COESI: Accessible website done well (UK)

Readers may be interested to see an example of a website that has gone to great lengths to make itself as accessible as possible without compromising an eye for a workable design. It’s the Centre of Excellence for Sensory Impairment (COESI). The Croydon (UK) based Centre “develops and provides integrated direct services for people with sensory and physical impairments”. Heads-up thanks to Pam Bennett. If readers know of other good examples, please post links in the comments.

Your weekend outrage: Indian government plans ‘alert device’ to stem crime

This is either the most outrageous example of ‘NIH’ (not invented here), willful ignorance or sheer howling incompetence by the Indian Government in the face of frequent personal assaults often leading to death. The Wall Street Journal India just revealed, in the blandest possible terms, that the Indian Government’s ‘department of electronic innovations’ will be working on plans to develop a prototype wristwatch by mid-year that can, when the wearer pushes the panic button 1) send a text message to police and family members, 2) has a GPS to send location and 3) shoots 30 minutes of video–for US$20-$50. As our readers will remember, an attack on a young couple in central Delhi in December, and her subsequent death from beating and rape, made international headlines in December, initiated mass protests and revealed police incompetence in fighting and prosecuting crime.

Needless to say that what immediately came to Editor Donna’s mind was that there are already several devices on the market that do precisely that for the alert functions; the two top-of-minds were Aerotel’s GeoSkeeper and Lok8U’s Freedom but this Editor is sure our readers can identify others. All the state-run telecom, ITI, need do is adopt or license the technology and market it at a low affordable price perhaps subsidized by said Government. Cheaper, better, faster.

A panic button will not save the vulnerable from attack. Any device may be ineffective in a remote area, where the police are distant or not responsive and if the wristwatch is torn off. Encouraging women to take courses in situational awareness and personal self-defense–including the proper use of self-defense weaponry such as tasers, pepper spray (Mace) or even low-load pistols–would be a lot more effective as a first line. Better policing and law enforcement would also be strong deterrents. This ‘watch’ idea is a decent tool and a backup especially for those who cannot carry said defense, and better than nothing in discouraging assaults. And video is not needed–so after the fact, hardly a deterrent and perhaps even a further incentive for a criminal to badly maim or kill a victim.

So why is the Indian Government taking its sweet time in developing, then providing, an alert and video wristwatch to mitigate crime, when ‘off the shelf’ alert versions are readily available? Is it merely a bone thrown to the protestors? Certainly those who have been victims, or are close to someone who has been, will grimace consuming this serving of oatmeal. A Wrist-Worn Answer to Sexual Attack? (Wall Street Journal IndiaRealTime) A hat tip to Toni Bunting, TANN Ireland.

Update 4 Feb: Here’s a combination that in a right-side world might seize the imagination of the Indian Government: pepper spray, blinding light, quick photo that is then sent via Android smartphone to authorities. Stop/divert attack, get evidence and send to the police. Devised by three students from Cornell University for their ‘Design for Microcontrollers’ course, it may be far from finished work but even starting at this point, the turnaround to a workable, inexpensive defense/notification tool might be far shorter than the magic watch, and do more. Article (The Next Web) and the students’ project PDF. Another tip o’ hat to Toni Bunting.

Worcestershire Pathfinder pre-tender docs: Tender is the Stitch-up

Frankly, the last thing I [editor Steve] want at 7.00am on a Friday when I’m about to prepare the day’s alerts email (sign-up box above), is to receive documents that demand to be read and for an item to be written. But ‘thanks’ to a reader that is what I’m now doing. I therefore apologise that the alerts email is late this morning.

Late last Wednesday night I published a link to the 3millionlives (3ML) website which had published a document by Worcestershire County Council, prepared in October 2012, that set out its ‘business case’ for tendering its telecare and telehealth service as a 3ML Pathfinder Site. Yesterday it attracted nine highly critical comments from four TA readers. If you have not done so yet, read the item and the comments, now running onto two pages.

The two documents the aforementioned reader sent me are Worcestershire’s follow-on documents that are part of the formal pre-tendering process: the Prospectus (PDF) and the Pre-Qualification Questionnaire (PQQ) (Word Document). The latter is for return by the end of February if you are interested in bidding.

So what, on the basis of early morning skim-reading, has compelled me to write this item? (more…)

Is mHealth delivering in developing countries?

For the past few years, mHealth has been advocated, quite plausibly, as a key part of improved public health in low to middle-income countries. Cell phones are ubiquitous in African countries, and in the West there’s news of potentially revolutionary apps and clinical device attachments at least every month. Now here is another one of those pesky review studies, published in the Journal of Medical Internet Research. While not dumping a cold bucket of water on these high hopes, the review certainly points out the need for more rigor. Studies to date are heavy on process documentation, few demonstrate impact on outcomes, and lack scale. Most programs involved text/SMS messaging or support tools for community health workers. The review was authored by a team from the Malaria Consortium (UK, Uganda), the Institute of Global Health, University College London, and the London School of Hygiene and Tropical Medicine. Mobile Health (mHealth) Approaches and Lessons for Increased Performance and Retention of Community Health Workers in Low- and Middle-Income Countries: A Review (JMIR) Also iHealthBeat and FierceMobileHealthcare

Brace yourself #2: global telehealth to reach 1.8 million patients by 2017

InMedica (IMS Research) drops another shoeful of data in its latest publication ‘Analysis of Demand Dynamics’ [TA 4 Jan] by predicting a global rise to 1.8 million patients annually by 2017, up from 308,000 patients in 2012 remotely monitored by their providers. The majority of currently monitored patients have congestive heart failure (CHF) followed by chronic obstructive pulmonary disease (COPD), but by 2017 InMedica projects that COPD will be surpassed by diabetes. InMedica release

Related: A large N (8,000) study finally on telemedicine virtual visits published by JAMA Internal Medicine compares the quality of patient care between ‘e-visits’ and in-person visits. Patients had sinus infections and urinary tract infections and were surveyed between January 2010 and May 2011. For both patient groups, 7% or less returned for another consultation within three weeks. This suggests that both forms of visits have the same quality–and the e-visit cost 21% less. JAMA 14 January. Institute for HealthCare Consumerism (also InMedica)

A review of 75 mHealth consumer studies

Not just one, but two major analyses of mHealth studies to date. Published in PLOS Medicine with the 42-study review of mHealth as used by health professionals [TA 18 Jan] is a separate review, by the same team, of 75 studies evaluating disease management outcomes and behavior change in health care consumers. Like the review of professional studies, the outcomes are inconclusive and inconsistent due to study quality. What was promising was perhaps the simplest: “Text messaging interventions increased adherence to ART (antiretroviral therapy) and smoking cessation and should be considered for inclusion in services.” The Effectiveness of Mobile-Health Technology-Based Health Behaviour Change or Disease Management Interventions for Health Care Consumers: A Systematic Review (PLOS Medicine) The much-discussed Scientific American article, App’d to Fail: Mobile Health Treatments Fall Short in First Full Checkup

Your Friday robot fix, plus two

Korean ‘nurse droid’ being tested in nursing homes. The KIRO-M5, which resembles a pint-size (3′) version of R2D2, can wake up residents, announce meals, schedule daily exercise–and can sniff the air to alert an aide or nurse when an elderly patient needs a diaper change. The KIRO also sterilizes and deodorizes the air, and totes supplies. Developed by the Korea Institute of Robot and Convergence. Korean nurse bot sniffs the air to detect soiled diapers (GizMag)


A polymer patch delivers vaccine. Designed by MIT, a dermal patch with microneedles slow-releases vaccine DNA rather than viruses or proteins, to allow the body to build immunity. Could this open up fresh horizons on drug delivery? And with a wafer-thin transmitter, can monitor it? Polymer patches could replace needles and enable more effective DNA vaccines (GizMag)


And finally the most amazing–a prosthesis mostly out of a 3D printer. A five-year-old boy, Liam, now has a workable hand with moveable fingers made using a Replicator 2 3D printer. The fingers are attached to a brace worn over the hand, and controlled via cables and return bungees. The designers who collaborated long distance from Washington state and South Africa, have also released the design into public domain. Inexpensive home-brewed prostheses created using 3D printers (GizMag)

BlackBerry 10: the Last Chance Saloon? (UK/US)

Once the favorite of doctors and health professionals, now completely overwhelmed by Apple, the BlackBerry 10 is widely seen as the last chance for the now eponymous company. Coming in predictive word lookup touchscreen (Z10) and keyboard (Q10) versions (addressing the accuracy problem of touchscreens, not good in healthcare data entry), the BB10 also offers a dual-mode between work and personal information–very appealing to healthcare CIOs–with supposedly fast switching between the two. Despite design and handling raves from tough customers such as ZDNet (with the usual grousing about apps), the forecast is cloudy at best; BB’s enterprise base here in the US as of Q4 2012 dropped to a distant 6%–third–behind iPhone and Android OS phones. Curiously, the UK will be first to get the BB 10 in the touchscreen version only, which hints at a slow or ‘debugging’ rollout; March for the US. From the healthcare side, Mobihealthnews. From the tech side, ZDNet: Beautiful phone playing serious catch-up; It’s all in the name

Patient monitor Intuitive Health raises $3.8 million

A capital way to start 2013. According to the Dallas Morning News and an SEC filing, Texas-based Intuitive Health, which this past year was in pilot with AT&T and Texas Health Resources, obviously made their case to (undisclosed) investors with a raise of $3.8 million in an equity offering at end of 2012. The Intuitive Health system uses AT&T connectivity to send patient telehealth information to providers; AT&T touted Intuitive in their 2013 predictions [TA 6 Dec]. The Texas Health Resources pilot from April 2011 to August 2012 reduced chronic heart failure readmissions by 27%. One hopes that they use part of that $3.8 million to develop their website beyond a single page with a crawl at the page bottom. MedCityNews

HomeTouch: A brand new service (UK)

Take two clever people and a personal need to co-ordinate care and communications for family members on different continents and you come up with another new service. The launch press release describes HomeTouch’s founders Dr Jamie Wilson and Daniel Mueller as ‘a former NHS physician’ and ‘an electrical engineer’ respectively. However, their About Us web page reveals that description to be extremely modest. The HomeTouch system is a monthly-fee-based software-as-a-service and has three linked components:

  1. a tablet application for older people, with basic services services including messaging, videocall, calendar and photo album
  2. a cross-platform (smartphone, desktop) application with dashboard analytics and services for families and carers
  3. an ‘intelligent’ server that monitors activity and manages communication between the two applications

At the moment they are offering some free trials – contact them through the HomeTouch website.

Let’s hope they have the funding and the nerve to make a success of it. Anyone with a decent product who is aiming at the ‘children of aging parents’ market that has yet to show any signs of taking off in the UK deserves some success. Ed. Steve

UK Government’s £5m fund competition

The Department of Health announced at the beginning of January [Sorry I missed it before. Ed Steve], a competition that may be of interest to some of the smaller telecare/telehealth companies. They are encouraging new products and services that will help improve the experience of people with mental health illnesses and people at the end of their life. The deadline for applications is 28 February 2013. Details here.

Telemedicine and the law (UK-mostly)

This item is an oddity because it is undated and was part of a thesis written for someone’s Master in Laws (LLM) at Cardiff Law School. Although UK- and EU-focused, includes examples from the US and other places and it is a potentially useful reminder of the principles of law relating to the practice of telemedicine and telehealth. It covers topics such as consent, confidentiality and malpractice owing to equipment failure. Most interesting is the final paragraph which points out that once a particular way of working becomes the ‘accepted practice’ then doctors can be negligent if they choose not to use it – and that the adoption of technologies can become widespread quite quickly. Now that has interesting implications for telehealth and its adoption. Emedicine & Telemedicine Law Info.

One big step for iRobot, one small step for doctorkind (US)

It’s always been a gripe of ours that the telepresence/telemedicine carts used in hospitals were person-guided and therefore not ‘really worthy’ of being termed robots. However, according to the GizMag item (with video), iRobot receives FDA approval for physician avatar RP-VITA, iRobot “realized that they should not waste the time of either the physician or the hospital staff in guiding the robot around the hospital[so now] the doctor need only click on the location of the next patient to visit, and RP-VITA signals when it has arrived on site.” Oh, and there is that small matter of FDA approval.

2012 a breakthrough year for health tech investment, no matter who’s counting

We had earlier this month reported on Rock Health’s digital health estimate of $1.4 billion, up 45% vs. 2011 with 20% going towards the five biggest deals of the year [TA 8 Jan]. Now Austin, Texas-based Mercom Capital Group does its own slightly lower count of $1.2 billion in VC investment in what’s termed HIT, but this is 200% higher than their prior year total of $480 million. There’s overlap but difference in their five big companies: Castlight Health (provider comparison), 23andMe (personal genetics), GoHealth (health insurance comparison), Kinnser Software (home health clinical support) and the Practice Fusion EHR. Mercom also details the M&A activity topping $7 billion with McKesson being the most active acquirer. Finally, Mobile Health Market News did its own analysis and came up with $907 million, led by ‘health care IT service’, monitoring and consumer apps (although skewed wildly from Castlight Health in this category). What is also clear is that the pace slowed in 3rd and 4th quarters–and that the pace of 2013 investment very much depends on the US economic climate and the effects of government healthcare policy. Mercom: iHealthBeat (summary), MedCityNews, Healthcare IT News. Mobile Health Market News, mHealthWatch