding. (‘Bubbly’ factors that may influence this year–not for the better)

We round up the Official Healthcare Circus of CES, Verily rolls along with $1 bn in investment, and Walgreens Boots finally makes an alliance splash with Microsoft

It’s Official: CES is now a health tech event (updated) (And still a circus! We round up the top coverage so you don’t have to)
News roundup: Walgreens Boots-Microsoft, TytoCare, CVS-Aetna moves along, Care Innovations exits Louisville
Verily, Google’s life sciences arm, gathers in another billion to go…where? (Updated for Study Watch clearance) (Still a mystery)


The King’s Fund’s annual Digital Health and Care Congress is back on 22-23 May. Just announced–Secretary Matt Hancock keynoting Day 2. Meet leading NHS and social care professionals and learn how data and technology can improve the health and well-being of patients plus the quality and effectiveness of the services that they use. Our Readers are eligible for a 10% discount using the link in the advert or here, plus the code Telehealth_10.


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


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We thank our present and past advertisers and supporters: Tynetec, Eldercare, UK Telehealthcare, NYeC, PCHAlliance, ATA, The King’s Fund, HIMSS, Health 2.0 NYC, MedStartr, Parks Associates, and HealthIMPACT.

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

Thanks for asking for update emails. Please tell your colleagues about this news service and, if you have relevant information to share with the rest of the world, please let me know.

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

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Suddenly hot: chronic condition management in telehealth initiatives at University of Virginia and Doctor on Demand

Chronic condition monitoring is suddenly hot. UVA has been a telehealth pioneer going back to the early oughts, with smart homes, sensor based monitoring, and remote patient monitoring. Their latest initiatives through the UVA Health System focus on preventing or managing chronic conditions. It will include remote monitoring for patients with diabetes, screenings for patients with diabetic retinopathy, home-based cardiac rehabilitation programs for heart failure patients and streamlined access by primary care physicians to specialists through electronic based consults. The program will also include specialized trainings for health care providers.

The programs are being funded by a $750,000 grant from the federal Centers for Disease Control and Prevention (CDC) and the Virginia Department of Health. UVA press release, Mobihealthnews

Mobihealthnews earlier noted that Doctor on Demand, a smaller commercial telehealth company, is also expanding in the management of chronic conditions through a new service, Synapse, that creates a digital medical home for personal data. This data can include everything from what is generated by fitness trackers to blood pressure monitors. The data can be directly shared with a provider or across health information exchanges and EMRs. Doctor on Demand plans to use this longitudinal data to identify gaps in care and increase access to healthcare services–and also integrate it into existing payer and employer networks.

This Editor recalls that this was a starting point for telehealth and remote patient monitoring as far back as 2003, but somehow got lost in the whiz-bang gadget, Quantified Self, and tablets for everything fog. Back to where we started, but with many more tools and a larger framework.

Events, dear friends: MedTech London, Aging 2.0 Philadelphia, speakers wanted for Connected Health Summit

MedTech London, 11 April, London South Bank University

LSBU, SEHTA and the GLA have an event that blends commercial partnerships with academics and developing research collaborations.  The event also includes information on the latest NIHR Funding Programme and the Simulation for Digital Health programme supporting healthtech start-ups, SMEs and the Knowledge Transfer Programme Scheme by Innovate UK. The day’s agenda and registration is here.

Aging 2.0 Philadelphia: 13 March evening

Caregiving is becoming a new frontier for innovation. This free evening hosts a panel of caregiving and home care experts. More information and registration is here.

Connected Health Summit’s Call for Speakers: 27-29 August San Diego

Parks Associates’ Connected Health Summit has opened invitations for speaker submissions on two general topics–Innovation and Partnerships and Empowering Consumers with Connected Health–each with seven sub-topics. Interested applicants should submit here by 29 March. TTA has been a media partner of the Connected Health Summit over the past few years.

First they came for the fax machines….now NHS is coming for the pagers

Bloop, Bleep. The NHS has officially announced the phasing out of pagers in hospitals by the end of 2021, with all hospitals required to have their plans and infrastructure in place by September 2020. Replacing pagers will be mobile phones, and smartphones with health communication apps, which facilitate two-way communications and coverage.

According to Digital Health, the pager-less pilot was at West Suffolk NHS Foundation Trust (WSFT), which is one of the Global Digital Exemplar (GDE) sites. The 2017 test resulted in junior doctors saving 48 minutes per shift and nurses 21 minutes on average. The platform  used was Medic Bleep, which integrates audio, text, image and file sharing on web, iOS, and Android. 

NHS is estimated to use about 10 percent of all pagers in use worldwide. The cost, according to this report in Bloomberg, is also stunning. Its 130,000 pagers cost £6.6 million ($8.6 million). A single device can cost as much as £400 pounds, which came as a great surprise to this Editor. Only one UK company, Capita Plc’s PageOne, even supports pagers. So this ‘War On Pagers’ as Digital Health dubs it, has some rationale. Supposedly, the NHS can keep some pagers for emergencies, when Wi-Fi fails or when other forms of communication are unavailable, but even that is doubtful as PageOne will likely go out of the pager business by then.

Mr. Hancock is quoted extensively in both reports. “We have to get the basics right, like having computers that work and getting rid of archaic technology like pagers and fax machines. Email and mobile phones are a more secure, quicker and cheaper way to communicate which allow doctors and nurses to spend more time caring for patients rather than having to work round outdated kit.”

In the US, pagers have largely been replaced by smartphones with advanced communication and file sharing/monitoring except in one specialty–psychiatry. Many psychiatrists in private practice retain their pagers and answering services as a needed triage between themselves and patients. (Over 55 percent of psychiatrists are also aged 55+.)

The King’s Fund Digital Health and Care Conference announces Matt Hancock as Day 2 keynoter

The latest word is that the Rt Hon Matt Hancock MP, Secretary of State for Health and Social Care, will be giving the keynote address on the second day (23 May) of The King’s Fund’s annual Digital Health and Care Congress. If you are UK-based or do business there, and you haven’t signed up…what are you waiting for? This link here or on the right sidebar will take you straight to the program site. When you’re there to register, don’t forget to use the code Telehealth_10 to get an exclusive 10 percent discount for our Readers. TTA is pleased to be again an official supporter of the Digital Health and Care Congress.

About time: digital health grows a set of ethical guidelines

Is there a sense of embarrassment in the background? Fortune reports that the Stanford University Libraries are taking the lead in organizing an academic/industry group to establish ethical guidelines to govern digital health. These grew out of two meetings in July and November last year with the participation of over 30 representatives from health care, pharmaceutical, and nonprofit organizations. Proteus Digital Health, the developer of a formerly creepy sensor pill system, is prominently mentioned, but attending were representatives of Aetna CVS, Otsuka Pharmaceuticals (which works with Proteus), Kaiser Permanente, Intermountain Health, Tencent, and HSBC Holdings.

Here are the 10 Guiding Principles, which concentrate on data governance and sharing, as well as the use of the products themselves. They are expanded upon in this summary PDF:

  1. The products of digital health companies should always work in patients’ interests.
  2. Sharing digital health information should always be to improve a patient’s outcomes and those of others.
  3. “Do no harm” should apply to the use and sharing of all digital health information.
  4. Patients should never be forced to use digital health products against their wishes.
  5. Patients should be able to decide whether their information is shared, and to know how a digital health company uses information to generate revenues.
  6. Digital health information should be accurate.
  7. Digital health information should be protected with strong security tools.
  8. Security violations should be reported promptly along with what is being done to fix them.
  9. Digital health products should allow patients to be more connected to their care givers.
  10. Patients should be actively engaged in the community that is shaping digital health products.

We’ve already observed that best practices in design are putting some of these principals into action. Your Editors have long advocated, to the point of tiresomeness, that data security is not notional from the smallest device to the largest health system. Our photo at left may be vintage, but if anything the threat has both grown and expanded. 2018’s ten largest breaches affected almost 7 million US patients and disrupted their organizations’ operations. Social media is also vulnerable. Parts of the US government–Congress and the FTC through a complaint filing–are also coming down hard on Facebook for sharing personal health information with advertisers. This is PHI belonging to members of closed Facebook groups meant to support those with health and mental health conditions. (HIPAA Journal).

But here is where Stanford and the conference participants get all mushy. From their press release:

“We want this first set of ten statements to spur conversations in board rooms, classrooms and community centers around the country and ultimately be refined and adopted widely.” –Michael A. Keller, Stanford’s university librarian and vice provost for teaching and learning

So everyone gets to feel good and take home a trophy? Nowhere are there next steps, corporate statements of adoption, and so on.

Let’s keep in mind that Stanford University was the nexus of the Fraud That Was Theranos, which is discreetly not mentioned. If not a shadow hovering in the background, it should be. Perhaps there is some mea culpa, mea maxima culpa here, but this Editor will wait for more concrete signs of Action.

A short but canny look at consumer behavior as a driver of health technology

Whether the global ‘smart home healthcare’ market actually totals $30bn by 2023, as a Research and Markets study trumpets, is debatable, but one thing that this Editor agrees with is that successful home health devices need to take a chapter from Steve Jobs’ Apple and famed industrial designer Raymond Loewy’s playbooks (search our Loewy references here) and design for how the consumer lives and would use their product. It isn’t flashy design awards, but how that technology can not only fit into a person’s life but also be an asset that they’d miss if someone took it away–a point often forgotten in the rush of initial design, testing, and funding.

Writer Scott Thielman of Product Creation Studio, a Seattle-based industrial design and engineering firm, outlines four health tech products/services that represent technology that is intuitive, easy-to-use, accessible, and, I would add, have a little something extra that makes them indispensable.

  • Athelas, a next-generation immune monitoring device that resembles an Amazon Alexa in being a 3D black cylinder. Instead of playing music, it measures neutrophils, lymphocytes, platelets, white blood cells, morphology, and cell activation all within minutes from a test strip inserted in the cylinder. (Investigational device awaiting FDA review)
  • Rochester Institute of Technology (RIT)’s smart toilet seat (which Editor Charles punningly referred to here) was tested with heart failure patients. It measured nine clinically relevant features, including weight, single-lead ECG, systolic/diastolic blood pressure, blood oxygenation and localized pulse timing, and a ballistocardiogram (BCG) for measuring the mechanical forces associated with the cardiac cycle. Normally, the patient would have to use several devices for these measurements rather than taking a seat. Speaking of the seat, it is standard white and replaces the one in the bathroom. Results were published in JMIR mHealth and uHealth.
  • ResMed’s connection of its continuous positive air pressure (CPAP) sleep apnea treatment devices to the cloud before the patient uses them, plus their patient smartphone app helps them to claim that 84 percent of new users reach the necessary usage threshold for Medicare adherence in the first 90 days of treatment.
  • Clarify Medical’s build-in of user feedback for its home vitiligo and psoriasis treatment that goes direct to their in-house customer service also registers patient usage, needed fixes, and outreach to those who need additional coaching and training.
  • Livongo’s acquisition of myStrength’s behavioral health app [TTA 31 Jan] also points to the importance of consumer behavior in a somewhat different aspect–the 20 percent and more who are struggling with behavioral health issues along with one or more chronic conditions managed by Livongo for employers and health plans.

How to design home healthcare devices that people will use (Medical Design & Outsourcing)

 

News roundup: of logos and HIMSS roundups, Rock Health’s Digital Health Consumer Adoption survey, and the millennial/Gen Z walkaway from primary care

HIMSS19 was last week. Onsite reports to this Editor declared it ‘overwhelming’, ‘the place to be’, ‘more of the same’, and ‘stale’. With a range of comments like these, everyone’s HIMSS is different, but HIMSS is well, a place that for most of us in digital health, have to be (or their companies have to be). It is still a major commitment, and if you are small, a place where you might be better off with no display and simply networking your way through. 

HIMSS must be conscious of a certain dowdiness, because HIMSS is ‘reforming’ with a preview of a new logo and graphics here that changes out their Big ’80s curvy lettering and muted colors to hard edges in typefaces and equally hard blues.

Mobihealthnews (a HIMSS company) delves into blockchain (Boehringer Ingelheim and IBM Canada) and Uber Health’s continuing foray into non-emergency medical transport. Dimensional Insight’s blog takes some of the sessions from the data governance and healthcare business intelligence perspective, including the opioid crisis, AI to detect cancer (the link between falling hemoglobin rates and a cancer diagnosis), and pediatric disease registries. And there is the always incisive HISTalk with last Monday Morning’s Update, their 2/14/19 roundup, and Dr Jayne’s Curbside Consult on John Halamka’s world travels, including nascent care coordination in China and interoperability in Australia.

Rock Health’s survey of consumer attitudes towards digital health adoption leads with these insights:

  • Wearable use is shifting away from fitness toward managing health conditions
    • There was a 10% increase in use of wearables to manage health, corresponding to a 10% decline in physical activity tracking
  • Telemedicine adoption is climbing, with urban consumers more than twice as likely to use live video telemedicine than rural consumers
    • Paradoxical but true, in terms of adoption of at least one form, it was 67 percent for rural residents and 80 percent for urban residents.
  • Highly trusted entities like physicians and health plans lost credibility in 2018—consumers were less willing to share data with them than they were in 2017. There’s an increasing distrust of ‘big tech’ and confidence in their ability to keep private data private–a wise takeaway given the Cambridge Analytica and Facebook scandals.

More acceptance of healthcare tools, less intermediation–and not trusting that data is secure spells trouble down the road unless these issues are addressed. Rock Health surveyed 4,000 respondents of US adults age 18 and over.

They’re not trad, dad. Accenture’s survey (released at HIMSS) also tracks the rejection of intermediation and gatekeepers when it comes to millennials and Gen Z in choosing non-traditional modes of healthcare, such as retail clinics, virtual and digital services. They are two to three times more likely than boomers to dislike in-person care; over half use mobile apps to manage health and use virtual nurses to monitor health and vital signs. Over 40 percent prefer providers with strong digital capabilities. Also Mobihealthnews 

The Theranos Story, ch. 58: with HBO and ABC, let the mythmaking and psychiatric profiling begin! (updated)

This Editor thought that her next articles about Theranos would be trial coverage. There are court dates pending for Elizabeth Holmes and Not-So-Sunny Balwani–with the DOJ for 11 counts of wire fraud [TTA 16 June] and, for Mr. Balwani, with the SEC on (civil) securities fraud [TTA 15 March]. 

Instead, Theranos hits the headlines again. On 18 March, there’s the debut of an HBO documentary on Theranos. Titled The Inventor: Out For Blood In Silicon Valley (YouTube preview), we can treat ourselves once again to the SteveJobs-esque presence of Ms. Holmes, down to the unnaturally deep voice, blondined hair, and wide blue eyes, unpacking the deception and fraud that was part of the company from early days. But that’s not all! There’s a six-part ABC Radio ‘Nightline’ docu-podcast that started on 23 Jan and airs in six parts through February, which includes audio of depositions taken of board members, whistleblower Tyler Shultz, and patients affected by bad test results. (This Editor will give a listen on this alone.) Episode 5 and links to 1-4 are here via Yahoo.

On websites, we’re regaled with rehashes. The articles range from Teasing the Doc to Where The Ex (Balwani) Is Now (they don’t know) to What Is Her Net Worth (not $4.6 bn). There’s even a flurry of sensational podcasts and videos on YouTube–just Google them. 

Fascinating Fraud. There’s fascination in The Long Con perpetrated by the principals, and less examined, our tendency to Want To Believe. Many of us like legal procedurals and the drama inherent in them (the eternal appeal of the long-running Law & Order in several countries.) Let’s face it, there’s a substantial dollop of schadenfreude mixed in.

What we are witnessing is the building of a myth, increasingly divorced from the real world where it happened, and not improbably or with superpowers. 

Where it goes a little off the cliff. There is a curious article in Forbes that is written by a contributor who writes and teaches courses on stocks and entrepreneurship. He interviewed a former neighbor of Ms. Holmes, Richard Fuisz, MD. It turns out this psychiatrist, inventor, and former CIA asset knew her in childhood. The families were friends and Dr. Fuisz helped out her father when he hit a bad patch. There’s some sketchy profiling in this article, but it does make a fair attempt to get to the heart of the forces that put the gap in Elizabeth Holmes’ ethical makeup, including the Big Steal of Ian Gibbons’ IP. His position is somewhat complicated by a patent dispute (settled) between Dr. Fuisz & Son and Theranos. He’s still hammering on at it on Twitter (@rfuisz).

What’s missing? Much credit to the estimable John Carreyrou, who broke the story in the Wall Street Journal and got his livelihood (and perhaps a few other things) threatened a few times by Tough Guy Lawyer David Boies.

(Updated) At least it is here in a Vanity Fair article on the Last Days of Theranos, where they had to move to downscale Newark (California) and Ms. Holmes’ dog pooped where he wanted to poop. Her ‘persecution’ doesn’t seem to faze her from living in SF, frequenting cafes with said dog, and her new romance with a ‘younger hospitality heir’–a far cry from her former employees who wear the months or years of their lives at Theranos like a Scarlet Letter as they look for work and loose cash in the sofa.

We’ve gotten to the point where the hard business analysis ends and the looser parts of psychologizing begins, as we attempt to understand why. Beyond a certain point, does why matter when damage to real patients has been done? Collateral damage persists in funding of startups and for entrepreneurial women in health tech.

For this Editor, she looks forward to the warmer weather, when it’s expected when the Legal Action–and reality–resumes. 

TTA’s Week: Eric Topol does the NHS’ future, robotic therapy for autistic children, telehealth’s wind at back, and Editor Charles’ roundup

 

The Topol Review’s relationship to reality explored by Roy Lilley. Robotics effects in therapy for children with autism and CP. The wind’s even more at the back of telehealth–but there are caveats. Plus Editor Charles is back with a UK digital health roundup.

And scroll below for news of The King’s Fund’s Digital Health and Care Congress–plus 10% off registration for our Readers!

Roy Lilley’s tart-to-the-max view of The Topol Review on the digital future of the NHS (This week’s Must Read)
Robots’ largely positive, somewhat equivocal role in therapy for children with autism and cerebral palsy (HIMSS)
The wind may be even stronger at the back of telehealth this year–but not without a bit of chill (VA, Virginia as indicators–and the hurdles when you get there )
A selection of short digital health items of potential interest (Editor Charles is back with views on AI and events)

The telehealth entrepreneur and the $5 million fraud = 15 years in prison. Scotland’s Current Health wins FDA clearance, Latin America telemedicine’s uncertain state, women in eHealth, and studies on digital health in health systems.

News roundup: Current Health’s Class II, Healthware Italy’s €10 million boost, the low state of Latin America telemedicine, weekend reading on digital health in health systems
Digital health versus eHealth: ‘here we go again’ with the confusion and the differences. Plus Women in eHealth (JISfTeH) (Reviving the terminology discussion)
The telehealth ‘entrepreneur’ whose $5 million funding bought stays at the Ritz and portfolios at Bottega Veneta (And 15 years in the Federal pen. Tell your mum or uncle to be wary of good stories)

Our lead this week is the sale of Tunstall’s US operation. Unicorns need to hype less and publish studies more. The King’s Fund’s two events in March and May, Bayer’s accelerator winners, and news from Apple to teledermatology for São’s spotted!

Short takes: Livongo buys myStrength, Apple Watch cozies with insurers, Lively hears telehealth and $16 million
Tunstall Americas sold to Connect America
(Tunstall conceding their business is outside the US)
Where’s the evidence? Healthcare unicorns lack the proof and credibility of peer-reviewed studies. (Unicorns need to add substance to the sparkle)
News roundup: Virginia includes RPM in telehealth, Chichester Careline changes, Sensyne AI allies with Oxford, Tunstall partners in Scotland, teledermatology in São Paolo
The King’s Fund ‘Digital Health and Care Explained’ 27 March
(Readers also get a 10% discount at the 22-23 May Congress)
Bayer’s G4A accelerator awards agreements with KinAptic, Agamon, Cyclica (DE) (A truly international accelerator program)

Latest through the revolving door is NHS’ chief digital officer, digital health may be more ‘bubbly’ than you would like, telemedicine and telehealth gain important consumer and Medicare facing ground, and fill your calendar some more!

NHS England digital head Bauer exits for Swedish medical app Kry, but not without controversy (The revolving door reveals a self-made cloud over her head)
Events, Dear Friends, Events: UK Telehealthcare, Mad*Pow HXD, dHealth Summit (Get out the calendars–and the checkbooks/app)
Telemedicine virtual visits preferred by majority in Massachusetts General Hospital survey (Over 94% loved the convenience alone)
Medicare Advantage model covering telehealth for certain in-person visits starting in 2020 (The needle moves–slowly)
It’s not a bubble, really! Or developing? Analysis of Rock Health’s verdict on 2018’s digital health funding. (‘Bubbly’ factors that may influence this year–not for the better)

We round up the Official Healthcare Circus of CES, Verily rolls along with $1 bn in investment, and Walgreens Boots finally makes an alliance splash with Microsoft

It’s Official: CES is now a health tech event (updated) (And still a circus! We round up the top coverage so you don’t have to)
News roundup: Walgreens Boots-Microsoft, TytoCare, CVS-Aetna moves along, Care Innovations exits Louisville
Verily, Google’s life sciences arm, gathers in another billion to go…where? (Updated for Study Watch clearance) (Still a mystery)

Our first full week in January is full of news and events, from CES to RSM, plus lots of healthcare acceleration!

News roundup: CES’ early beat, CVS-Aetna pauses, digital health fizzes, Yorkshire & Humber Propels
Events, Dear Friends, Events part 2: Newcastle and Texas accelerate, Aging2.0 NYC gets happy, AutoBlock’s Meetup, Wearable Tech, HealthImpact East
Events, Dear Friends, Events: Hancock at the RSM, MedStartr NOLA Challenge, RSM and The King’s Fund

We start our 2019 first in West Africa with a health facility mapping initiative addressing epidemics and service distribution. On to the UK with Babylon Health’s chatbot problems revealing an increasingly fractious relationship with the business press–one of our most read articles ever. And 3rings may be exiting, but doing so with grace and consideration–another Top Read.

Healthsites, eHealth Africa mapping health facility locations in West Africa to improve emergency care (Fighting epidemics and improving disaster response using health tech)
Is Babylon Health the next Theranos? Or just being made out to be by the press? (Soapbox) (A few best practices might stop a growing pile-on–or a Big Problem)
3rings’ well-handled transition to their March shutdown (updated) (Referring their clients to other UK companies based on the customer’s needs) 


The King’s Fund’s annual Digital Health and Care Congress is back on 22-23 May. Meet leading NHS and social care professionals and learn how data and technology can improve the health and well-being of patients plus the quality and effectiveness of the services that they use. Our Readers are eligible for a 10% discount using the link in the advert or here, plus the code Telehealth_10.


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

Thanks for asking for update emails. Please tell your colleagues about this news service and, if you have relevant information to share with the rest of the world, please let me know.

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

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Roy Lilley’s tart-to-the-max view of The Topol Review on the digital future of the NHS

Well, it’s a blockbuster–at least in length. Over 100 pages long, and in the PDF form double-paged, which will be a tough slog for laptop and tablet readers. It’s Eric Topol’s view of the digital future of the NHS and it’s…expansive. In fact, you may not recognize it as the healthcare world you deal with every day.

Our UK readers may not be so familiar with Dr. Topol, but here you can get a good strong dose of his vision for the NHS’ future as delivered (electronic thunk) to Secretary Hancock. I haven’t read this, but Roy Lilley has. You should read his 12 February e-letter if you haven’t already.

Here is a choice quote: It’s a mixture of science faction, future-now-ism and away-with-the fairies.

Here’s some background. The Vision’s been around for awhile. Dr. Topol thinks and talks Big Picture, in Meta and MegaTrends. His view is patient-driven, self-managed, with their genomic sequenced and at their fingertips, with the doctor empowered by their records, his/her own digital tools for physical examination, with AI to scan the records and empower a partnership model of decision-making.

Topol In Person is quite compelling. This Editor’s in-person take from the 2014 NY eHealth Collaborative meeting is a review of vintage Topol. His expansive, hopeful view was in contrast to the almost totalitarian view (and it is fully meant) of Ezekiel Emanuel, with his vision of the perfectly compliant, low choice patient, and squeezed like a lemon medical system. At that time, I concluded:

One must be wary of presenters and ‘big thinkers’–and these doctors define the latter, especially Dr Emanuel who looks in the mirror and sees an iconoclast staring back. Fitting evidence selectively into a Weltanschauung is an occupational hazard and we in the field are often taken with ‘big pictures’ at the expense of what can and needs to be done now. Both Drs Topol and Emanuel, in this Editor’s view, have gaps in vision.

A year later, I reviewed his article The Future of Medicine Is in Your Smartphone which came out at the time of ‘The Patient Is In.’ which was quite the succès d’estime among us health tech types. “The article is at once optimistic–yes, we love the picture–yet somewhat unreal.” It seemed to fly in the face of the 2015 reality of accelerating government control of medicine (Obamacare), of payments, outcomes-based medicine which is gated and can be formulaic, and in the Editor’s view, a complete miss on the complexities of mental health and psychiatry.

Back to Roy Lilley:

There is an etherial quality to this report, spiritual, dainty. The advisory panel is 70 strong.

Studies and citations galore, from the world’s top research organizations. The advisory board–I believe well over 70–there’s not a soul down in the trenches running a hospital. Government, academics, and a few vendors (Babylon Health, natch). A lot of emphasis on AI, genomics, and training for ‘collective intelligence’. After reading but a few dizzying, dense pages, I admire the vision as before, but wonder again how we get from here to there.

Roy’s essay is a must read to bring you back to reality. 

Robots’ largely positive, somewhat equivocal role in therapy for children with autism and cerebral palsy (HIMSS)

A Georgia Tech study presented at this week’s HIMSS19 conference presented findings of an eight-week study of children with specific neurological conditions who were assisted by robotics in specific therapies for movement and cognition. The study began with the simple attraction of children to robots. Robots also don’t have the negative connotations of therapists, and in fact, based on the studies cited, robots  are more trusted than humans by both adults and children.

For a child, robots ‘repetitive and predictable interactions’ can be reassuring (like Pepper in a Belgium hospital two years ago) , along with ‘gamified’ therapies and child-robot direct interaction as well as therapist-guided. The study’s approaches took several forms:

  • Virtual reality therapy games
  • Guided physiotherapy in movement–gross and fine motor skills
  • Cognitive therapy to improve attention span
  • ‘Gamified’ therapy
  • Robot therapy coaching
  • Tablet-based games

At the start of the study, physical and cognitive baselines were taken and retested at four weeks. By eight weeks the difference in movement parameters between normally developing children and those with cerebral palsy had largely equalized. In a second study, when the robots were withdrawn, their improvement decreased, but not back to baseline. The researchers’ concern was of course, dependency on the robots for therapy on a long term basis. HIMSS presentation by Ayanna Howard, professor of robotics at Georgia Tech is currently online–view quickly as usually they are withdrawn shortly after HIMSS is over.  Mobihealthnews