When mHealth and telehealth become ‘just healthcare’ (US)

GovernmentHealthIT reports that, speaking yesterday during the first day of the World Congress on mHealth and Telehealth in Boston, US, Jonah J. Czerwinski said Veterans Affairs (VA) had managed the health of some 500,000 people using telehealth in 2012.  He expects this to rise to over 600,000 this year.  He is senior advisor to the Secretary of the U.S. Department of Veterans Affairs, where he leads the VA Center for Innovation.  That’s some endorsement for telehealth!

“It’s connected healthcare – no ‘tele-,’ no ‘m-,'” he is reported to have told the audience: “This is just healthcare.”

Picking up on the topic of automating telehealth monitoring, he also described how the VitaLink home monitoring system, one of the VA’s more promising telehealth projects, has been developed by the VA from algorithms used in the mining industry to detect when drill bits embedded deep in the earth were stressed out and ready to fail.

Soapbox: Further thoughts on CarelineUK, O2 & WSD

The many, excellent, comments on O2’s withdrawal of their current telecare & telehealth offerings in the UK market, most notably from my fellow editor Alasdair Morrison, have prompted further thoughts on the post about CarelineUK’s 25th anniversary earlier today: what will CarelineUK,  and other organisations like it, look like in 25 years’ time?

Perhaps the most significant change that appears to be coming in the area of telemonitoring is  (more…)

CarelineUK celebrates 25th Anniversary

Congratulations to CarelineUK on the 25th anniversary of the receipt of their first emergency call.  According to the announcement on their website they are now the largest monitoring centre in the UK, covering over 110,000 service users across the country.  Over 120 people work at their New Forest call centre which has the ability to integrate telecare & telehealth monitoring. and is compatible with digital networks.

Telehealth – the RSM guide

Some while back a suggestion was made that the Royal Society of Medicine produced a short guide to telehealth that gave an unbiased a view as possible of the topic.

Well it’s now been published on the website and will also be available in print at selected conferences and similar gatherings.  The intention is that it can be given to clinicians, patients and other interested parties that want to know more.  It is also unashamed publicity for the RSM’s (unbiased) telehealth-related events, for those that want to know even more – the website version will be refreshed as events come & go.

I should immediately declare an interest as one of the authors – the others are Prof Brian McKinstry, Dr Richard Williams and Helen Lyndon.

Special thanks to inHealthcare and medvivo for their kind sponsorship.

Hope you like it!

Leicester City CCG sets impressive standard for COPD telehealth savings

EHI describes what looks to be a hugely impressive COPD project being run by NHS Leicester City CCG.  Using a “definition of saved admissions that identifies when a clinical intervention has been made that stops a patient being admitted to hospital within 14 days” they reckon they have prevented 107 hospital admissions over the past 30 weeks and they are currently up to only 47 patients.  As these 30 weeks referred to will have spanned the winter months (usually the worst time for COPD exacerbations) even if there are no avoided hospitalisations at all in the remaining 22 weeks to the first anniversary of the project, on these figures they are preventing upwards of (more…)

O2 to stop selling telecare & telehealth in the UK

To quote from the O2 website: “We would like to let you know that O2 Health has taken the difficult decision to stop selling our telecare (Help at Hand) and telehealth (Health at Home) in the UK. We will cease providing the Help at Hand and Health at Home services to existing customers.”

There are more details on the website – the reason given for the decision is that the uptake of mobile telecare and telehealth in the UK marketplace has been slower than anticipated.

As someone who attended the launch of Help at Hand in March, and who has been really excited about O2’s decision to move into the end-consumer market as the harbinger of the development of a consumer telemonitoring service market, this has left me in a state of shock.

There are of course now apps that can make a standard smartphone or tablet behave in a similar manner to the dedicated kit that O2 has provided.  However the principal challenge with retail sales of telecare and telehealth has always been the monitoring/response end, which O2 will now presumably be withdrawing.

A sad day!

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/07/o2-on-sale-after-withdrawl-26jul13.jpg” thumb_width=”200″ /]Update 26 July: A reader has sent us a snap of the O2 display taken today at their local (Hertfordshire) Tesco pharmacy counter. That person spoke with the pharmacist who said they hadn’t been told it had been withdrawn! This Editor (Donna) notes that the display is jammed in adjacent to the £5 Cholesterol Check and flyers for ‘Are You At Risk For Diabetes?’ Aside from its unattractiveness and medicalization, whatever happened to what presumably was the marketing takeaway message–freedom to live life out of the home in safety for the first time, delivered simply? Looks like the POS (point of sale) missed that all-important mark.

Stats on medical apps on Apple & Android

iMedicalApps reports on the latest stats on medical apps on Apple & Android.  Overall figures show Apple with more than twice as many as Android.  It would be interesting to know how that split would be for apps aimed at patients – notwithstanding the previous post, I get the impression that the balance between the two is evening up.

There is a stark contrast between these numbers (over 19,000 for Apple, just over 8,000 on Google Play) and the small number of medical apps approved by the FDA (just over 100 according to a comment on the report) and on the NHS Choices health apps library.  Even making a very generous allowance for clinician-focused apps, this still emphasises the importance of the work underway just now on ordering the market to give users greater confidence in the safety and efficacy of what they download.

Clever use of augmented reality in patient education medical app (iOS)

iMedicalApps reports the first example it has seen of the use of augmented reality in an app aimed at educating customers – in this case about eye problems.  The iTunes link for EyeDecide is here.  The app is produced by Orca MD.

Looks an impressive app.  The example shown is of the effect of age-related macular degeneration: anything that can encourage people to have their eyes regularly checked by showing them what happens if they don’t has to be good.

Establishing high-level evidence for the safety and efficacy of medical devices and systems

I have recently been made aware of an excellent publication jointly by the Royal Academy of Engineering and the Academy of Medical Sciences entitled Establishing high-level evidence for the safety and efficacy of medical devices and systems, so this post is to reach out to those like me who were previously unaware.

It is a major step forward in applying engineering methodology to evaluating the effectiveness of medical devices & systems and, even more important, ensuring their ongoing safety.  Those of us who have participated in a substantial randomised control trial such as the Whole System Demonstrator (see earlier post today) will take great interest at what follows the quote: “For pharmaceutical innovation, the randomised controlled trial is the acknowledged gold standard for creating a body of high-quality evidence. But designing clinical trials to establish the evidence for medical devices has proven more problematic.”

(Included in the paper is the observation  that the ultimate health improvement device when you leave an aeroplane that is in the air – the parachute – has never been proven by an RCT.)

Finally just to return to an earlier comment, the report makes the point that because medical devices can be changed far more often than the composition of a drug, the importance of appropriate safety monitoring is absolutely critical, an issue that is becoming increasingly relevant as penetration of telehealth (in particular) and telecare increases.  Whilst  we might choose to ignore the different nature of medical devices when assessing a trial, we cannot ignore the different nature of medical devices when designing and putting in place appropriate safety systems.

Digital economy twice the size the government thought it was (General interest)

The FT reports that the National Institute of Economic and Social Research conservatively estimates that there are 270,000 digital companies compared to less than half that estimated by the government.

The report, just out, supported by Google, is entitled Measuring the UK’s Digital Economy With Big Data.  As the title suggests, it makes a strong case for the use of extensive data analysis in determining that the digital economy  has spread into every sector of the economy.

Hal Varian, Chief Economist of Google, wrote the foreword which includes the only reference to ‘biotech’ specifically in the report: “The UK is one of the world’s strongest internet economies yet the myth persists that it consists largely of tiny dotcom or biotech startups in a few high technology clusters that quickly bubble up and often go bust.”

Telehealth Soapbox: Time to bid farewell to the WSD?

TTA Contributing Editor Charles Lowe asks whether it is now time to stop looking back to the UK’s pioneering Whole Systems Demonstrator (WSD) programme.

As the person who led the bid for Whole System Demonstrator status for LB Newham back in 2006/7, this is my case that it’s time now to bid farewell to the programme, as soon as is possible.

Why?  This was a great programme that came up with some encouraging results for telehealth, and taught us a huge amount about how best to implement telehealth and telecare.  However the echoes from that long gone time are increasingly providing ammunition for the naysayers, when in reality the world is now a totally different place.  The technology is unrecognisable from that that we considered when bidding for the WSD in 2006; it is far more efficacious and far cheaper; and it can be deployed much faster & for many more conditions, opening up many possibilities not available to us when we won in 2007.  We now know much more about how to implement the technology too: in particular it delivers greatest benefit when a part of an overall programme for improving care and not, as the WSD randomised control trial (RCT) treated it, as a simple intervention, like most drugs.  In retrospect therefore there were significant weaknesses in the way the trial was run.

The continuing drip-feed of WSD results is sadly resulting in (more…)

Hospitals can benefit from telemonitoring (US)

As someone who has spent a huge amount of time attempting to persuade acute trusts in the UK that telehealth is in their interests (with, I’m glad to say, a modicum of success more recently) it is good to see this paper entitled The Financial Impact of a Pediatric Telemedicine Program: A Children’s Hospital’s Perspective in the July 2013 edition of the Journal of Telemedicine & e-Health (freely accessible).  The key finding is (more…)

App platforms & mobile devices: what’s hot and what’s not (free report)

Readers might be interested in an excellent free report entitled “Developer Economics 3Q 2013: State of the Developer Nation” produced by VisionMobile.  Based on a survey of 6,000+ respondents from 115 countries it charts the fortunes of the different app platforms, and of the hardware suppliers on which those apps sit.

Just one quote to whet your appetite:”2013 presents an inflexion point in the evolution of app ecosystems.”

Many thanks to Professor Mike Short for the pointer.