Sometimes it takes a 90 year old to design products

click to enlargeBarbara Beskind has a dream job at age 90. She is on staff as a designer for trendy design consultancy IDEO, which designed the Apple mouse. She was a US Army major who after retirement, designed and holds six patents on inflatable devices that assist children with balance issues. Major Beskind is still working on balance problems, in this case now for people in the senior community where she lives. She’s also working on glasses which would help with face-name recognition, and is a resource for other IDEO designers who check with her on hidden drawbacks, like too-small batteries on automated bifocals that can’t be changed by those with mobility problems. If your company is designing products, health tech, apps and more which will be used by an older market, bring on staff an older, perhaps retired, designer to help your team think it through–and get your own secret weapon. NPR AllTechConsidered (photo from NPR) Hat tip to Founder Steve.

‘Separating the wheat from the chaff’ in medical apps daunting: JAMA

Medical apps may not be strangers to doctors’ offices anymore but they also realize that apps are difficult to recommend responsibly to patients or even to find, because there is no real guidance or validation. This current article in JAMA online confirms the perception and the need for care integration that both Editors Charles especially and Donna have pointed out lo these many years. However this Editor is quite disillusioned at the attempts to date to ‘curate’ apps with the Happtique failure and the relatively low profile to date of IMS Health’s AppScript and professional review site iMedical Apps and the stated intentions of SocialWellth which purchased Happtique. The reality is that the numbers are against it–IMS Health in their study estimated 40,000 medical apps–in 2013. For apps that want to take the high road, it’s economically difficult, but could be rewarding in the long term. The WellDoc BlueStar diabetes tracking and management support app did with FDA clearance and prescription-only use, but few so far can see a revenue model there. Also MedCityNews.

Intended use determines degree of health app regulation–and also how you communicate your attributes and performance claims. Bradley Merrill Thompson, who performs an invaluable service by advising our field on regulation, compliance and interacting with FDA, demonstrates how a developer can determine where the intended use of an app might fall (more…)

Weekend Must Read: How an EHR in a teaching hospital gave a patient a 39X overdose

Weekend reading and a banquet for your consideration.

Though computers can and do improve patient safety in many ways, the case of Pablo Garcia vividly illustrates that, even in one of the world’s best hospitals, filled with well-trained, careful and caring doctors, nurses and pharmacists, technology can cause breathtaking errors.

This one began when a young physician went to an electronic health record and set a process in motion that never could have happened in the age of paper.

From The Overdose: Harm in a Wired Hospital by Robert Wachter, MD (Medium.com Backchannel), Part 1 of 4

The situation is a pediatric patient with a severe chronic illness, with multiple symptoms requiring multiple medications to control, admitted to University of California San Francisco (UCSF). The article is a case history of the chain of events, both technological and human, that led to an severe overdose of a routine antibiotic medication, which the patient had already been maintained on for years, nearly killing the child. You will see, with horror, how every check-and-balance failed in the prescribing and dispensing procedure, and why.

Dr Wachter is not only chief of the medical service and chief (more…)

HIMSS’ last full day highlights company partnerships

click to enlargeIt’s almost time to Say Goodbye to Sinatra’s ‘My Kind of Town’, but there’s still news: Samsung+Partners Healthcare, IMS Health, AliveCor, Interoperability≠Humana, Panasonic+Cisco

  • Samsung and Partners HealthCare announced a direct-to-mobile partnership to develop chronic care management mobile software that monitors vital signs such as blood pressure, blood glucose and weight, as well as delivers mobile patient engagement, medication adherence and wellness self-management. Clinical trial is scheduled for June. Partners has always been a pioneer in the mHealth area, but playing with Samsung, Partners is flying at a slightly higher level than with Wellocracy and certainly the late Healthrageous. Partners release, Mobihealthnews
  • App Rating and Prescribing Lives! IMS Health has awakened, shaken off its post-IPO torpor around AppScript [TTA 9 Jan] and was reportedly pushing the app certifier vigorously at HIMSS. Currently AppScript is for doctors in hospitals to rate and suggest apps, devices and educational videos for patients. Their next iteration reportedly is a consumer rating site going live in late May. Hat tip to molto-dapper Dr Dave Albert @DrDave01. MedCityNews
  • Speaking of Dr Albert and his company’s mobile snap-on ECG AliveCor, The British Journal of Cardiology published a highly positive study on its effectiveness in identifying atrial fibrillation. “In particular, the sensitivity was consistently high, which would ensure a high true-positive rate of identification.” and that it should be an option for early identification of patients with unknown AF.
  • Interoperability now is a whole lot more significant beyond us gearheads, because the CEO of mega-insurer Humana said so–but the article concentrates (as presumably his remarks) on ‘value-based’ and ‘outcome-based’ payments. Somehow, interoperability would create an New Jerusalem of efficient, cost-effective healthcare. Does the logic follow? Healthcare Informatics
  • A look at the real hard slog on EHR interoperability was delivered by Dr John Halamka, who’s not even at HIMSS. His field reporter noted working models from Surescripts (patient match-record locator) and CommonWell Alliance (Relay Health‘s FHIR–see TTA 17 Mar) as well as good intentions on Epic‘s part. And the workarounds, even if limited to certain areas such as claims and financial or data analytics, took an entire area of the show floor. MedCityNews
  • And in a foreshadowing of June’s CEWeek New York, Panasonic and Cisco debuted an Connected Patient Room with a networked super-TV which will stream an interactive hospital map, video, patient ed and medical staff messages via Panasonic devices. Content provider to follow. MedCityNews, Panasonic release

Scanadu, Intelesens team for Qualcomm Tricorder XPRIZE (US/UK)

Does it seem that the run-up to the Qualcomm Tricorder XPRIZE has been going on forever? Perception is reality since its various stages have been taking place since 2013 and the $10 million award won’t be until early 2016. This past August, the finalists were narrowed to 10. Now two are teaming up: the best known, California-based Scanadu and (known to our Readers) Belfast-based Intelesens zensor in what will now be known as Team Scanadu/Intelesens. Team zensor also includes Northern Ireland-based Randox clinical diagnostics, CHIC (Connected Health Innovation Centre) as facilitator and CIGA Healthcare for self-test products. Scanadu shipped the Scout as a non-FDA-cleared working prototype only to its Indiegogo backers last year. Intelesens has developed several types of electrodes as wearable patches for hospital and home remote monitoring.

The next stage starts in June with diagnostic experience evaluations and consumer testing at the University of California San Diego (UCSD) Clinical and Translational Research Institute (CTRI). The winning teams must successfully create a device capable of diagnosing and interpreting a set of 15 medical conditions and capturing five vital health metrics. Intelesens release (PDF download)

Tunstall to demo mHealth Down Under at Connect Expo

click to enlargeBreaking from our HIMSS coverage, Australia takes its turn in technology mega-events with the Connect Expo next week, 21-22 April, in Melbourne. It features one expo and 11 conferences, including the Future Health Summit covering telehealth, big data, analytics, wearables and robotics. Featured are speakers Tim Kelsey from NHS England and Dr George Margelis. Reports indicate that sponsor Tunstall will be debuting its mymobile telehealth app, which ties into their Integrated Care Platform, and the myCareTrack app, a mobile safety solution meant for lone workers, including health professionals on in-home patient care visits. The Tunstall website in its release also has presentation times.  Pulse+IT (Australasia) (Returning to the US, we note that Tunstall was absent from HIMSS, and will also be from ATA2015 where they have been a major sponsor in the past. And we wonder how things are developing with mHealth platform designer Tactio.) Hat tip to Guy Dewsbury via Twitter

GE moving out of the hospital EHR business–and healthcare lending?

click to enlargeSpring cleaning at GE continues that may affect healthcare more than EHRs. Neil Versel catches at HIMSS, if not an exclusive, close to it, by finally getting a GE exec to admit the awful truth–that they are phasing out their Centricity Enterprise (hospital) EHR. Versel: “It’s now helping customers with a “graceful transition over a number of years,” said Jon Zimmerman, general manager of clinical business solutions at GE Healthcare.” Even more remarkable, that decision was made three years ago. MedCityNews

The GE Capital exit may affect healthcare too. The other and more major part of the spring cleaning–their exit from GE Capital with the sale/spinoff of assets over the next two years–was announced over the weekend (Bloomberg). Their Healthcare Financial Services lends to healthcare entities including hospitals, life science and in senior housing/health facilities. It also houses the Healthymagination Fund, the capital source for GE Ventures, its early stage developmental arm for healthcare, software and energy. According to The Wall Street Journal, GE will retain healthcare financing to support what it makes in its GE Healthcare unit: ultrasound, imaging, patient monitoring and diagnostics industrial equipment, down to the Vscan (yes! it’s still there). Does this mean that its healthcare real estate unit within Healthcare Financial Services, which lends to senior housing, skilled nursing and medical properties, is on the block, especially as GE this weekend completed the sale of its real estate holdings? What else, we wonder, will GE sell at the right price to pull up share price–and in the longer term, the future of its manufacturing in areas like major healthcare equipment which have been facing a declining and heavily competitive US market?

Exiting the hospital EHR business makes sense. While it retained a solid footprint of vendor loyalty and satisfaction (more…)

IBM Watson Health adds 2 companies, three partners, moves to Boston and into the cloud

click to enlargeA Day with a Big Exclamation Point for Healthcare Data and Analytics. In a series of press releases late NY time on Monday and a spectacular announcement at HIMSS (photo hat tip to Sandeep Pulim via Twitter), the recently quiet-on-the-healthcare-front IBM Watson has announced multiple major moves that re-position it squarely into the healthcare arena as the 90,000 lb. Elephant.

  • IBM Watson Health is now a separate business unit headquartered in Boston. The Watson New York headquarters will be expanded, but that may be for their other businesses: travel, retail, veterinary care, cognitive computing, and IT security and support. IBM claims that Watson Health will be hiring up to 2,000 healthcare consultants, clinicians and researchers, folding in existing units such as Smarter Care and Social Programs.
  • The IBM Watson Health Cloud is now their secure, open and HIPAA compliant platform for health-related data: physicians, researchers, insurers and health and wellness companies.
  • Three new partnerships were announced, designed to bolster IBM in different aspects of what is to be done with All That Data being generated from health and fitness devices. IBM Watson Health Cloud will be the secure platform, storage and analytics for Apple’s HealthKit and ResearchKitJohnson & Johnson will be working with Watson on pre/post-operative coaching and education and Medtronic on diabetes management using data from Medtronic devices. (more…)

HIMSS Monday highlights

HIMSS is the largest US healthcare conference in the world, and Neil Versel, who has just joined the staff of MedCityNews, reported that registrations in this year’s event in Chicago were in excess of 40,000. He has a 37 minute interview with HIMSS Executive Vice President Carla Smith where they touch on CMS, Meaningful Use, EHR interoperability, data security, patient engagement and the empowered patient such as E-Patient Dave deBronkart (who will also be at The King’s Fund Digital Health conference in June). HIMSS is also showcasing on the show floor mobile health, interoperability, cybersecurity, disaster preparedness, intelligent health and the connected patient….Another sign that the Wild West days of digital health are over is the increasing oversight of the Federal Trade Commission (FTC) on non-HIPAA regulated health data collected by fitness and wellness devices. This is in addition to health apps making unsupported claims (see today’s and previous articles on melanoma detection apps) and the PaymentsMD patient billing software that was collecting a little extra patient data. This is both extra- and in addition to FDA. Mobihealthnews….. The Venture+Forum on Sunday discussed doctor burnout particularly in acute care and to ease this, focusing on the Holy Grail of proactive rather than reactive care and results rather than ‘shiny new objects’ (what this Editor has called Whiz-Bang Tech) “Doctors want clinical decision execution. Don’t give me any more tools.” Healthcare IT News….A survey by Accenture released today on doctors and EHR usage headlines good news–79 percent US doctors feel more proficient in their EHR usage than in their 2012 survey. The bad news is that other numbers are plummeting: fewer believe that EMR has improved treatment decisions (46 percent in 2015 vs. 62 percent in 2012), reduced medical errors (64 vs. 72 percent) and improved health outcomes for patients (46 vs. 58 percent). Familiarity breeds contempt? Buried way down in the release is that US physicians offering telehealth monitoring to patients has tripled since the last survey, from just 8 percent in 2012 to 24 percent now. Accenture surveyed over 2,600 physicians in six countries….HIMSS goes to Thursday, so more to come!

Melanoma app fined by FTC for deceptive claims (US)

click to enlargeFollowing on Editor Charles’ reporting since February on two ‘melanoma detection’ apps cited by the US Federal Trade Commission as making unsupported claims on diagnosis of assessment of melanoma risks, one of the two, MelApp, has been fined approximately $18,000, deciding 4-1 in a final consent order. MelApp, an iOS and Android app developed by Health Discovery Corporation and retailing for $1.99, claimed without proof that it could assess skin lesion risk (low, medium, high) through a smartphone photo plus questions about the mark. From the FTC release: “The final order settling the action bars the company from claiming that any device detects or diagnoses melanoma or its risk factors, or increases users’ chances of early detection, unless the representation is not misleading and is supported by competent and reliable scientific evidence. It also prohibits Health Discovery Corporation from making any other deceptive claims about a device’s health benefits or efficacy, or about the scientific support for any product or service….” No word on a final consent order against Mole Detective, but we believe it will follow shortly. FTC press release. Previously in TTA: Action on bad apps, Mole Detective still available, and Mole Detective vanishes. Photo courtesy of the 23 February FTC release

All the sillier then that the VentureBeat article on the FTC action takes the tack that “The fine shows how difficult it will be for future mobile entrepreneurs to launch health apps that go beyond basic fitness and heart rate monitoring.” (more…)

Capita announces partnership with Medibank Australia

Capita Healthcare Decisions is forming a partnership with Medibank, an Australian click to enlargeinsurance and healthcare company, according to a press release issued by Capita. One of the areas highlighted in the announcement is that Capita will provide its TeleGuide product which click to enlargeMedibank has customised to the Australian market.

Capita, with 68,000 staff, is a UK company providing process management and professional support services in the UK, Europe, South Africa and India and has a checkered history with UK Government health service contracts.

In Nov 2008 Capita won the contract to run UK’s NHS Choices website which provides information on medical conditions, treatments and services to UK patients on behalf of the UK Department of Health. The Cabinet Office then refused to renew the £60m 3-year NHS Choices contract with Capita in 2013. (more…)

The underweight may be at higher risk of dementia: UK study

With a personal connection. This study, just released in The Lancet, has created headlines because it contradicts previous research and conventional wisdom that the obese are at the highest risk for dementia. Of nearly 2 million aged 40+ (median age 55), developed from the UK Clinical Practice Research Datalink (CPRD) over 15 years and screened for body mass index (BMI), the highest risk–34 percent– was found among those with a BMI lower than 20, which would include low-normal and underweight, versus those in a normal weight range with BMI 20-25 percent. The very obese, with BMI over 40, had a 29 percent reduced risk versus the normal range. This leads of course to why this is, for others to study. So it looks like you should eat right and exercise, but you don’t have to be a social X-ray. Also The Telegraph, The Guardian. Cheers to one of the researchers, statistician Michelle E Johnson, MSc, of OXON Epidemiology, London–the daughter of TTA founder and EIC Emeritus Steve Hards.

Free e-consultation event for medical students and doctors at the Royal Society of Medicine

For two years in a row, Leicester Medical School has been successfully introducing its first year medical students to e-consultations, an interactive and virtual training program built in partnership with Patients Know Best (PKB). Since then, it has been expanded to three other schools including pharmacy at De Montfort University and has garnered a lot of attention from international schools.

Last year’s event was widely successful as Leicester Medical School and PKB reflected on their experiences, implications of the tool, and lessons learned.

This year, again hosted at the Royal Society of Medicine, Leicester Medical School’s Dr. Ron Hsu and his team are sharing their thoughts and approaches about this training program and reflecting on what will be expected of future generations of physicians and pharmacists.

Anyone interested in e-consultation should consider attending this event. Further details are in this poster. To sign up for the free event on Tuesday, May 5, 2015 from 6:30pm – 8:30pm, please email Dr. Ron Hsu at rth4@leicester.ac.uk.

30 ways mHealth is impacting healthcare–and EHRs need to be

If EHRs were perfect, there wouldn’t be so many companies developing communication workarounds. And why does a HIT consultant play Blame The Doctor?

Practice Unite, an early-stage company fresh out of Newark (cross the Hudson, head south) that knits together patient and clinician communications in highly customized app platforms for healthcare organizations [TTA 11 Mar], has put together a thought-provoking and fully attributed list of 30 ways mHealth is impacting healthcare: the value for patients and clinicians, the need for mHealth apps as part of collaborative care platforms and communication, plus the investment trail towards digital health. Hat tip to @PracticeUnite via Twitter.

One notable point is the difficulty current systems have in integrating data and the increased administrative load (+10 percent more) physicians experience with EHRs versus paper patient records. Confirming this are two items in Thursday’s POLITICO Morning eHealth: one, the privately-driven workaround for universal health data interoperability that the CommonWell Health Alliance is seeking as a non-profit trade alliance. and two, what happened when the GE Centricity EHR used by MedStar Health group’s DC and Baltimore-area outpatient clinics crashed after a weekend upgrade and stayed down through Tuesday night. Weekend data was lost. One doctor’s reaction:

“They kept saying it would be back up in an hour, but when I left work Tuesday night it was still down.” This doctor told us that the outage was “disruptive and liberating at the same time. I wrote prescriptions on a pad for two days instead of clicking 13 times to send an e-script. And I got to talk to my patients much more than I usually do. But of course we didn’t have access to any notes or medication history, and that was problematic.” 

Now this observation is neither petty nor isolated. Last Fall we noted a JAMA study of internal medicine physicians finding that for both experienced physicians and trainees, there was a loss of time across the board in taking notes, reviewing patient data and at least one data management function was s-l-o-w-e-r. [TTA 12 Sept 14] Houston, we have a problem.

Yet there are still the ‘nothing to see here, move along’ types sailing down A River in Egypt. Others blame the victims, as in the doctors, for their cloddish unwillingness to Get With The HIT Program. (more…)

NY Digital Health Accelerator 2015: call for applications

click to enlargeDeadline: 18 May. The third annual call for applications for the New York Digital Health Accelerator is now open. NYDHA, a joint program run by the New York eHealth Collaborative (NYeC) and the Partnership Fund for New York City, is a five-month program for ten early- and growth-stage digital health companies in New York (or willing to locate in NY state). What makes the program distinctive in their view, in addition to being in NY, is that it offers unique exposure to top-level healthcare executives and venture capitalists while accelerating product development and access to capital. Certainly its 20+ partners come from the top level of NY healthcare companies and providers, such as Aetna, North Shore-LIJ Health System, Winthrop University Hospital, Rochester General, VNSNY, Mount Sinai and many others. 15 companies in the prior two years of the program have done extremely well, raising a total of nearly $41 million in additional capital post-program, securing 33 pilots and creating more than 120 jobs. Two were acquired: Avado and Remedy Systems. New for 2015: to encourage collaborative innovation, two companies can jointly apply to present a combined solution. NYDHA website, press release, FAQs on applying.

European tours for professionals in aged & disability care (Australia)

Sydney-based Community Resourcing Worldwide and CORAL (The Community of Regions for Assisted Living) have three Professional Development Tours to Europe primarily for Australian professionals. These tours are designed as professional exchanges of best practices with international experts in community aged and disability care to explore practice, policy and funding models. Visits are arranged to state-of-the-art facilities and community initiative programs that exhibit innovative approaches to service delivery, selected to showcase outstanding approaches to service delivery and innovation. Particular focus has been made on the application of assistive, enabling and operational technologies which are significantly changing the service and workforce models deployed as well as achieving greater health and social outcomes for the consumers of services.

  1. 8 June 2015, starting in Geneva and held in conjunction with the 13th International Conference On Smart Homes and Health Telematics (ICOST 2015)
  2. 15 June, Netherlands-Denmark
  3. 22 June, Catalonia

CRW website. Tour information and registration PDF. Or you may contact Elizabeth Dodd on 0457 838 570 for more information: liz@communityresourcing.com.au