A ‘desperate’ call for healthcare innovation creates a stir

When you are trying to shake things up in healthcare, sometimes enthusiasm gets mistaken for desperation.

Alex Fair is known to many of our American Readers as one of the Grizzled Pioneers of what eventually became known as Health 2.0. He’s head of a Meetup group in NYC with close to 5,000 members (Health 2.0 NYC, for which this Editor was an event organizer/producer for over a year), founder of health innovation-only crowdfunding platform Medstartr (see ‘Websites We Like’), a successful health tech event producer (MedMomentum 16 coming up 1-2 December) and a few other things in between. In short, Alex Hustles For The Cause.

One of his projects is the Major Depressive Disorder (MDD)/Depression Care Innovation Challenge with Takeda, which closed for applications last Monday. There was a last flurry of promotion via personal notes in social media and emails which is standard–well-known in style for those of us on Alex’s lists. But sometimes enthusiasm gets misinterpreted.

So a funny thing happened to me yesterday on Twitter. Someone told us that we sounded “desperate” in our tweets and posts. At first, my lizard brain said “what, I don’t want to be seen as desperate!” as if I was trying to get a date for the Junior Prom (which I did, thank you very much.) But then my mission-driven, we-have-got-to-fix-this-NOW-so-more-people-like-Jess_Jacobs-Live-longer-and-better-lives brain fired up and said, “Damn Right I’m Desperate!” The fact is that if we want to move the needle on innovation, we need to do something about it and desperate times DO call for desperate measures.

Read all about it here. If you want to change healthcare, especially in the US, you might get a little frustrated! (P.S. Along with the controversy is a calendar of upcoming NYC health tech events).

Chubb expands Community Care into Scandinavia (UK)

click to enlargeChubb Community Care, a UK company which provides home and mobile technology enabled care solutions (TECS) for independent, assisted, sheltered and extra care housing, announced their expansion into Norway, Sweden and Finland, partnering with Norwegian equipment supplier HEPRO which provides local service and market knowledge. Their first project is in HEPRO’s home country with the new Chubb Care Call. Care Call (left) is a colorful wall-mounted mobile-connected unit with simple buttons that connects the resident to onsite staff and remote call centers in case of emergency or need for assistance. HEPRO will be installing the units in seven municipalities. Release. Earlier this summer, Chubb won a contract with Places for People to install their CareUnity at 16 independent living locations across the North West, Hull and Bristol. Care Unity is a PERS/carephone-based system that integrates a wide range of safety and security peripherals. Release

Video Consulting Clinics NHS Scotland pilot — tender due Monday

NHS National Services Scotland (a/k/a The Common Services Agency) is requesting tenders for virtual video clinics. The supplier would furnish software, hosting and support for one year in up to 50 clinics in all of Scotland or in six regions. This ‘video consulting system’ would link NSS, Health Boards and potentially other Scottish public sector Participating Authorities. The tender is due noon UK time on Monday 26 August. Further information may be found here and also at the Public Contracts Scotland website. Hat tip to Suzanne Woodman of BRE.

A brief history of robotics, including Turing and Asimov (weekend reading)

click to enlargeTechWorld gives us a short narrative on robotics history dating back to Asimov’s Three Rules of Robotics (1942), Turing’s Imitation Game (1950) and the pioneering work of several inventors in the late 1940s. There’s a brief tribute to Star Wars’ R2-D2 (Kenny Baker RIP) and C-3PO.  It finishes up with AI-driven IBM Watson and Deep Mind’s AlphaGo. Breezy but informative beach reading! Hat tip to Editor Emeritus and TTA founder Steve Hards; also read his acerbic comment on Dell and Intel’s involvement in Thailand’s Saensuk Smart City

Opportunity for developers – can you help asthma sufferers?

Asthma UK today unveils a key report that tells developers how mHealth could help asthma sufferers better. Entitled “Connected asthma: how technology will transform care”, whilst picking out a few excellent exemplars, it describes how poor the average asthma app currently is – for example only 6% of such apps provide pollution status, and only 8% cover inhaler technique.

Historically CHF, COPD & diabetes have been regarded as the key long term conditions to manage using telehealth. When, as this editor did a few years back, a suggestion was made to try it on asthma, clinicians tended to look askance. Yet as this report shows, mHealth can do a huge amount to improve the management of asthma especially now many people have smartphones. And, bluntly, asthma kills (more…)

Intel, Dell develop an IoT “smart city” to support older people in Thailand

Rarely do we hear beyond India and Japan in Asia-Pacific health tech. But here comes Thailand with the Saensuk Smart City developed with prestigious partners Dell and Intel Microelectronic (Thailand)

Saensuk is a Thai municipality with 46,000 registered local residents, 15 percent of whom are 65+, as well as a touristic area around the Bangsaen beach. The Smart City is a three-year public-private partnership with the first aim of supporting older people in their homes through IoT-powered applications including health monitoring (RPM) of vital signs, fall detection, emergency notifications, environmental monitoring and safety tracking.The targeted number for the pilot is between 30 and 150 homes in the initial phase. Residents, for instance, are given a smartwatch that alerts for falls and also conveys information at entry into the program. Intel-based systems from Dell aggregate and analyze the large amounts of health data generated daily.

Visiting nurses, fairly common in Thailand, (more…)

A flurry of news from Tunstall Americas and UK

Tunstall Healthcare has been, quite untypically (for years) and aseasonally, burning up the newswires with press. The first we’ll mention is from Tunstall Americas announcing the availability of smoke detection sensors as part of their their newly introduced Vi+ and the CEL mobile PERS. The units when triggered by heat or smoke sound an audible alarm and generate an alert over to the 24/7 monitoring service. Like last week’s announcement of ambient temperature sensing, there’s nothing revolutionary here but these add-on features are extremely helpful to older people who use these systems. It also is a bit of sales upsell for their growing network of local home monitoring monitoring dealers/services [TTA 3 Aug]. Tunstall release.

We’ve also noted a new surge of activity in Australia (the Staying Strong telehealth pilot) with vital signs monitoring using the myclinic telehealth hub in the homes of older Aboriginal and Torres Strait Islander peoples. In the UK there is the PegasusLife new Malt Yard assisted living development for care alarms, Wakefield District housing and providing extra care services at Hare Hill-Rochdale Boroughwide Housing (RBH). Roundup here on their press page. For their LTC work at Tameside Hospital NHS Foundation Trust Community Services, Tameside and Glossop Clinical Commissioning Group (CCG) and Tameside Metropolitan Council (TMBC), Tunstall UK won the HealthInvestor Technology Provider of the Year Award. Tunstall telehealth solutions reduced hospital admissions by 38 percent or £2.7m where mymedic was used. Release

VA’s moves spell the end of the homegrown EHR

The Veterans Health Administration (VHA) is formally reaching out to the private sector to explore switching from its current, pioneering EHR system, VistA (also referred to as CPRS, Computerized Patient Record System) to a commercial system. Their ‘feeler’ is an August 5 and 8 notice in FedBizOpps.gov titled 99–TAC-16-37877 * RFI – VHA supporting COTS EHR REQUEST FOR INFORMATION (RFI), Solicitation Number: VA11816N1486. This requests information on business support for transitioning to a commercial-off-the-shelf system (COTS–don’t governments love acronyms?–Ed.) and closes 26 August, which is not a lot of time even for an RFI.

VHA has been under extreme pressure from Congress to modernize its EHR, lately in July hearings before the Senate Appropriations Committee. EHR replacement is also in line with the Congressionally-mandated, now concluded Commission on Care’s recently published recommendations on a total, top-down reorganization of VHA, including a sweeping reorg of their HIT management. The VHA strategy appears to be that while they are walking down the road to replace VistA and have already spent to assess where they are with KLAS and other EHR consultancies (spending $160,000+ on surveys), they are essentially ‘kicking the can down the road’ to the next administration (POLITICO’s Morning eHealth, 14 July).

Current state is to continue to upgrade VistA through late 2018, though the closely related Department of Defense’s Military Health System is in the long process of cutting its homegrown AHLTA over to Cerner-Leidos as MHS Genesis, awarded last August, with a first trial in the Pacific Northwest later this year (HealthcareITNews, Ed. emphasis). Of course, it will take the VHA years to roll it out; there are close to 9 million veterans enrolled in the closed system that is the VHA.  FCW, Morning eHealth 10 August

Love EHRs or hate them, the sheer size of the VHA and its growing concession that VistA won’t do in caring for American veterans makes it clear that the future of EHRs is in private systems from major developers–a field which is winnowing out to The Few (take that, GE).  (more…)

Summertime, and the health data breaches are easy….

click to enlargeCybersecurity is the word, not the bird, from South Korea (see here) to the US.  The week opened with an unusual healthcare plan supplier breach: 3.3 million payer records held by a card issuer, Newkirk Products of Albany, NY. The company issues ID cards for several Blue Cross and Blue Shield plans and provides management services to other commercial payers. Ironically, it was discovered five days after their $410 million acquisition by Broadridge Financial Solutions of Lake Success, Long Island. On July 6, Newkirk discovered ‘unauthorized access’ to a server with records containing the member’s name, mailing address, type of plan, member and group ID number, names of dependents enrolled in the plan, primary care provider, and in some cases, date of birth, premium invoice information and Medicaid ID number. “No health plans’ systems were accessed or affected in any way” according to the release. MedCityNews, Newkirk release on notice

Another supplier breach affected another estimated 3.7 million patients at Arizona’s Banner Health. This one was a bit closer to home, hacking computer systems used in payment processing on debit and credit cards used at their food and beverage outlets in four states between June 23 and July 7.  A week later, the hackers gained unauthorized access to systems containing patient information, health plan member and beneficiary information, as well as information about physician and healthcare providers. MedCityNews, Banner Health release

But what’s secret anymore about your health data anyway? It’s all those apps that are sending data via your Apple Watch and your Fitbit which aren’t necessarily covered by HIPAA or secure. (more…)

Tunstall Americas’ Vi+ offers free temperature monitoring

click to enlargeLast week Tunstall Americas emerged from a long period of quiet with their introduction of Tunstall’s Vi+ telecare home unit [TTA 3 Aug]. We noted that Vi+ included an integral ambient temperature sensor which could alert their response center on extremes in home temperature and that the release highlighted it. This week, we learned the reason why, as on Tuesday they announced marketing that capability as free Temperature Extremes monitoring for subscribers of their medical alert monitoring service. When the ambient temperature sensor is activated, their call center will be alerted when the room temperature rises above 89°F or falls below 50°F. The subscriber and registered contacts are then notified so that the person can be checked and the situation corrected. Tunstall release (PRWeb)

South Korea’s ambivalence towards telemedicine

The surprising reasons why. 5.8 million South Koreans aren’t exactly tech-phobic, enjoying a nationally swift internet backbone and high personal smartphone penetration. The home of the two leading smartphone makers is pioneering mobile-first retailing and a national IoT network. South Korea (SK) also has the need–an aging population living in rural areas. Yet South Korea bans doctor-patient virtual visits in their Medical Act, and expects major demonstrations by doctors and activists when it comes up for a vote later this year in their National Assembly. Telemedicine and also telehealth/RPM may happen eventually, backed by powerhouses like SK Telecom, Samsung and LG, but will have to take into consideration some unique circumstances:

  • Cyberattacks from North Korea, which have already hit a Seoul university hospital’s software security contractor and demonstrated their system’s HIT vulnerabilities
  • The government’s glitch-ridden telemedicine pilot program with serious problems in data management, encryption and weak passwords
  • The fear that only the rich will be able to afford it–and in SK’s split system, the fear that funding may be withdrawn from the extensive network of community clinics instead of benefiting them

Medical professionals, including the 100,000 doctors in the KMA who successfully blocked telemedicine in 2014 and haven’t participated in the pilot program, are calling for “a slower, more collaborative plan of attack that establishes safety protocols and smart regulatory oversight.”  Quartz

NHS Liverpool seeks telehealth provider

NHS Liverpool Clinical Commissioning Group (NHS LCCG) is soliciting a telehealth (remote patient monitoring) technology for a three-year contract. The first step for the telehealth provider is to submit a Pre-Qualification Questionnaire (PQQ) document by 5 September. If invited, providers will tender for the provision of telehealth technology services. The contract is valued at £2.4 – £14.4 million (including VAT), to start 3 April 2017 and extendable for two years after the initial three. The clinical portion–patient recruitment/assessment, back-end clinical monitoring and clinical support elements– is part of LCCG’s NHS Community Health Services provision and will be separately bid. For complete information, see the listing on the new Gov.UK Contracts Finder. Hat tip to Suzanne Woodman.

Broadband and health in USA

The Federal Communications Commission (FCC) has been investigating click to enlargethe relationship between broadband and health in the US through their Connect2Health Task Force and this week it has released an online tool “Mapping Broadband Health in America”.
It is an interactive map that allows users to visualise, overlay and analyse broadband and health data at the national, state and county levels.

This tool allows easy access to existing health and broadband access data to anyone who wants to look at the possible influence of broadband access on health over a period of time or to identify gaps which may provide opportunities to develop or expand online health services.

The interactive tool allows the user change the broadband availability measure (by say proportion of coverage or download speed for example) and select a health measure such as say obesity rate or preventable hospitalisation days and shows where the selected broadband measure is satisfied, where the selected health measure is satisfied and where both are satisfied. The types of health measures are currently limited but if users find the tool useful and feedback to the FCC there may well be further expansion.

Have a play with the map here.

The Theranos Story, ch. 18: Is the ‘miniLab’ the Real Edison, or The Great Oz 1.0?

click to enlargeIs the Great Oz Behind the Curtain? Updated for The Box and additional articles. Before a skeptical audience Monday afternoon at the American Association for Clinical Chemistry‘s (AACC) annual meeting in Philadelphia, Theranos‘ CEO Elizabeth Holmes, due to be banned from the industry by CMS for lab violations, unveiled a new lab technology. According to Ryan Cross in the MIT Technology Review, “Holmes claimed her company had developed a sophisticated “miniLab” capable of carrying out an array of tests, including detecting the Zika virus, from a finger prick of blood.” A cube-like box, developed in secrecy, she called it a “single platform” able to carry out a wide array (or several–depending on what quote you read!) of different test types using small volumes of blood (apparently finger sticks). The device will be small, portable and directly connected to the internet to centrally send and verify test results. Ms Holmes actually took questions from a three-person scientific panel. When asked if she would be sharing the device with other researchers, she said she was “working on it right now.” It is not, of course, FDA-approved or in production.

Updated for video and new articles (as of 8/19/16).

  • MedCityNews’ Stephanie Baum must have some OSS/CIA blood in her, because it appears she’s beaten everyone on the miniLab Box picture plus posting the Theranos presentation video, which went up via AACC’s YouTube site within hours of the presentation. Other commitments prevent me from an analysis of the hour until later, but gone is the black turtleneck, remaining is the talent for tap dancing around hard facts. The comments in the article and from elsewhere echo the profound skepticism and cynicism found in the MIT and WaPo articles. Yes, the ‘Sympathy for the Devil’ intro was dark humor, served up the way we like it!
  • Bloomberg interviews attendees (scientists, clinical directors, professors, doctors) who believe they were baited and switched. The bait was the justification for Edison performance. The switch was The Box–a new technology, untested, untried and not even peer reviewed–that simply crunched down multiple existing tests into one container.
  • (Updated 8/19) AACC’s published article was short and straight up. “(Dr Steven) Master told Holmes that her data “fell far short” of what he expected based on the wide menu that Theranos promised previously.” Plenty of promises from Ms Holmes at the end, but if CMS has their way, which is likely, Ms Holmes’ “I’ve made the decision to double down and stick by it no matter how hard the path” and to be involved with AACC in the future, will be more empty Theranos promises.

Also WaPo, TechCrunch and POLITICO Morning eHealth

Is Theranos–and Ms Holmes–too far ‘gone’ to be credible or funded? Will there even be a Theranos company to develop this? Will Ms Holmes remain in the business through successfully appealing her imminent ban? The only sensible conclusion is that we’ll believe the technology–and her–when we see it is properly and independently verified–and operated by a company with proper governance and controls.

Stay Tuned to See if The Fix Is In.

Thumb through the prior 17 chapters of the Theranos Story here. Hat tips to @EdifInstruments and Editor Chrys Meewella for the links (WaPo and MIT respectively).

Google’s Verily joint ventures with GSK into bioelectronics (UK/US)

Verily, the Alphabet (Google) life sciences research group, and GlaxoSmithKline are partnering in a joint venture that may replace drugs for disease with micro-electronic implantable devices. GSK will own 55 percent of Galvani Bioelectronics, with Verily owning 45 percent. They have pledged an investment of £540 million in the new UK-based business over 7 years, as well as contributing intellectual property rights to Galvani. Most of the staff will be at GSK in Stevenage with some at Verily’s HQ in South San Francisco, and led by Kris Famm, formerly GSK’s vice president of bioelectronics R&D. The deal is expected to close by end of year.

According to Business Insider UK, GSK has been involved with bioelectronics for four years. It’s defined as “a relatively new scientific field that aims to tackle a wide range of chronic diseases using miniaturised, implantable devices that can modify electrical signals that pass along nerves in the body, including irregular or altered impulses that occur in many illnesses.” The diseases that are being targeted are inflammatory, metabolic and endocrine disorders, including type 2 diabetes. According to the MedCityNews interview of Verily’s CTO Brian Otis, the systems will be closed loop where the devices listen to the nerve signals, do real-time signal processing and send the optimized signal back to the nerve to restore healthy function. GSK has the diagnostic and biologic expertise, Verily has the device smarts. Also Mobihealthnews, Recode

Tunstall Americas introducing Vi+ telecare home monitoring

click to enlargeWe don’t hear much from Tunstall Healthcare in the US other than their traditional/mobile PERS business (formerly AMAC‘s). That may be changing with their introduction (finally) of the Vi+ telecare home unit. It has medical alert, fall detection (via ‘intelligent pendant’) and integrates with home monitoring an array of what they call ‘Virtual Sensors’–motion and other sensors to monitor activity in the home, including wireless sensors for fire, flood and gas leaks. They do make a point of having an integral ambient temperature sensor which will alert their response center if an unsafe high or low temperature is detected.

Other than the press release, no information on Vi+ is on the Americas website yet, including pricing. (Vi without the sensor array has been sold for some time.) Vi+ is marketed in most Tunstall countries in Europe, Australia and New Zealand. The fact sheet from Ireland is representative of Vi+ in most markets.

It’s interesting that Tunstall Americas has chosen to enhance their PERS/call center services with sensors, versus entering the hotter telehealth area. Sensor-based activity/danger monitoring is hardly new. (more…)