The evolution of Facebook: implications for social health

The Telegraph’s recent retrospective on Facebook and its evolution from 2004’s ‘Thefacebook’ of Harvard University students to the Facebook that many of us use now, with Chat, timeline and a converged mobile and desktop design, led reader Mike Clark to drop Editor Charles a line about how healthcare isn’t maximizing social media and internet-based innovation. Recent studies have indicated that these social patient communities benefit their members. Agreed, but there are increasing qualifications–and qualms.

Back in 2014, Facebook made some noises on forming its own online health communities, a move that was widely derided as Facebook monetizing yet another slice of personal (health) data from users. While Charles has made the excellent point that “almost all good health apps are essentially the tailored interface to an internet service that sits behind it, a fact often forgotten by commentators”, Editor Donna on her side of the Atlantic has seen concerns mount on privacy, security and the stealthy commercialization/monetization of many popular online patient support groups (OSGs) which Carolyn Thomas (‘The Heart Sister’) skewers here, excepting those with solid non-profit firewalling (academic, government, clinical). Example she gives: Patients Like Me, which markets health data gathered from members to companies developing products to sell to patients. How many members, with a disease or chronic condition on their mind, will browse through to this page that says in part: “Except for the restricted personal information you entered when registering for the site, you should expect that every piece of information you submit (even if it is not currently displayed) may be shared with our partners and any member of PatientsLikeMe, including other patients.”

We’ve also noted that genomics data may not be sufficiently de-identified so that it can’t be matched through inference [TTA 31 Oct 15], with the potential for sale. And of course Hackermania Running Wild continues (see here).

For now general information sites like WebMD and personalized reference sites such as Medivisor feel more secure to users, as well as small non-commercialized OSGs and ‘closed’ telehealth/telemedicine systems.

Mississippi to get VA telemed pilot amid controversy

Mississippi has led the way in telemedicine projects in southern USA for some time with the University of Mississippi Medical Center’s various successful projects click to enlargeattracting well deserved funding. Now the US Secretary of Veteran’s Affairs has announced that a new pilot programme to use telemedicine to reduce wait times for new patients at VA hospitals will take place in Mississippi.

This pilot programme comes in the wake of the highly criticised wait times reported for new patients at VA hospitals in 2014. A CNN report based on internal VA documents claimed that thousands of veterans had to wait more than three months to see a specialist.

(more…)

IBM automates diagnostic image analysis

“Most smart software in use today specialises on one type of data, be that interpreting text or guessing at the content click to enlargeof photos. Software in development at IBM has to do all that at once. It’s in training to become a radiologist’s assistant” writes Tom Simonite in MIT Technology Review.

According to Simonite, the IBM software, named Avicenna, analyses diagnostic images like CT scans and the associated data such as a patient’s medical record and suggests possible diagnoses.

An example quoted was the case of a 28-year old with shortness of breath whose pulmonary angiogram images and medical history were analysed by the software. Using a family history which showed a tendency to form blood clots the software diagnosed a pulmonary embolism which was the same diagnosis an independent radiologist reached.

Simonite reports that IBM have thus far used annonymised data and are now working on commercialising the software although an independent researcher is quoted as saying that the accuracy needs to be increased before it would be a useful diagnostic tool.

Read the full article here.

Philips, Validic partner on health data integration

click to enlargeEarlier today, Philips and health data ‘connector’ Validic announced a partnership where Philips’ multi-part HealthSuite digital health platform will expand with Validic’s access to third-party device data. The surprise is how much data Validic now can access: a claimed 223 million people in 47 countries, which was a surprise to this Editor. Philips’ HealthSuite includes Personal Health Programs, the Lifeline PERS line, eCareCoordinator and eCareCompanion eHealth applications. Exactly how Philips will use this access is not disclosed. Philips release

Can technology help to bridge the Loneliness Factor?

The Guardian’s impassioned article on how common and harmful loneliness is among older adults led to some reflection by this Editor on how difficult and ‘multi-part’ an approach to help can be, even if you call it ‘The Campaign to End Loneliness’. “Studies have found loneliness can be more harmful than smoking 15 cigarettes a day, increases the risk of premature death by 30% and the chances of developing dementia by 64%. More than one million people aged over 65 are thought to be lonely – around 10-13% of older people.”–statistics from the article and AgeUK’s press release on their recent study, ‘ Promising approaches to reducing loneliness and isolation in later life’.  GPs see a lot of them, and some more for an ‘event of the day’ than actual medical need. Loss of hearing, sight and mobility further isolate the older person, particularly those in rural areas where everyone and everything is at a distance requiring driving, creating dependency among those who can no longer. Even among the middle-aged, loss of hearing reduces engagement in social situations. (And the article does not include the disabled.) It closes with suggestions that councils need to budget for and organize programs to reach out to lonely adults, including carers, and that not one approach can fit all, but emphasizes more personal approaches such as groups and one-on-one support. Hat tip to Malcolm Fisk via Twitter

Is a way to fight the Loneliness Factor located in technology, even remote patient monitoring? That’s been the primary reason for some systems such as GrandCare, but even in RPM, whether hub-based or smartphone/tablet based, the reminders and active clinician monitoring part of chronic care management can and do engage. Older people are using smartphones and tablets–perhaps not as fully as a 40 year old, but they are using Skype, calendaring and social media (Facebook, LinkedIn and news/opinion sites). A big help here, according to Laurie Orlov, would be voice recognition and integration into safety/alarm technologies. This Editor also sees proactive alerting to changes in condition as a still-untapped area.  There’s $279 billion of potential in ‘silvertech’ as estimated by AARP and Parks Associates–it’s a matter of getting young techies/entrepreneurs excited about it, and the Sand Hill funder crowd realizing that yes, it’s sexy too. Long Term Living

Using sensors to speed scientific experimentation

click to enlargeA Boston-based startup with some impressive backing, Elemental Machines, is seeking to solve the variability problems that hinder scientific experimentation, particularly in drug development. Misfit and AgaMetrix founders Sonny Vu and Sridhar Iyengar join co-founders Elicia Wong and Gary Tsai in raising $2.5 million in seed funding, with investors including Founders Fund, backer of SpaceX and Lyft. The company’s purpose is to develop sensors (called “elements”) sending data interpreted by cloud-based software that will help scientists better detect and control for the most common variable factors that take place during experiments–temperature, humidity, vibration, light, instrumentation and protocols. The goal is to accelerate the experiment and research process so that drugs, devices and products make it to market (eventually) faster and less expensively. BostInno, TechCrunch

Is ‘telehealth lite’ good enough for the Spanish-speaking market? (US)

Pioneering or inadequate? Mercer LLC, a major employee benefits consulting company that is part of business consulting giant Marsh & McLennan, and digital health platform developer ConsejoSano (Health Advice) recently announced a partnership where Mercer will market the ConsejoSano platform to its large base of US employers and also to the wider US Hispanic market of 54 million with at least 22 million in the workforce. Their pitch is to the group most comfortable communicating in Spanish as a primary language. The service is via phone or mobile app, and connects employees to native Spanish-speaking doctors. However, you won’t be able to visit that doctor unless you go to Mexico; they are provided via Salud Interactiva S.A. de C.V., a Mexico City-based medical services/telehealth company. Because the doctors are ex-US, they cannot refer or write a prescription, and only address questions on general health needs, mental health, nutrition and chronic disease management. Still, ConsejoSano claims a 60 percent resolution of medical needs upon the first call.

This Editor asks: What about that other 40 percent? This conceivably is a ‘first turn’ service for that Spanish-speaking person, and after you’ve built up that trust, the consult isn’t completed. Why isn’t this built with warm transfer capability to US-based assistance which can refer the person to either local in-network doctors, a telehealth doctor in their employee insurance network or other assistive services? Is this a good-looking glass-half-full for the Spanish-primary speaking population? Mobile Strategies 360, Mercer release

Exploring how best to use telehealth to manage COPD – can you help?

Anyone working in telehealth knows that, of the principal long term conditions to which it is applied, COPD is the most problematic, with many telehealth trials showing no significant benefit. However in various meetings, Dr Julia Bott has tantalised me by suggesting that she and Dr Hilary Pinnock may know how to use telehealth more effectively.

Therefore, on 3rd March, we are holding a small, free, meeting at the Royal Society of Medicine in London from 3pm-5pm to examine how telehealth can be used to manage people with COPD better. Present will be both Dr Hilary Pinnock (University of Edinburgh) and Dr Julia Bott (University of Surrey).

So far we have senior representatives from two major telehealth organisations attending and probably need at least three more. If you are interested, please do email this editor, charles.lowe@btinternet.com, explaining why you’d like to join us for what I suspect may prove to be a groundbreaking event.

The rich store of information in…human sweat

click to enlarge‘Don’t sweat it’ may in future be the wrong thing to say. University of California-Berkeley researchers have developed a prototype sensor array on a band that successfully captures readings of multiple sweat analytes and sends the information to a smartphone app for analysis, making it the first device capable of continuous, non-invasive monitoring of multiple biochemicals in perspiration. The five sensors measure metabolites glucose and lactate, the electrolytes sodium and potassium, and skin temperature, which serves to calibrate the other readings in real time. The device (left), which can be in a wristband or headband form, also contains a flexible printed circuit board that amplifies the sensor signals and sends them to the smartphone app. The Berkeley researchers look forward to commercializing the technology to capture more analyte readings, for athletic performance, medical and fitness tracking usage–and in the longer-term, population-level studies for medical applications. We wonder how long it will be before these show up in a new model Misfit, Jawbone or Fitbit. Berkeley News   Hat tip to former TTA Ireland Editor Toni Bunting

The security risks, and the promise of, the Internet of Things

Jason Hope, who back in September wrote on how one of the greatest impediments to the much-touted Internet of Things (IoT) was not security, but the lack of a standardized protocol that would enable devices to communicate, has continued to write on both this topic and IoT security. While The Gimlet Eye had great fun lampooning the very notion of Thingys Talking and Doing Things Against Their Will [TTA 22 Sept 15], and this Editor has warned of security risks in over-connectivity of home devices (see below), relentlessly we are moving towards it. The benefit in both healthcare monitoring/TECS and safely living at home for older adults is obvious, but these devices must work together easily, safely and securely. To bend the English language a bit, the goal is ‘commonplaceness’–no one thinks much about the ubiquitous ATM, yet two decades ago ‘cash machines’ were not in many banks and (in the US) divided into regional networks.

As Mr Hope put it as the fifth and final prediction in his recent article:

The IoT Will Stop Being a “Thing”
How many times in the past week have you said, “I am getting on to the World Wide Web?” Chances are, not very many. How many times have you thought about the wonder of switching on a switch and having light instantly? Probably never. Soon, the Internet of Things, and connectivity in general, is going to be so common place, we also won’t think about it. It will just be part of life and the benefits and technology that wow us right now will cease to be memorable.

This Editor continues to be concerned about how hackers can get into devices, (more…)

Three of the best – digital health events at the Royal Society of Medicine for 2016

The Royal Society of Medicine has two unbeatable benefits to offer conference attendees: virtually every world expert is keen to present there and, because it is a medical education charity, charges are heavily subsidised. As a result you get the most bang for your buck of any independent digital health event, anywhere!

And just now the offer is even more attractive as if you book for all three in the next 14 days (ie by 12th February) the RSM will give you a 10% discount on all three!

On February 25th, the RSM is holding their first 2016 conference: Recent developments in digital health. This is the fourth time they have run this popular event which aims to update attendees about particularly important new digital heath advances. For me the highlight will be Chris Elliott of Leman Micro who plans to demonstrate working smartphones that can measure all the key vital signs apart from weight without any peripheral – that includes systolic & diastolic blood pressure, as well as one-lead ECG, pulse, respiration rate and temperature. When these devices are widely available, they will dramatically affect health care delivery worldwide – particularly self-care – dramatically. See it first at the RSM!

I’d also highlight speakers such as Beverley Bryant, Director of Digital Technology NHS England, Mustafa Suleyman, Head of Applied Artificial Intelligence at Google DeepMind (who’ll hopefully tell us a bit about introducing deep learning in to Babylon), Prof Tony Young, National Clinical Director for Innovation, NHS England and Dr Ameet Bakhai, Royal Free London NHS Foundation Trust. It’s going to be a brilliant day!

Book here.

On April 7th the RSM is holding Medical apps: mainstreaming innovation, also in its fourth year. Last year the election caused last minute cancellations by both NICE & the MHRA, who are making up for that with two high-level presentations. Among a panoply of other excellent speakers, I’m personally looking forward especially to (more…)

On the passing of Bob Pyke Jr.

Bob Pyke Jr. Many readers of Telehealth and Telecare Aware will join our editors in sending condolences to the family of Bob Pyke, who died on Sunday 24th January 2016. (Obituary and condolences link here.)

Bob’s enthusiastic promotion of all things telehealth by linking to relevant articles online pre-dated TTA by many years. A Google search of his name will show up thousands of items and associations to which he was linked. He continued to post articles to his Facebook page up until last November, despite the debilitating effects of his amyotrophic lateral sclerosis (ALS), or motor neurone disease (MND) as it is known in the UK.

In July 2014 he announced his illness with typical frankness and simplicity “I wish I could write as well as Danny Sands who recently wrote about his own health experiences, my writing style is a cross between Monty Python and Mark Twain. On this past Friday, I was diagnosed with ALS. I am blessed to have a loving family and friends who support me and encouraged me to keep a journal about my changed life.”

Bob was a nurse and the humanity which led him into that profession always shone through: “Since being diagnosed with ALS, I am not a patient with ALS, I am a person who has ALS.” Nor did he shrink from noting some of the more difficult aspects of his illness “…living with ALS or dying is the most singular and solitary experience one undergoes.”

Ten years ago Bob and I collaborated on setting up a social networking site for community nurses. Unfortunately it did not get past the early stages but it was always a pleasure working with him. Looking back through my emails I see that I once described Bob to a colleague as “a long term avid sniffer out of news”. I think he’d have liked that.

Bob built up a worldwide network of people interested in nursing and telehealth and he inspired and encouraged them. We will miss him.

Steve Hards
Founder and ex-editor, TTA

 

Eight TECS expected to change health and care

click to enlargeThe King’s Fund is still bullish on the transformative capabilities of technology-enabled care services for health (even if others are not, see following article). This article (which almost passed this Editor by this month) highlights eight areas which have the greatest potential. Some are expected–but at least two are surprises. You be the judge!

  1. Smartphones: apps, as hubs/hub replacements, and research transmitters (voluntary but also involuntary?)
  2. At-home and portable diagnostics; smart assistive technology
  3. Smart or implantable drug delivery
  4. Digital therapeutics/interventions; cognitive behavioral therapy; lifestyle interventions
  5. Genome sequencing
  6. Machine learning (computers changing based on new data, spotting pattern) in big datasets (Surprise #1)
  7. Blockchain, the tech behind bitcoin; decentralised databases, secured using encryption, that keep an authoritative record of how data is created and changed over time, to bring together decentralized health records. (Surprise #2)
  8. The connected community; P2P support networks and research communities

The King’s Fund’s publications 1 Jan

Health tech innovations are doing little for baby boomers

click to enlargeWonder why the duck is upside down and sinking? Maybe it’s looking for all that transformative tech! Versus The King’s Fund sunny article above is Laurie Orlov in Boomer Health Tech Watch. Her POV is that as of right now, health tech innovations are not moving the needle for obese (39 percent) and chronically diseased US baby boomers. They aren’t downloading health apps and wearing wearables. Workplace wellness programs? Au contraire, they make us feel less well (Harvard Business Review) and anxious that we’re getting spied on by the company. Maybe we realize that All That Data isn’t secure (healthcare being a Hacker’s Holiday Camp), so we’re not playing the game. And the cost of care that the ACA was supposed to level off? Not if you’re a self-insured Boomer struggling to pay an ever-higher monthly premium, or even in a corporate high-deductible plan, paying increased deductibles, restricted networks, ever-higher treatment costs and fighting your insurer at nearly every turn. Add to that safety risks of procedures, mistakes compounded by EHRs [Dr Robert Wachter, TTA 16 April]  and (not mentioned) hospital-acquired infections. No wonder investment has cooled. Health and tech innovations do little for baby boomers

International Summer School Integrated Care (ISSIC) 27 June – 01 July

The International Summer School on Integrated Care, “Integrated Care in Theory and Practice” is organised by the International Foundation for Integrated Care’s Integrated Care Academy©. It will run from 27 June – 01 July at Wolfson College, University of Oxford, UK.

It will provide a week of intensive training on theory and practice of integrated care. It is aimed at health and social care professionals, clinicians, researchers and managers who want to strengthen their understanding of integrated care, get a comprehensive overview of the state of the art in theory & practice, and hone their competencies in analyzing, designing, evaluating and practising integrated care.

It is eligible for Continuous Professional Development (CPD) or Continuous Medical Education (CME) credits for professionals and managers. (more…)

VerbalCare debuts a new symbol-driven app for patient health communication

click to enlargeMany patients in both home and hospital/post-acute settings have difficulty communicating their needs for a variety of reasons: post-stroke, cognitive impairment, facial surgery, aphasia, age (very young, very old) and of course there are language and cultural obstacles. VerbalCare‘s relaunched patient and caregiver apps may find a way around it. The patient clicks on icons in the VerbalCare Patient tablet app, which if touched in succession can form a sentence, then sends the message either to family members or the care team via the paired Messenger app for smartphone or tablet. The app can also send custom texts, phrases, or reuse a favorite selection; it will record patient appointments with patient consent. It has been tested over the past four years at Massachusetts General and Franciscan Hospital for Children. The Boston-based early stage company was acquired in August 2015 by an area durable medical equipment company company, Medical Specialties Distributors (MSD) and operates as a subsidiary (Mobihealthnews). The current pricing is for the VerbalCare Patient app $9.99 per patient per month, BYOD, but founder/CEO Nick Dougherty expects that healthcare organizations will pick this up. MedCityNews  What would be interesting is if a telehealth company licenses this for integration, in part or wholly, with its remote patient monitoring–Ed. Donna