UK health grassroots programs not waiting for the NHS: VR for COPD patient exercise, Now Patient for chronic care management

With the painfully slow adoption of health technology (besides telecare and limited telemedicine) in the UK, it’s heartening to see that there are some ingenious approaches outside the NHS gaining traction. The stories behind these two are interesting and inspiring.

Pulmonary Rehabilitation in Virtual Reality (PRinVR) from Concept Health was developed by a GP in a rural area of South Cumbria. Dr. Muhammad Farhan Amin of the Burnett Edgar Medical Centre on Walney Island in Barrow-in-Furness has many patients with pulmonary and lung problems who need to exercise and do specific breathing exercises. To aid them, he developed a five-step VR assessment and rehab program, It uses only a smartphone and a VR headset to transport a patient to a virtual beach where they can interact in an exercise class. The VR program connected via data to the internet can also tailor the breathing exercises individually and send the exercise record back to the health professional. It’s part of the ‘Better Care Together’ program that provides educational help, coaching on breathing strategies, and nutritional advice. Using VR this way is not new–we have reported on VR-aided rehab for several years going back to Microsoft Kinect and Army Medical–but what is different is its use in specific pulmonary conditions and its development in a very remote area. Dr. Amin’s Concept Health is only a year old, according to LinkedInThe Academy of Fabulous Stuff

On the waterfront in Salford Quays, Manchester, a local digital ad exec father who couldn’t book a GP for his son a few years ago has developed a telemedicine app that has virtual doctor visits and prescribing. Lee Dentith’s Now Healthcare has a private individual service (NowGP) that claims to be Europe’s largest, Now Healthcare (group/corporate), and the free Now Patient which combines pharmacy and the virtual visit. The apps and services have been inspected by the Quality Care Commission (QCC). 

Mr. Dentith told the Manchester Evening News that his market for Now Patient is the 15 million people with chronic care conditions who need regular repeat prescriptions, and noted that GP practices, despite the NHS, are private businesses. Now Patient achieved 60,000 downloads shortly after its October 2017 debut. Their focus is on the individual, group, and private pay market. To date Now has a £4m investment from MediCash in a Series A (Crunchbase). Now aims to have 25 million users on the three platforms. 

Hat tip to Roy Lilley’s NHS Managers newsletter via Steve Hards.

DARPA’s $5.1M contract with Kryptowire to develop passive smartphone health monitoring, predictive analytics

click to enlargeTruly unobtrusive health monitoring on the horizon? The Defense Advanced Research Projects Agency (DARPA) has contracted with cybersecurity firm Kryptowire to develop a health monitoring and analytics app to assess the health and readiness of warfighters (to us civilians–soldiers, sailors, airmen, and Marines) especially in the field. The WASH program–Warfighter Analytics using Smartphones for Health–will use the data from smartphone sensors like microphones, cameras, pedometers, thermometers, and accelerometers (see DARPA illustration, left above). Through sensor-based information, physiological and cognitive symptoms can be captured and analyzed.

Based on their information, most of the assessment will be passive rather than actively diagnostic, and with an emphasis on predictive health and a real-time approach to disease detection and biomarker identification. Part of the challenge will be to filter out the ‘noise’–extraneous information also captured by these sensors on a daily and extraordinary basis. Security, of course, is a major concern. (Where better than to award the app development to a cybersecurity company?)

DARPA is fond of commercializing its technologies (remember something called DARPANET?) so this is planned for commercial release in due time. Usage in clinical trials is an area mentioned. One day we may all be wearing smartphones which unobtrusively monitor our health and positive behaviors. (I’ll leave it to our Readers to say Yay or Nay to this notion.)

The award is for $5.1 million. A development timeframe is not mentioned. Business Wire, DARPA WASH page, HealthcareITNews, Daily Mail (which amusingly tries to paint this as a spy program through an ACLU representative quote).

The health tech events of summer: The King’s Fund (London) and Parks Associates (San Diego)

Summer is coming, even if you are freezing, rained or snowed on today. Here’s a preview of two health tech events to put on your calendar this summer.

The King’s Fund Digital Health and Care Congress 10-11 July, at their location in London. Content and case studies include creating the right culture for large-scale digital change, using digital technology to improve quality of care, prevention and changing behaviors, population health informatics, tools for self-management, and much more. Speakers include Matthew Swindell of NHS England and the Rt. Hon. Paul Burstow of the TSA. Information and registration are now available here. Follow The King’s Fund on Twitter here: #KFdigital18. TTA is a media partner of the Digital Health Congress.

Parks Associates’ 2018 Connected Health Summit: Engaging Consumers will be held 28-30 August at the Manchester Grand Hyatt in San Diego, California. This year will analyze the role of innovative connected health solutions in driving changes in consumer behaviors as well as how healthcare systems, insurers, and hospital networks interact with consumers. Speaker submissions are open until 1 June–more information is here. Early registration is now open. TTA is a media partner of the Connected Health Summit.

The Theranos Story, ch. 48: down to 24 employees in a last ditch before bankruptcy

click to enlargeThe ground is next. Theranos is down to its last two dozen employees or less, in a bid to buy a few more months of time before bankruptcy, according to a breaking report in the Wall Street Journal.

The announcement was made by Elizabeth Holmes Tuesday to approximately 125 remaining employees at its downscale Newark, California headquarters. (This Editor wonders if she wore a black turtleneck.) Interestingly, Ms. Holmes remains CEO after settling civil charges with the Securities and Exchange Commission (SEC) while a criminal investigation continues out of the US Attorney’s office in San Francisco. 

The WSJ article from the estimable John Carreyrou (who deserves an old-school Pulitzer Prize for his investigative reporting) recaps Theranos’ fall for those who need it. But…there’s more. Theranos received only $65 million of $100 million promised in their last (ditch) funding from Fortress Investment Group late last year, revealed by Ms. Holmes in an investor email this past Tuesday. The remainder is contingent on Theranos achieving an FDA Zika blood test approval using their miniLab. She stated that this test is still having problems and appealed to investors for yet more funding. The layoffs were designed to keep their cash reserve over $3 million until the end of July, below which Fortress is entitled to seize Theranos’ assets and liquidate them. This, as we have previously noted, is Fortress’ specialty–as now fan dancing is Ms. Holmes’.

According to Mr. Carreyrou’s sources, Ms. Holmes is still living large in basic black. “Until Tuesday, Ms. Holmes still had two personal assistants and two security guards who drove her around in a black Cadillac Escalade SUV, according to the people familiar with the matter.” This Editor wonders what happened after Tuesday. Public transit? A used car for a few thousand?

Theranos and the $900 million in lost investment may have also put a wet blanket on 2017 health tech funding, based on what we’ve learned in Rock Health’s report [TTA 5 Apr]. Other companies with real advances and promise may be paying the price for Theranos’ hype and fakery.

Our 47 past chapters and other Theranos mentions are for your perusal in our pages here

Soapbox: JPM’s Dimon takes the 50,000 foot view on the JP Morgan Chase-Berkshire Hathaway-Amazon health joint venture

Mr. Jamie Dimon, the chairman and CEO of JP Morgan Chase, had a few thoughts about the JPM-Berkshire Hathaway-Amazon healthcare JV for all three companies. You’ll have to fill up the tea or coffee mug (make it a small pot) for it’s an exceedingly prolix Annual Shareholder Letter you’ll have to sled through to find those comments. Your Editor has taken her punishment to find them, towards the end of the letter in ‘Public Policy’. 

They demonstrate what this Editor suspected–an headache-inducing mix of generalities and overreach, versus starting modestly and over-delivering.

  • Point #1 sets up what has gone wrong. Among several, “Our nation’s healthcare costs are twice the amount per person compared with most developed nations.” Under point 2 on how poor public policy happened, an admission that Obamacare fixed little:

Here’s another example: We all know that the U.S. healthcare system needs to be reformed. Many have advocated getting on the path to universal healthcare for all Americans. The creation of Obamacare, while a step in the right moral direction, was not well done. America has 290 million people who have insurance — 180 million through private enterprise and 110 million through Medicare and Medicaid. Obamacare slightly expanded both and created exchanges that insure 10 million people. But it did very little to fix our broken healthcare system and has, in fact, torn up the body politic over 10 years — and this tumult may go on for another 10 years.

  • Point #7 is about fixing the deficit and the ill effects if we don’t. In Mr. Dimon’s view, healthcare is a major part of this through the uncontrolled growth of entitlements, with Medicare, Medicaid and Social Security leading the pack–skipping over the fact that nearly all Americans pay into Medicare and SSI well in advance of any entitlement collection. Healthcare is also an offender through unnecessary costs such as administrative and fraud (25-40 percent),  and six mainly chronic conditions accounting for 75 percent of spending.
  • The experts–specifically, their experts–will fix it! “While we don’t know the exact fix to this problem, we do know the process that will help us fix it. We need to form a bipartisan group of experts whose direct charge is to fix our healthcare system. I am convinced that this can be done, and if done properly, it will actually improve the outcomes and satisfaction of all American citizens.”
  • The generalities continue with
    • The JV “will help improve the satisfaction of our healthcare services for our employees (that could be in terms of costs and outcomes) and possibly help inform public policy for the country.” 
    • Aligning incentives systemwide ‘because we’re getting what we incentivize’
    • “Studying the extraordinary amount of money spent on waste, administration and fraud costs.”
    • “Empowering employees to make better choices and have the best options available by owning their own healthcare data with access to excellent telemedicine options, where more consumer-driven health initiatives can help.”
    • “Developing better wellness programs, particularly around obesity and smoking — they account for approximately 25% of chronic diseases (e.g., cancer, stroke, heart disease and depression).”
    • “Determining why costly and specialized medicine and pharmaceuticals are frequently over- and under-utilized.”
    • “Examining the extraordinary amount of money spent on end-of-life care, often unwanted.”
    • “To attack these issues, we will be using top management, big data, virtual technology, better customer engagement and the improved creation of customer choice (high deductibles have barely worked”).

This Editor has observed from the vantage of the health tech, analytics, payer, and care model businesses that nearly every company has addressed or is addressing all these concerns. So what’s new here? Perhaps the scale, but will they tap into the knowledge base those businesses represent or reinvent the wheel? 

A bad sign is Mr. Dimon’s inclusion of ‘end of life care’. This last point is a prime example of overreach–how many of the JV’s employees are in this situation? The ‘attack’ tactics? We’ve seen, heard, and many of us have been part of similar efforts.

Prediction: This JV may be stuck at the 50,000 foot view. It will take a long time, if ever, to descend and produce the concrete, broadly applicable results that it eagerly promises to its million-plus employees, much less the polity. 

2017’s transition in digital health funding: is it maturity or a reconsideration?

Rock Health’s topline for 2017 digital health funding is impressively upbeat, casting it as “the end of the beginning in digital health, the start of a new era with new challenges”. Digging into it, there is a continued slowing that Rock Health itself predicted back in their 3rd Quarter report [TTA 3 Oct 17]. It seems that the big did get bigger, but if you weren’t on the train in 2016 or prior, 2017 wasn’t the year you left the station. Their findings bear this out, keeping in mind that their tracking is for US companies with deals over $2 million in value, which excludes much of the action from young and international companies:

  • No digital health IPOs this year, in a weak year in general for IPOs
  • For the companies already in public markets, they outperformed the S&P 500 31 percent to 19 percent
  • Average deals hit an all-time high of $16.7M ($5.8 bn over 345 deals) 
  • Big money went to better-developed, more mature companies like Outcome Health and Peloton exercise equipment at $500 million and $325 million. Rock Health duly notes Outcome Health’s troubles since. (To this Editor, Peloton is not a digital health company despite its glitzy overlay of video and exercise community.)  
  • Seven $100 million + mega-deals front-loaded in the first half of the year. Second half’s sole big deal was genetic testing and data marketer 23andme. The dominant category of business? Consumer health information represented by Outcome, 23andme, PatientPoint, PatientsLikeMe, and ShareCare, most with a B2B2C model.
  • Looking at deals by stage, not surprisingly the funding at D and later rounds soared to an average size of $74 million (from 2016’s $46 million). Seed and A rounds’ average funding at $7 million, while the majority, hasn’t varied much since 2011. Series B funding was also flat at $17 million on average.
  • Exits continued to be weak, indicating the reality of healthcare investing being long haul. M&A deals declined for the second straight year to 119–18 percent fewer than 2016 and 36 percent fewer than 2015

Also Modern Healthcare.

This Editor’s opinion? One damper on 2017 was the $900 million credulously blown on Theranos. Call it the Theranos Effect.

As usual we will look at StartUp Health‘s always numerically bigger report after release, but this Editor’s bet is that it won’t be ‘crazy’ like earlier in 2017. 

Breached healthcare records down 72% but incident numbers steady. Then there’s MyFitnessPal’s 150 million…

click to enlargeHackermania in healthcare may be running less wild…but what about consumer health devices? Year-end and top-of-year analyses indicate that the flood of breached records may be starting to drain. A Bitglass analysis of 2017 US Department of Health and Human Services (HHS) data from its infamous ‘Wall of Shame’ is encouraging. They found that the number of breached records decreased over the 2015-2017 period by 72 percent between 2015 and 2017 and by 95 percent from 2016. The calculation excludes the huge spike in breaches due to two 2015 incidents at Anthem and Premera Blue Cross [TTA 9 Sep 15]. Numerically, the breach incident numbers decreased but are relatively steady: 2017 at 294, 2016 at 328. Data security company Protenus in its tracking found more incidents in 2017 versus 2016 (477 in 2017 v. 450 in 2016) but the same reduction in records affected, with five times fewer records in 2017 versus 2016’s 27.3 million records.

What’s been successful has been reducing mega-breaches and containment of healthcare device loss and theft through education and enforcement of employee practices. What continues is the major cause of breaches continue to be insider-related via error and wrongdoing; this includes the major annual Verizon report. Healthcare Informatics

Protenus’ February report, while continuing the reduction trend, had its share of hacking and insider incidents. Of the 39 incidents in their report affecting over 348,000 records, insider actions such as the misuse of system credentials accounted for 51 percent of breached records while hacks were 46 percent, with the majority involving ransomware or malware. Hacking as a cause hasn’t disappeared but perhaps has shifted to easier targets.

UnderArmour’s MyFitnessPal delivers another breach blow. Late last month, the company revealed that 150 million user records were hacked in February. The MyFitnessPal mobile app (more…)

Shulkin out, Admiral Ronny Jackson MD nominated for VA head

You’re Fired! Dr. David Shulkin is out the door as VA Secretary as of Wednesday evening. US Navy Rear Admiral Ronny Jackson, MD has been nominated for the position. In the interim, while confirmation takes place, Robert Wilkie, currently the Undersecretary of Defense for personnel and readiness, will move to VA as Acting Secretary.

Dr. Shulkin’s downfall was an Inspector General report last month that criticized his personal actions on a recent Europe trip (e.g. gratis Wimbledon tickets), actions (too much time spent on personal travel/personal time for the funding of the trip), and the poor way he handled the publicity around the report. Other issues centered on internal turmoil as he attempted to reform VA practices. As late as Tuesday, things were looking up based on White House statements, though Chris Ruddy of Newsmax was far less sanguine last Sunday on ABC. Our extensive coverage on Dr. Shulkin’s tenure at the VA is here. Our Readers who are engaged with US telehealth knew him as an IT ‘maven’, but from this Editor’s perspective, the rocky process of contracting in the Home Telehealth area and the downgrading of the program in recent years was dismaying.

Dr. Shulkin’s subsequent appearances in the pages of the NY Times and on TV were also less than stellar, overly personal, and to this Editor, ill-considered, blaming privatization and stating he did not resign. 

The announcement was made yesterday evening from President Trump’s Twitter account. An (unnamed) White House official said the embattled Shulkin was no longer effective in his role, saying his “distractions were getting in the way of carrying out the President’s agenda.” according to CNN. 

Rear Adm. Ronny L. Jackson moves from being personal physician to both President Trump and previously for President Obama. It is a White House tradition that personal physicians are from the Navy. He has combat medicine experience, having been deployed during Operation Iraqi Freedom in charge of resuscitative medicine for a forward deployed Surgical Shock Trauma Platoon in Taqaddum, Iraq. In 2006, during President G.W. Bush’s administration, he joined the White House Medical Unit. (more…)

PARO: The robotic therapy seal that benefits so few

click to enlargeI have a problem with that cute, robotic seal cub PARO.

More accurately, I have a problem with the ethics of the business model of the Japanese company that makes it, Intelligent System Co. Ltd.

PARO started development in 1993 and the first English press release was in 2004 – a year before Telehealth and Telecare Aware started! Since then the indications that PARO is good for people with dementia have been building and building, as Editor Donna most recently highlighted in this item: PARO therapy robot tested, cleared by NHS for — hygiene.

I have no problem believing, as Donna summarised, “the research has shown that it lowers stress and anxiety, promotes social interaction, facilitates emotional expression, and improves mood and speech fluency.”

However, in response to an enquiry last week, it was confirmed to me that neither price or delivery time information is available but that PARO seals continue to be made individually, by hand. This is a huge production bottleneck and cost.

It is entirely proper for a company that produces handmade cars to have high prices and long waiting lists for their rich man’s toys but I am completely at a loss to conjure up any justification to apply that thinking to PARO. (PARO cost $6,400 in 2017.)

I believe that the insistence that PARO continues to be made in this way is an unethical denial of a benefit to millions of people.

Does Intelligent System not have the will or the skill to scale up production and bring down the cost so that every care home or dementia ward could acquire a PARO (or even a ‘PARO lite’) within a few years? If not, they should license it to a company that can.

At least they should stop pretending that PARO is benefiting people with dementia when it reaches so few.

This Telehealth and Telecare Aware Soapbox item is the personal opinion of TTA founder and Editor Emeritus Steve Hards.

Upcoming London events–a few suggestions

Here are three upcoming events in London that readers may be interested in.

The Royal Society of Medicine’s mHealth Apps conference, 19th April

This, the sixth such annual event, brings together the good and the great in the medical apps world to inform you of recent and expected developments in evaluation, regulation, legislation, behaviour change and assessment, as well as some heartening stories of successful apps. Presenters will include Alexia Tonnel of NICE, Neil McGuire from MHRA and Hazel Jones from NHS Digital alongside Prof Jeremy Wyatt, giving an academic view, Julian Hitchcock, a European regulatory view and Dr Richard Brady his not-to-be-missed “Bad Apps” exploration of the dark side of medical technology.  Book here.

Bridging the Gap, 2nd May, Wellcome Collection, London

Join Commercial Directors from across the AHSN Network on Wednesday 2 May 2018 for a range of 1:1 advice sessions, workshops and networking opportunities at the AHSN Network’s fully subsidised “Bridging the Gap” event that’s open to all health technology companies.Delegates will be able to get advice about how to make their engagement with the NHS sharper and more cost effective. That means understanding how decisions are made in the NHS, who makes the decisions and how to get their attention. They’ll also provide opportunities to test and and develop your value proposition, budget impact model and your approach to evaluation and case study development. Book here.

Confirmed AHSNs taking part include: Eastern, HIN, ICHP, Kent Surrey Sussex, South West, West Midlands, West of England, UCLPartners, Yorkshire and Humber. National organisations also taking part and supporting the event include: NHS England, NICE and NIHR.

The Future of Medicine; the role of doctors in 2028, on 13th June

This, the fourth annual event on this topic from the RSM, will focus on how technology is likely to change the way medicine is delivered over the next ten years. This year we have three speakers focusing on how technology is affecting the way medicine is taught, and how medical students are being taught differently, to enable them to be most effective in this new world. Should be essential attendance for digital health executives looking for new inspiration!

Presenters include Professor Jo Martin, Professor of Pathology, Queen Mary University of London, Director of Academic Health Sciences, Barts Health NHS Trust, and President Royal College of Pathologists, and Will Cavendish who was the senior Civil Servant in the Office of Life Sciences (OLS) when George Freemen (a previous presenter at this event) was heading the OLS. Book here.

Disclosure: Charles Lowe is ex-President of the RSM’s Telemedicine Section and was involved in setting up both the above RSM events.

Is the Amazon Effect good or bad for consumers–and health tech?

Your busy Editor, who has been on business assignment this past month, has noticed the relative quiet around the subject of How Amazon is Rattling Healthcare. We’ve already noted here the retail and pharmacy/pharmacy benefit effects with CVS-Aetna, Albertsons-Rite Aid, and Cigna-Express Scripts. Aside from the bottom line, and Cigna finally closing a gap with other insurers with pharmacy benefit management services (PBM), is it good for the healthcare consumer as promised? 

Max Nisen’s article in Bloomberg Gadfly (sic) says ‘not so fast’. His argument is as follows:

  • Companies are largely following the lead of UnitedHealth and its Optum units, which integrate not only insurance and PBM but physician groups and analytics.
  • Deals will continue. There’s other insurers like Anthem, Humana, and the regional Blues; urgent clinics like CityMD, AtlantiCare, and MedExpress. Looming above all with clinics and retail pharmacies is Walgreens Boots and on the retail side, other supermarkets like Publix and Ahold Group.
  • Consolidation means fewer alternatives, competition, and thus less downward pricing pressure for both providers and consumers, as options decrease into what resembles a closed system. The merged companies will have debt to pay off, with pressure to pay off lenders and shareholders.

All this is regardless of what Amazon does with JP Morgan Chase and Berkshire Hathaway. Their admirable, seemingly altruistic reasons for this joint venture, in this view, has multiple unintended consequences and negative effects for ordinary folk–and doctors.

As for healthcare technology, when a Big Trend takes the air out of the room–EHRs, ACA, Watson/big data, even wearables, IoT and Big Data– more mundane everyday tech like remote patient monitoring and telecare, which depend on integrating into  healthcare/wellness/chronic care management systems and reimbursement (by those same insurers), tend to suffocate. 

Also of interest: Cigna may be too late to the PBM party (InvestorPlace)

Butterfly IQ handheld ultrasound offers clinical-quality body imaging for under $2,000

click to enlargeButterfly IQ is a NYC and Connecticut-based company which has developed a handheld ultrasound that transmits images to a smartphone. Where it differs from current handhelds like GE’s VScan is that it uses a single transducer for all images both near-field and deeper in body, and connects to a iPhone loaded with their software.

Larger machines, even on portable carts like the Philips Lumify [TTA 27 Mar] operate on an older vibrating crystals-based technology. The IQ uses capacitive micro-machined ultrasound transducers or CMUTs. 

It claims to be FDA-cleared for 13 applications. All this is delivered for under $2,000, far under other handhelds or carts (VScan is above $12,000, Lumify about $6,000), with delivery this year (pre-order notification at present) in the US only. Butterfly is also working on problems such as the volume of blood a heart is pumping or detecting problems like aortic aneurysms.

The IQ has a brace of impressive testimonials from doctors at Yale, UC Irvine, Denver Health, Rocky Vista University, Mass General, St. Elizabeth’s (Boston), and Metrowest Medical Center. According to vascular surgeon and company chief medical officer Dr. John Martin, he used it on himself to diagnose a mass in his neck last year that turned out to be Stage 4 cancer, for which he is under treatment. Daily Mail, 9to5 Mac, MIT Technology Review  Hat tip to Editor Emeritus Steve Hards

News roundup for Tuesday: room at the top at VA? (updated), Philips integrates teleradiology. 3rings Care premieres Amazon Echo service

Updated. Who’s the Leader? At the Veterans Administration, the soap opera plot accelerated on the continued tenure of Secretary David Shulkin who, after a strong start (and coming from within VA’s tech area), has stumbled over charges of inappropriate spending and staff turmoil since the beginning of the year. Journalist Christopher Ruddy, CEO of Newsmax, who speaks regularly with President Trump, indicated in an interview on ABC’s This Week on Sunday that Dr. Shulkin will likely be the next Cabinet departure. The fact that VA Choice 2.0 did not make it into the huge ‘omnibus’ budget bill indicated a disillusion with him on Capitol Hill. The lack of closure on replacing VistA with Cerner is also not in favor of a longer stay. The replacement may come from the VA House committee, the defense contractor community, or DoD. Why it’s important? VA is the largest purchaser of telemedicine and telehealth in the US, and has set the pace for everything from EHRs to info security. And there are those 9 million veterans they serve. Stay tuned. POLITICO Morning eHealth…..

By the next morning, a press secretary was saying “At this point in time though, he [President Trump] does have confidence in Dr. Shulkin. He is a secretary and he has done some great things at the VA. As you know, the president wants to put the right people in the right place at the right time and that could change.” But one of Dr. Shulkin’s biggest thorns-in-side at the VA, Darin Selnick, shuffled off last year to the Domestic Policy Council, will return to a post at the VA.

HIMSS continued to support VA’s and Dr. Shulkin’s efforts to increase veteran patient record sharing through changing the consent requirements authorizing the VA to release a patient’s confidential VA medical record to a Health Information Exchange (HIE) community partner. Letter.

Philips has entered the integrated teleradiology field by combining Philips’ Lumify portable ultrasound system and Innovative Imaging Technologies‘ (IIT) Reacts collaborative platform. It combines a compatible smart device that enables a two-way video consult with live ultrasound streaming. How it works: “clinicians can begin their Reacts session with a face-to-face conversation on their Lumify ultrasound system. Users can switch to the front-facing camera on their smart device to show the position of the probe. They can then share the Lumify ultrasound stream, so both parties are simultaneously viewing the live ultrasound image and probe positioning, while discussing and interacting at the same time.” Release

Following up on 3rings and their integration into the Amazon Echo virtual assistant system [TTA 18 Oct], Mark Smith from their business development area has told us that they have formally launched this platform earlier this month. The person cared for at home can simply ask Alexa to alert family and caregivers that they need help via voice message, text or email. Care staff or family can also use Echo to check through the 3rings platform by simply asking Alexa if that person is safe and OK. 3rings is now actively seeking to partner with innovative health, housing, and social care organizations. Overview/release.

PARO therapy robot tested, cleared by NHS for — hygiene

click to enlargePARO, the therapeutic robot seal developed in Japan by Professor Takanori Shibata for socialization use with geriatric dementia patients, is moving closer to being approved for use in the UK. It passed a cleaning and hygiene test conducted over nine months by Dr. Kathy Martyn, principal lecturer in the University’s School of Health Sciences, on a 10-bed dementia ward run by Sussex Partnership NHS Foundation Trust. The findings were that PARO was safe within the hospital setting for an acute care dementia unit.

TTA Editors have been covering PARO since 2010 (!) and despite the qualms in certain quarters [TTA 22 June 2010 ], unsurprisingly (to this Editor) the research has shown that it lowers stress and anxiety, promotes social interaction, facilitates emotional expression, and improves mood and speech fluency. Digital Health News (Picture from Toronto Star)

The Theranos Story, ch. 47: the post-mortem, blaming–and ghost chasing–begin

click to enlargeNow that Elizabeth Holmes is the former CEO of Theranos, many of the publications who huzzahed their ‘revolutionary’ blood testing system three short years ago are publishing their post-mortem analyses, often of how the wool was pulled over their eyes.

Jenny Gold from Kaiser Health News and NPR has a short ‘alarming’ tale of her press visit in November 2014 to a Theranos testing site at a Palo Alto Walgreens for an NPR feature. At Walgreens, she spoke with patients on the record and was invited to witness their blood draw–not the finger prick Theranos (and Walgreens) promoted, but a standard volume blood draw. After multiple and telling upset reactions from her company press handlers, including demanding Ms. Gold erase her audio recording (!) and accusing her of harassment, alarms went off at the Walgreens store for a non-existent fire. She was baited with an interview with Ms. Holmes–which never happened–and wound up with a corporate attorney instead who made unsupported statements. Ms. Gold canceled her story, which if she tracked the bad smell would have been likely the first press shot across the bow. What this post-mortem tells us is the extent of the coverup and the sheer (and unethical) fawning flackery that appeared in places like the New Yorker, Forbes, Inc., and Fortune.  NPR

The FT further digs into our gullibility, our wanting to believe that someone in a black turtleneck could put the Big Labs out of business,  how we in the press hungered for a new and female Steve Jobs to shake up the status quo. Andrew Hill: “Trouble often hits, though, when leaders stick to their story after it has diverged from reality, swerving into embellishment, mythmaking and, in Ms Holmes’s case, apparently fraud.”

But we were no smarter than those who gave Ms. Holmes and Mr. Ramesh ‘Sunny’ Balwani $700 million in Mad Money. (more…)

Contact lenses as a drug delivery system take home MIT Sloan Healthcare prize

This Editor has been covering contact lenses in health tech since at least 2013–contact lenses that detect glucose for diabetics (Google/Novartis/Alcon), eye pressure (Sensimed), and even detect multiple diseases (Oregon State University). None to date have made it into commercial release.

Here’s another try, this time from this year’s winner of the MIT Sloan Healthcare Innovation Prize competition. Theraoptix won the $25,000 grand prize, sponsored by Optum. The lenses are designed to deliver eye medication on a time release basis using a thin polymer film formed into a tiny circular strip sandwiched into the lens material. They can be worn for up to two weeks to slowly but constantly deliver drugs in the treatment of diseases like glaucoma or after surgery. It can also deliver drugs effectively for back of the eye treatment of macular degeneration, diabetic retinopathy, retinal vein occlusion, and similar diseases that today require in-office injections.

Theraoptix was developed by Lokendra Bengani Ph.D. of the Schepens Eye Research Institute of the Massachusetts Eye and Ear Infirmary. It was based on core technology by ophthalmologist Joseph B. Ciolino MD, who is Dr. Bengani’s mentor. We wrote about Dr. Ciolino’s research previously [TTA 7 Sept 16] including a look back at contact lens research. There were seven other finalists, of which the most interesting to this Editor was Kinematics shoe insole sensors for gait detection analysis (and fall prevention).  MIT News