Chronic care management with telehealth (US)

Our readers, especially those in the US engaged with medical practices, might be interested in reading a two-part interview with Editor Donna by occasional TTA contributor Sarianne Gruber. We discuss the new model for Chronic Care Management (CCM) now included in what the Federal Government (CMS-Center for Medicare and Medicaid Services) pays physicians for Medicare patient visits and services. Telehealth, or in CMS terms remote monitoring, can play a vital role in the provision of care coordination, assessment, documentation, patient access and facilitation of self-management as part of the care plan, culminating in better outcomes at lower cost. Published in the new RCM (Revenue Cycle Management) Answers, a spinoff of HITECH Answers. Part 1.  Part 2

National telehealth plan to improve rural health called for in Australia

Ahead of the forthcoming Australian Telehealth Conference 2015, one of the speakers has spoken to the media partner of the conference, Australian Aging Agenda Technology Review. In an article published on the Aging Agenda website, the speaker, Dr Shannon Nott, is quoted as saying “There needs to be a telehealth plan put in place in Australia. We need to start looking at telehealth and say this is something we should seriously invest in. We need to look at it and get it right from the start; that includes getting it right for indigenous communities [and] getting it right for rural and remote communities”.

Nott is said to have spent four months last year researching telehealth in rural and remote Alaska, Canada and Brazil including indigenous communities. The article quotes him as saying “In Alaska for every dollar that they spend on telehealth software and programs they save $10.50 in travel alone in terms of healthcare costs. Not to mention the hospital admissions avoided, the GP admissions avoided.”

click to enlargeThe Australian Telehealth Conference 2015 takes place on the 23rd and 24th of April in Sydney.

NHS Apps Library embraces mental health…and Mole Detective vanishes

Thanks to Mike Clark for pointing this editor to the breaking news that the NHS Mental Health Apps Library has now gone live. It features online tools, resources and apps that they claim have a proven track record of effectiveness in improving mental health outcomes.

It is accessible through the NHS Choices platform, a website that gathers over 40 million visits per month, 9.7 million of which are to pages on depression; 6 million per month to stress and 9.4 million to anxiety.

This is likely to be a major benefit to those who have difficulty obtaining access to face:face mental health services, especially as a number of presentations in the Royal Society of Medicine have suggested that online mental health services can often be more effective (more…)

Data breaches top 120 million since 2009 (US)

click to enlarge“The medical industry is years and years behind other industries when it comes to security.”–Dave Kennedy, TrustedSEC CEO.

We admire the Washington Post for arriving at the conclusion we did in 2010–that healthcare organizations are uniquely vulnerable to cyberattack because of the high value of patient data, and an often lighter level of HIT security. But now we get the finger wag that ‘it’s only going to get worse.’ (Beyond 120 million breached records?) Data security, of which HIPAA patient information protection is a part, wasn’t primary for years, especially in organizations overwhelmed with transitioning EHRs, getting EMRs to speak with EHRs, Meaningful Use, new care and payment models, 30-day readmissions and ‘oh, by the way, how will we get paid?’ The Premera Blue Cross (Washington state) breach of 11 million records was the second largest in healthcare history (after Anthem Health‘s February bunker buster of a breach). Most breaches are from stolen laptops or shared/easy to guess passwords (or none at all)–but these have not been in the millions. Premera’s theft took place on 5 May 2014 and was only discovered in January; it included SSIs, bank information, claims data, patient name/address and date of birth. Those affected were in California and Alaska primarily, but also included Federal employees.

But Premera can’t say they were not warned. The US Office of Personnel Management’s Office of the Inspector General (OPM OIG) independently audited Premera in April 2014 detailing several vulnerabilities, including a lack of timely patch implementations, a lack of methodology to “ensure that unsupported or out-of-date software is not utilized” and insecure server configurations, and the need to upgrade physical access controls in their data center. FierceHealthIT

Premera’s medical files data may expose other payers, which in turn may legally come after Premera, according to FierceHealthIT.

Only now are health systems and practices focusing on securing all information  (more…)

Assistive tech for older adults gets fresh developer interest, funding

Companies and investors are waking up to the potential of technology to assist both older people, wherever they live, and families to keep in touch, live more safely and to compensate for impediments created by physical or cognitive conditions. Ozy, an online news aggregator new to this Editor, notes the $5 trillion annually that boomers and older adults spend in what’s termed the ‘new old-age economy’ (AARP has previously termed it the ‘longevity economy‘) and that there’s money in tech solutions to their problems. Examples: the Lift Labs [TTA 1 Oct 13] stabilizing food utensil that cancels out most active tremors (as in Parkinson’s) while eating; Caremerge which has EHR, care coordination and secure messaging features for the care team in long-term and transitional care, but also connects families with a smartphone app and residents with reminders; GeriJoy [TTA 3 July 14], a tablet that combines an interactive pet avatar/companion with engagement, reminder and education tools for older and cognitively impaired adults.

While we’ve noted many developments along similar lines over the past ten years, interest and financial backing is aligning. (more…)

W Australia telehealth scheduling contract awarded to Telstra

Telstra Health has won a contract to provide its iScheduler product to the Western Australia Country Health click to enlargeService’s Statewide Telehealth Service, worth $3.2m over five years, according to an article in Pulse+IT. iScheduler will be used to support the scheduling and management of emergency telehealth services, patient telehealth consultations and education and training for doctors, specialists, nurses and other staff according to the article.

The Western Australia Country Health Service is the largest country health service in Australia and one of the biggest in the world, providing health services to approximately half a million people, over a vast 2.5 million square kilometres area. The range of health services provided cover primary health care, emergency and hospital services, population health, mental health, Indigenous health and aged care.

The Rural Doctors Association of Australia has, in October last year, previously criticised a new telehealth service launched by Telstra that was to connect patients to random GPs via phone and video, saying it could undermine the viability of rural general practice (see Australian Rural Doctor).
Telstra launched its ReadyCare service in October, announcing it would offer patients around the clock advice, diagnosis, referrals and prescriptions from doctors either over the phone or through video link.
The communications giant had claimed the service will deliver better healthcare to rural and remote Australians who live a long way from their doctor.
But the RDAA and the AMA disagreed.

Next DHACA Members’ Day 27th April – come for free!

The next DHACA members’ Day will take place on April 27th at the Norcroft Conference Centre at Bradford University (Tumbling Hill St, BD7 1DB) starting at 9.30 am – all members are invited, free, and membership currently remains free, too.

The principal focus of the day will be five projects that members of DHACA special interest groups (“SIGs”) are beginning work on – the intention is to engage all DHACA members in at least one. The five projects are:

  • Testbeds for digital health
  • Developing mHealth Apps
  • Wearables for Self-Care
  • Defining the digital platform for citizen engagement with the NHS
  • A Programme of Education to promote apps and other digital technology in self care

To start the day, we have invited Beverley Bryant, Director of Strategic Systems and Technology at NHS England, and Bill McCarthy, Deputy Vice-Chancellor (Operations), and Honorary Professor of Health Policy at the University of Bradford, to speak.

Join DHACA here. Book your place for April 27th here.

Radiation from smartwatches, wearables: real, alarmist, or the NY Times?

click to enlargeThe Gimlet Eye has that certain half-baked radioactive ‘glow’. The healtherati are all aTwitter over a New York Times Style (!) section article that does the unthinkable–it dares to raise the question of the possible harm of radiation that wearables, including smartwatches as well as smartphones, might present to both adults and children. The writer, Nick Bilton, is a regular tech columnist.

After an unfortunate baiting for attention at the start, making an analogy of cellphone/wearable radiation to 1930s adverts with doctors ‘endorsing’ cigarettes, he for the most part tries to take a balanced approach. By the end, he lines it up like this. Bluetooth LE and Wi-Fi–no evidence of harm in adults. 3G/4G cellphone radiation–you may want to be careful. He points out that studies aren’t definitive. Older studies, such as the WHO’s, a Swedish and some European studies point to harmful (carcinogenic) effects from phones held extensively too close to the head, but nothing is definitive in causality as the CDC pointed out and additional studies have proven no conclusive evidence of harm. Conclusion–use anything 3G/4G with caution, away from the head, limit exposure by children or pregnant women. Cautious enough?

Oddly, he advocates Bluetooth headsets but doesn’t mention using speakerphone settings–and then, for the smashing windup, won’t put the Bluetoothed Apple Watch near his head. It’s a weirdly sourced (an alternative doctor the only one cited? Old studies?) and half-baked, partially tossed salad article. Consider: most wearables are–surprise, Bluetooth or Wi-Fi connected. But it does bring up the inconvenient question, only partially answered, of All Those Rads and What (If Anything) Are They Doing To Us.

What’s really interesting? The immediate, twitchy and prolonged press response. As they say in New Jersey, they are ‘jumping ugly’. (more…)

Scotland invests £30M over 3 years on telehealth (UK)

In a news release this morning (19 March 2015) the Scottish Government said it is to allocate click to enlarge£200m over two years to support the implementation of health and social care integration.

According to the release the investment will extend the current Integrated Care Fund into 2016/17 and 2017/18, and comes on top of £100 million of funding already allocated for 2015/16. The money will be distributed among the 32 local NHS and social care partnerships that have been set up as part of the move towards integrated services.

The Integrated Care Fund forms part of over half a billion pounds of Government investment over the next three years that will be used to support integration, including £100 million over three years for delayed discharge, and £30 million over three years for Telehealth.

The Integrated Care Fund supports the implementation of plans to  bring together health and local authority care services by 1 April 2016.  This will give the partnerships the resources to focus on preventative care and early intervention as well as support for people with multiple and long-term conditions. (more…)

Recent developments in digital health – RSM event report

The third successive year’s sellout “Recent developments in digital health” event, hosted by the Royal Society of Medicine (RSM) in London, UK, attracted prestigious speakers from across the NHS, industry and academia and provided delegates with a comprehensive overview of digital healthcare advancements in 2015.

Organised by Dr Andrew Harper, from the Telemedicine & eHealth Section at the RSM, the meeting provided insight into how the NHS is lining up to integrate and deploy digital health technologies to advance patient care.

Attracting senior NHS England members including: Paul Rice, Head of Technology Strategy; Dr Mahiben Marruthappu and Dr Harpreet Sood, Senior Fellows to the Chief Executive, the vision for digital health integration and deployment throughout the NHS was finely characterised and explained to delegates.

These sessions were supplemented by real-world experiences from Dr Dominic (more…)

A mélange of short subjects for Tuesday

ATA accredits American Well, Apple ResearchKit, diabetic contact lenses, Hackermania Falls on Indiana, patent trolls get a haircut, and more

The ATA (American Telemedicine Association) has gained more than 200 applications for their US-only Accreditation Program for Online Patient Consultations [TTA 17 Dec 14]. First past the post in accreditation is American Well’s Amwell virtual visit app, which will shortly be listed on the ATA consumer website SafeOnlineHealth.orgRelease, MedCityNews….Stanford University, one of the five academic centers using the Apple ResearchKit, had a mind-boggling 11,000 signups for a heart health study–in 24 hours. The downside is that they may not be representative of the whole population [TTA 10 Mar, see 11 Mar update] including us Android users. 9to5Mac….The Google-Novartis glucose-measuring contact lens [TTA 17 July 14] for diabetes management just gained some Canadian competition–Medella Health in Kitchener, Ontario, founded by a team of (more…)

EHRs can’t exchange patient records? $$ in workarounds.

Some of the Excedrin/Panadol Headaches (#11, #14, #23 and #54) in healthcare are around the very ‘miracle technology’ that was supposed to make it all seamless, non-duplicative, time/cost-effective and coast-to-coast–EHRs. The exchange of patient records between hospitals, within health systems between sites and with medical practices plus vice versa–works haltingly if at all. It works best within well-established, highly integrated delivery systems –the VA, DOD, Mayo Clinic, Kaiser, Geisinger, Intermountain Healthcare. But once you’re away from it–good luck. Where are the problems? The closed standards of the major hospital EHRs–Epic, Cerner, Allscripts, McKesson and brethren; the extreme customization most health systems demand (nay, a major Epic selling point!); structured versus unstructured data and how handled; a lack of a secure interoperability standard are but a few. Where is the gold? Getting patient health records exchanged, accessible and transportable, among systems that were essentially designed not to speak with each other. (more…)

University of Mississippi telehealth center to expand (US)

click to enlargeA Baton Rouge, La.-based data company set its sights on Jackson, Mississippi, and announced on Tuesday (10 March 2015) it will build a technology center that, in part, will house one of the University of Mississippi Medical Center’s fastest growing services – telehealth, according to a news release from UMMC. UMMC entered into a lease agreement with Venyu Solutions, LLC, which will construct a stand-alone, 16,000-square-foot facility to accommodate the increase in the services UMMC’s Center for Telehealth provides to hospitals, clinics, corporations and patients across the state.

Venyu CEO Scott Thompson is quoted to have said construction would start in April or May and take a little less than a year. The hospital’s lease will begin on or around July 1, 2016. (more…)

Sweat analyzing sensor patch flies high at USAF Research Lab

click to enlargeCall them ‘sticky sensors’, biosensor tattoos or as you like, but there’s been a lot of research happening in the past three years around gathering biometrics from skin contact. Whether it’s the John Rogers ‘skunk works’ at University of Illinois at Urbana-Champaign measuring ECG, EEG and cardiovascular conditions; University of California-San Diego’s lactate and blood glucose monitoring; MC10’s Biostamp for infant temperature, head impacts and neurological disorders plus NewDealDesign‘s multi-purpose implants, skin is in. Though the Apple Watch was flummoxed (for now) by biometrics due to hairy arms and sweat [TTA 18 Feb], these sensors thrive on the latter. The US Air Force (USAF) Research Laboratory has been working on sweat analytic sensors for some time now [TTA 24 Apr 14]. (more…)

State telemedicine legislation update (US)

Here’s some brief updates on US telemedicine legislation scene to hit the news recently.

Florida

Florida is progressing the telehealth bill we reported on 12 Feb 2015. The Florida Senate click to enlargeTelehealth Policy Committee revised the draft bill on 18 Feb 2015 so the need for Medicaid reimbursements to be the same for telemedicine and face-to-face consultations is removed.

Mississippi

We have reported many telehealth initiatives from Mississippi and the state is now considered to be “a leader in telemedicine” according to a recent report in Politico. “Mississippi’s telemedicine program, ranked among the seven best in the country, has inspired neighboring Arkansas to take bigger steps in some areas of the field, and the impact of its success is making waves in Washington as well” continues Politico.

Mississippi is also helping to move telehealth at a federal level. Rep. Gregg Harper (R-Miss.) and Rep. Mike Thompson (D-CA) introduced a bipartisan bill in July last year to expand telehealth services under Medicare. The bill called Medicare click to enlargeTelehealth Parity Act 2014 starts to move face to face and telehealth consultations to be on an equal footing.

(more…)

‘Rotting In Place’

Laura Mitchell, who was one of the key people behind GrandCare Systems and now is a marketing consultant and healthy aging advocate, has written an interesting article on LinkedIn Pulse, now on her website, springing off an AgingInPlaceTech article by Laurie Orlov.  Like the latter’s article, it commented on the Washington Post profile of Prof. Stephen Golant, whose POV on ‘aging in place’ was mostly that AIP is oversold–that in many cases, it’s ‘rotting in place in their own homes’. It’s a highly provocative topic with equally provocative statements and Ms Mitchell does take him to the woodshed, as does Ms Orlov in a different way. Prof. Galant seems to take a more moderate tone in his book (publicity perhaps?), citing (in the Amazon summary) that “older people often must settle for the least imperfect places to live. They are offered solutions that are poorly implemented or do not respond to the totality of their unmet needs.” a statement with which this Editor finds it difficult to disagree.

This Editor will largely cite her previous LinkedIn comment with a few embellishments/edits: (more…)