Work for a UK LA? Apply for housing & technology improvements for people with learning disabilities

The Department of Health (DH) has announced an investment of £25m over the next two financial years (£10m in 2016/17 and £15m in 2017/18) in technology and housing for people with learning disabilities.

Half of the population of adults with learning disabilities in England live with their families; most of the remainder (33%) live in residential care. Only 15% of adults with learning disabilities have a secure long-term tenancy or their own home.

Having a home guarantees a place in the community, and is part of how people are accepted as equal citizens. People with learning disabilities are one of the most socially excluded groups in our society with limited life chances.   Investment in technology and housing to support independent living will provide the opportunity to make of reality of extending rights for people with learning disabilities.

The availability of appropriate housing is integral to the Transforming Care programme which aims to move people out of inpatient care into the community.  The additional DH funding announced is intended to have a broader focus aimed at those receiving support for their learning disability and is not restricted to those who are currently inpatients.

The DH is not looking to identify a single ‘winning’ approach.  DH expects innovation and impetus to come from local authorities, working closely with people with learning disabilities and family carers. Those areas interested in expanding their supported housing stock should note today’s announcement that it will remain exempt from the Local Housing Allowance cap until April 2019, from which point a new ‘local top-up’ model will be introduced. For more information on this specific point, click here.

The DH will apparently be looking for proposals that increase the capacity to deliver assistive technology and housing arrangements that provide innovative, person centred and flexible approaches to supporting independent living and maximising individual rights.

This capital funding will be deployed to enable local authorities to lead the way in bringing about a real change in how assistive technology and housing for people with learning disabilities can improve quality of life and outcomes for individuals and their families.

We would like information about the availability of the fund to be disseminated as widely as possible.  We would be grateful if you could circulate this information to your networks and contacts.

For further information and the application form please go here.

The closing date for applications is 28 October 2016. Any queries should be sent to: H&TC-Fund@dh.gsi.gov.uk.

More tattletale data gathering: EEGs and sub-cutaneous RFID chips

There’s a new biometric marker in town being used for authentication: the EEG (electroencephalograph). Brain waves have a cacaphony of information about emotional state, learning ability and personality traits, now being collected in relaxation or gaming apps through inexpensive headsets as simple as earbuds. So instead of iris scans and fingerprints, now it’s EEGs. However, it’s yet another privacy invading and eminently hackable source of data. Privacy: the collectors of information off that app may be matching your brain wave pattern to those on a data base–say, alcoholics. “In a blind trial, a machine learning classifier, trained to recognize brain patterns associated with alcoholism, used the brain wave data from the authentication systems to accurately identify 25 percent of the alcoholics in the sample.” You may not be a drinker, and the reading may be utterly ‘off’, but now it’s in the open, you have no idea of how it will be used. Similar patterns can be used to match from databases to identify learning disabilities, mental illnesses and more, which could make you tough to insure, for instance. IEEE Spectrum  Hat tip to former editor Toni Bunting.

The next generation of peripherals may not be external at all. Already around 50,000 early adopters or bodyhackers are implanting glass RFID chips in their hands or other parts of their bodies to let themselves into their homes and offices or to store emergency information. The head of a digital unit of Capgemini stored his Scandinavian Airlines boarding pass and travel information in a December test. This type of chip, about the size of a rice grain, uses no electricity but will activate when scanned by a reader. It’s easy to forecast medical uses such as records before surgery (operate on the right foot, not the left), an ID and information for someone post-stroke or with dementia, or as smart card loaded with funds. But this Editor can see it coupled with a nanosized battery as being tested now in external sensor patches or biostickers as John Rogers at University of Illinois, MC10 and others have been designing for several years–and the potential geometrically increases to send out other data such as vital signs. Perhaps EEGs one day? Wall Street Journal — plus a collection of our coverage of sensor patches

Fall/winter US events–Extra #1: TEDxNJIT, PCHA CHC and CHS

“Shuttle Corridor” Conferences this fall! Coming up fast: New Jersey Institute of Technology is hosting a TEDxNJIT event on Innovation and Collaboration next Wednesday 28 Sept at the Jim Wise Theatre on their Newark campus. It’s not strictly healthcare–it includes everything from nanotech to the arts, students, entrepreneurs and local government. TEDx is the local, self-organized version of TED talks and “Ideas Worth Spreading”. See their flyer and website. Hat tip to Michael Ehrlich of NJIT’s Martin Tuchman School of Management. 

Partners HealthCare is hosting its 13th Annual Connected Health Symposium (CHS) 20-21 October, with an opening networking event on the 19th October evening, all at the Boston Seaport World Trade Center. The theme this year is “Digital Technology That Cares: Bringing the Human Element to Life”. Speakers are listed here. The CHS has traditionally been focused on care delivery and how it impacts the daily lives of patients, with a significant academic bent. More information, registration.

And put a few days aside before Christmas for the PCHA Connected Health Conference at the Gaylord National Harbor Resort near Washington DC, now back in December (11-14) when it belongs. It also includes the Global Digital Health Forum on the last two days, a separate conference co-presented by PCHA and the Global Digital Health Network, with the Canada-US Connected Health Workshop on the 14th and three pre-conference events on Sunday the 11th. More to come. TTA is a media partner of the PCHA CHC for the 8th year, starting in 2009 when it was the brand new mHealth Summit.

 

Asthma UK recruiting for a new digital health role – interested?

Asthma UK has decided on a most exciting initiative to educate the tech industry on how they can best support the condition with new technology. Spearheading this activity will be this new role which is also expected to bring expertise to developing those digital health solutions: part stakeholder management, part UX designer.

If you want to know more, Joe Clift, Senior Policy Officer at Asthma UK, who is working alongside this new role, will be talking at the next DHACA Day in Leeds on October 6th (book here).

Details of the application are here. Applications close on 9th October.

TTA’s Friday roundup of interesting articles, updates and weekend reads

Fitbit may succeed in blocking Jawbone from selling in US? The Jawbone wins [TTA 27 July] in the US International Trade Commission court was apparently reversed due to a judge’s error for two Fitbit patents, and this may open the way for Fitbit to further block Jawbone. An additional California court action on infringement and misappropriation on trade secrets by Jawbone is headed for court in 2017. Mobihealthnews…..Maybe texting is enough? Dr Joseph Kvedar seems to think so for simple medication adherence and reminders, with reasons like the easy scaling of text messaging in EHRs, but prefers installing an app to deliver them due to the downsides of plain text messaging such as HIPAA and security. Thus we return to the logic of the desktop unit days (e.g. Health Buddy, Viterion) but delivered via smartphone. CHealthBlog….550 US primary care docs say no reimbursement, no telehealth (actually telemedicine). Usage in the past year was a scant 15 percent, with higher usage in Federally designated ‘safety net’ clinics (FQHCs) and HMOs versus PCMHs and ACOs where reimbursement by Medicare, Medicaid and private payers is far chancier. The survey was conducted by their association, the American Association of Family Physicians (AAFP). mHealthIntelligence….iHealth Andon Group buys France’s eDevice for $106 million. The aim seems to be integration of eDevice’s backend infrastructure to iHealth’s RPM devices. Mobihealthnews….A analysis of what went wrong at HealthSpot is in the new publication Telehealth & Medicine Today. A summary is that they had a business model that started out on point quite a while ago (2010) but then competitors and fresh technology ate their lunch (Editor’s term). They didn’t pivot to fit, moved too slowly and were overly wedded to their business model. A big problem was scaling costly kiosks and not finding the right places for them. While initially impressive, there was something all too elephantine about HealthSpot from the start. Our Readers interested in a Trip Down Memory Lane may read our collection of articles from 2013 here which pointed out most of the above….In the industry moves department, Peter Radsliff, whom this Editor worked with briefly on AgeTek-The Aging Technology Alliance (apparently defunct), has joined Arrayent, an IoT developer, as VP Marketing. Now that tells us something! Congrats to Peter!

And finally for a good long, but not light, read, this article in The Atlantic will give you a chilling glimpse of front-line medicine attempting to heal the carnage in Syria, using WhatsApp, texts and the simplest forms of telemedicine. A dedicated group of primarily Syrian-American doctors on a WhatsApp volunteer group called Madaya Medical Consultants uses it to perform consults with the minimal medical resources available in Syria. And yes, they know what Aleppo is.

Autumn/winter UK health tech events–Extra #1

SEHTA (South East Health Technologies Alliance), one of the largest healthcare networking organizations in the UK, has two upcoming digital health-related events of interest to those in London and the Southeast. Hat tip to Clare Ansett of SEHTA for the details.

London Innovation Surgeries 26 Sept at Queen Mary University, London. There are only two spots left so act quickly. More information here. SEHTA is in partnership with Kent Surrey Sussex Academic Health Science Network (KSS AHSN), GLA, MedCity, Digital Health.London and Enteric HTC.

How to Access Funding 12 October at City Hall, London. This is a ‘how to’ workshop on finding funding from crowdfunding to public/private sector. Partners are KSS AHSN, GLA, MedCity and Digital Health.London. More information here. Free but limited registration.

 

Add 3 years to ‘Paperless 2020’: Robert Wachter at The King’s Fund (UK)

The King’s Fund has helpfully published a report on the (duelling?) presentations at last week’s NHS Health and Care Innovation Expo by Robert Wachter, MD, the ‘digital doctor’ (our review of excerpts from his 2015 book here), and Secretary of State Jeremy Hunt on the feasibility of paperless health records. There is plenty of funding (£4.2 billion) for NHS.UK announced earlier this year, but plans are still sketchy. The adoption of the GOV.UK Verify service used in other parts of the UK government is intended to “standardise the process to activate patient accounts without the need for them to visit a GP surgery in person”. NHS is having another crack at an app library, and there was a bit of surprise, according to the writer, that Secretary Hunt said that fitness data will be integrated into NHS patient records. But Dr Wachter cautions that he’s walking back the 2020 date he advocated for full paperless records to 2023. He recognized that implementation in all but the most advanced hospitals (a handful) isn’t feasible. There are too many competing priorities and too little funding (and, this Editor would add, too many HIT threats like hacking and ransomware). Only the most “digitally-sophisticated hospitals” would be invited to be ‘global exemplars’ in exchange for matched funding, in his view. The King’s Fund will be publishing more about this later in September, presumably as a prelude to their upcoming Designing digital services around users’ needs on 6 Oct.  Wachter watch Hat tip to Reader Suzanne Woodman

The Theranos Story, ch. 20: How Arizonans fell hard and let Theranos change health policy

click to enlargeThe face is in the lake, and the yellow duck is upside down–augering in! A flatly-spinning Yak-52 no longer describes the glide path of Theranos, now at value 0. So as the dust settles, the Tales of When The Circus Came to Town are dusted off and published. Here Tim Steller, a writer and columnist with the Arizona Daily Star, reminisces on those dazzling Arizona days back in March 2015–18 short months ago–when Elizabeth Holmes swept into Phoenix in her bodyguarded SUV, trailing lobbyists and dropping names. The state legislature and Governor Doug Ducey, by this telling, were mere putty in her hands, star-struck into approving a bill permitting direct consumer ordering of lab tests, over the objections of the Arizona Medical Association and the questioning of the two doctors in the legislature. The Big Question–“does your blood-testing technology work?”–never was asked, and only two voted against the bill. At least Theranos only sought deregulation to facilitate its placement in Walgreens; Zenefits, another one-time Unicorn, gained employment incentives for its online HR-benefits brokerage, which were voided with recent layoffs. Tucson.com  See here for the 19 previous TTA chapters.

Diabetes management: the Next Big Health Tech Thing?

Big Data? Passé. Health IT security and hacking? At a peak. So what’s the Next Big Thing? If you’re tracking where the money’s going, it’s diabetes management. This week saw the joint venture Onduo formed by the controversial [TTA 6 Apr] life sciences-focused Verily (Google Alphabet) and Big Pharma Sanofi with a nest egg of $500 million. Onduo will be combining devices with services to help Type II diabetics. Based upon CEO Joshua Riff’s statements to MedCityNews, their platforms are yet to be developed, but “will be a digital platform that will involve software, hardware, and very importantly service” to change patient behaviors. Partnerships with Sutter Health in Northern California and Allegheny Health Network of western Pennsylvania will test their approaches in a clinical setting. Xconomy, Reuters

Verily’s other diabetes project include the £540 million bioelectronics partnership announced in August with UK-based GSK in Galvani Electronics [TTA 3 Aug] with a focus on inflammatory, metabolic and endocrine disorders, including Type II diabetes. With Dexcom, Verily is also building an inexpensive, smaller next-gen continuous glucose monitoring sensor; Mr Riff was coy about whether this sensor would be used but allowed that sensors might be used in Onduo’s approaches. Verily is also developing the well-known glucose-reading contact lens with Novartis [TTA 1 Sep 15].

Also this week, Glooko and Sweden’s Diasend announced their merger (more…)

Put them on the calendar: autumn/winter UK health tech events

click to enlargeSeptember means that we come back from our holidays. Those smartphone calendars come out and the gaps are filled for the last part of the year into 2017 (gasp!) Here’s our (now separate) starter list for UK.

The RSM’s Telemedicine and e-Health Section (which is chaired by our own Contributing Editor Charles Lowe, who will be updating them as usual)…Event listings here and surely more to come (All at the RSM)

Point of care testing: disruptive innovation – is the NHS ready for it yet?   22 November

Recent developments in digital health   28 Feb 2017

The King’s Fund’s upcoming meetings involving healthcare technology (All at The King’s Fund)

Designing digital services around users’ needs   6 Oct 2016
Learning from clinician and patient-centred service design

Integrated Care Summit 2016   11 Oct 2016
Improving local population health and delivering accountable care (more…)

Put them on the calendar: upcoming US IoT, connected health events (updated)

September means that we come back from vacations and holidays. The calendars come out and we start to fill in the gaps for the next few months into (gasp!) 2017. Here’s a forward look through to next August for US healthcare and IoT  conferences, including International CES.

If you’re in Dallas this coming Thursday, the Health Wildcatters accelerator is premiering their new office at Pacific Place with a bash starting at 5:30pm. Reserve tickets quickly and find out more #HWGrandOpening Hat tip to Hubert Zajicek

Since TTA’s been a media supporter of Parks Associates’ Connected Health Summit for the past two years, here’s a sample of their other IoT and connected home events.

CONNECTIONS™ Europe  (Smart home, IoT and the connected consumer)
November 2-3, 2016, Amsterdam     www.connectionseurope.com

CONNECTIONS™ Summit at CES
January 5, 2017, CES, Las Vegas    www.connectionssummit.com

CONNECTIONS™: The Premier Connected Home Conference
May 23-25, 2017, San Francisco   http://www.connectionsus.com

Connected Health Summit: Engaging Consumers
August 29-31, 2017, San Diego  www.connectedhealthsummit.com

December is a big month for US conferences; three of note (and likely partners again) are:

MedStartr Momentum (MedMo16) (more…)

Telehealth the way forward for chronic disease treatment – Australian report

  1. Telehealth has been confirmed as the way forward for sustainably treating the leading chronic diseases in Australia says a report published following a scientific study. The study, which analysed the effects of monitoring a mixed group of patients with chronic conditions using home-based telehealth equipment, concludes that use of home-based telehealth will not only reduce the hospital admissions but will also reduce the length of stay when admitted. The analysis of the data from the trial has shown that for chronically ill patients, an annual expenditure of AU$2,760 could generate a saving of between AU$16,383 and AU$19,263 representing a rate of return on investment of between 4.9 and 6. This is equivalent to a saving of AU$3 billion a year, says the report.

The Australian study, carried out by the Commonwealth Scientific and Industrial Research Organisation (CSIRO) is reminiscent of UK’s Whole System Demonstrator (WSD), the world’s largest randomised control trial of telehealth. Although the Australian study is much smaller with a total of 287 participants over 5 sites (covering the 5 States) compared with over 6,000 in the WSD, the principles are similar. Due to the smaller sample sizes and the need to have patients connected to the National Broadband Network (NBN) the selection of patients was not random but other techniques were used to obtain statistically significant results. Patients selected had unplanned acute hospital admissions indicationg one or more of Chronic Obstructive Pulmonary Disease (COPD), Coronary Artery Disease, Hypertensive Diseases, Congestive Heart Failure, Diabetes and Asthma.

The TeleMedCare Systems Clinical Monitoring Unit (CMU) was used as the home-based unit although not all features offered by the device were utilised in this study. The CMU system deployed in this study was developed in Australia, registered with TGA (Therapeutic Goods Administration) and has been extensively used and tested in previous trials.

Typically patients would have some or all vital signs measurements scheduled at a convenient time, typically in the morning. These measurements were blood pressure, pulse oximetry to measure arterial blood oxygen saturation, ECG (single channel), lung capacity, body temperature, body weight and blood glucose concentration. In addition to scheduled times, patients could take their vital signs at any time. A full suite of clinical questionnaires was also available.

The full report Home Monitoring of Chronic Diseases for Aged Care is available to download here.

The Theranos Story, ch. 19: the dramatic denouement, including human tragedy

click to enlargeThe deconstruction of Theranos continues, con il dramma, rounding back to those who touted it. There isn’t all that much new in Nick Bilton’s Vanity Fair article, but it adds context and color to this (literally) Bloody House of Smoke and Mirrors. (Ah, where’s Christopher Lee when you need him?–Ed.) There’s the usual Inside Baseball of closed-door meetings in ‘war rooms’, G150 jetting to awards, bodyguards, threatening lawyers, crisis managers, COO ‘enforcers’ (Sunny Balwani) and playing the Silicon Valley investor game (with Google Ventures taking a very smart pass). Where this gets unusual is the portrait of Elizabeth Holmes as an obsessive, secretive, blondined Steve Jobs knockoff from the age of 19, with a hot idea that never matched scientific reality from the start, but with a great line of ‘making the world a better place’ magnified by Silicon Valley’s incessant, We’re The Top And You’re Not narcissism.

Even Narcissus ultimately saw a fool in that pool. Played and tarred to a greater or lesser degree were: the only major SV VC lured in, Draper Fisher Jurvetson, and off-SV investors like mutual funds and private equity have lost it all; Fortune, Forbes, CNN plus much of the tech and financial press; and respected people lured to the board like Marine Gen. James Mattis, who had initiated the pilot program in DOD, Henry Kissinger and former Senator Bill Frist MD. Then the alphabet agencies marched in after the author: FDA, CMS, SEC and DOJ.

Oh yes, that Zika test announced in early August? Withdrawn at end of August. Ms Holmes is appealing her two year lab ban. But she still has absolute control of what’s left of the business. Business Insider

Finally, the lede in many articles is the suicide of British chief scientist Ian Gibbons and Ms Holmes reaction. Already ill with cancer, (more…)

A hybrid telehealth/telemedicine model for health systems

Your Editors have been projecting that the Big Future of telecare-telehealth-telemedicine lies in integrating services, not the Big Data backend (though there’s a Big Role there). These three have to be more tightly aligned with health systems, whether ACOs/IDNs (US) or the NHS. Most of our consideration has been where they go at the end of acute care–transitional care (post-discharge/post-acute–those bed-blockers)–but here’s a different approach that puts them at the start of the care continuum. Minneapolis-based Zipnosis [TTA 13 May] has an asynchronous platform that is ‘white labeled’ for a health system and carries their branding. Their model uses pre-screening/assessment first–an ‘adaptive questionnaire’ taken online or on mobile, compiles the information, then depending on the result, returns to the patient to schedule a virtual (video/audio) consult, lab visit or referral to a physician. The smart parts are that this is completely within the the health system and integrates with their EHR, making it reimbursable. It also can be used to expand the patient base even if the care is short term or episodic.

Zipnosis currently has 17 health system clients. The latest is Fairview Health Services in Minneapolis where the system test is first with their 22,000-plus employee workforce. The focus is on early detection of diabetes and heart disease. Also recently announced were two Nebraska health systems, Bryan Health and Memorial Health Care. Somebody likes the model as their Series A back in January was $17 million led by Safeguard Scientifics with participation from Ascension Ventures, the investment arm of Ascension, a large Catholic health system. mHealth Intelligence, Becker’s Health ITHealthcareITNews,

A review of digital health patent slugfests and Unintended Consequences

Mobihealthnews provides a recap of the past four years of patent actions pitting company against company in the hushed but deadly rings of the US Patent and Trademark Office (USPTO) and the US International Trade Commission. On the fight card: the never-ending American Well-Teladoc bout (Teladoc winning every decision so far by a knockout [TTA 18 June]–a second American Well patent being invalidated on 25 August); CardioNet vs MedTel, which the former won but has had to chase the latter out of the arena and down the street to collect; Fitbit-Jawbone which has gone both ways [TTA 27 July]; and the long trail of blood, sweat and Unintended Consequences around Bosch Healthcare’s heavyweight IP pursuit against mainly flyweight early-stage companies (not noting, as we did, their apparent ‘draws’ vs Philips and Viterion, then owned by Bayer).

The Reader will note our tracking Bosch’s activities go back to 2012 (here, here and here). Moreover, with Mr Tim Rowan of Home Care Technology, we broke the news of Bosch’s demise in June 2015, drawing the conclusion that their offense versus Cardiocom’s patents (now in Medtronic’s cardiac division) directly led to the invalidation of their key patents, IP–and the very basis of the company’s existence. See the 19 June 2015 article and our recap one year later in reviewing AW-Teladoc. (Any similar phrasing or conclusions within the Mobihealthnews article, we will leave to our Readers to decide!)

The ‘right package of care’ sought for ‘bed-blockers’, home care (UK/US)

click to enlarge‘Bed-blocking’ as a signal failure of transitional care. Here is a term that may be unique to the UK, but not the problem: older people who cannot be discharged after an illness because there is no plan and no suitable place for transitional care and/or a safe return home with care. According to the Guardian, the term originated among UK healthcare managers and economists as early as the late 1950s as a marker of system inefficiency. The writer, Johnny Marshall, director of policy for the NHS Confederation, correctly notes that it should be a marker of “(a) system that has failed to move quickly enough to put together the right package of care to enable the person in the bed to return home” and that unfairly blames the patient. He gives examples of programs across Britain with home assessment and care, particularly for older people post-fall injury, that reduce or eliminate hospital days.

In the US, transitional care is pointing to a blend of home care tech/services. Some of the indicators for LTC support that Laurie Orlov points out in Tech-enabled home care — what is it, what should it be?

  • Assisted living growth is flat as this past weekend’s open can of soda–housing is chasing residents (though cost doesn’t seem to be following the usual supply/demand curve), the average resident is 87 years old and staying 22 months, and their net worth can’t afford present AL
  • There’s a huge and growing shortage of home care workers for an ever-increasing number of old and old-old
  • Yet finally big investment is taking place in tech-facilitated home care locating and matching: Honor.com, Care.com and ClearCare–a total of just under $150 million for the three

But can technology–front and back end–make up for the human shortage? And there’s a value in wearing the Quantitative Self hat here. (more…)