Growing Army-Navy ‘jointness’ in telehealth (US)

Our readers will note that most advances in telehealth, in smartphone-based support and TBI research have originated out of the US Army’s  Telemedicine and Advanced Technology Research Center (TATRC), the Army Research Laboratory, Medical Research & Materiel Command and the Research, Development and Engineering Command. The US Navy has jumped in with Kinect for rehab with the West Health Institute. Now the US Army Medical Information Technology Center at Fort Sam Houston (Texas), part of the Joint Base San Antonio (JBSA), is the point of contact for the Navy for a pilot program using instant messaging hardware and software–Jabber–to be tested at Naval Hospital Camp Lejeune, North Carolina and planned to be rolled out through worldwide naval medical facilities. JBSA is the locus for medical training in the Army and much of the armed forces; the Army’s medical school AMEDDC&S is located there. Fort Sam Houston’s Video Network Center also handles telemedicine consults for the Army, Navy and VA. USAMITC helps telehealth become a reality for Navy medicine (JBSA release).

Two more useful – Simple Telehealth – items for GPs (UK)

Nearly a month ago we posted links to GP Online two articles written by Professor Ruth Chambers for UK GPs about practical ways to use the NHS Simple Telehealth system–aka Florence or Flo. They covered hypertension and inhaler use. Now we discover two further articles, oddly, on a different part of the site. They follow the same useful pattern as the earlier ones. They are:

  • Adopting remote monitoring via telehealth in your CCG’s practices – part 3: smoking cessation
  • Adopting remote monitoring via telehealth in your CCG’s practices – part 4: weight loss

EU ahead of US on telehealth

US law firm Epstein Becker Green analyses two key differences between the US and EU regulations affecting telehealth. First they identify the ability of health workers to treat their patients even when the patient moves to another EU state. Second is about getting health insurance companies to cover costs when health services are received abroad – it seems that insurance companies are required to do so under an EU directive whereas in the US cover is mostly state based: E.U. Way Ahead of the Game on Telehealth. Heads-up thanks to TANN England editor Chrys Meewella.

The diabetic experience: the fly in the Quantified Selfing ointment

click to enlargeQuantified Selfers (QSers) maintain that their obsessive practice not only is the be-all and end-all of leading a Healthy Life, but if only more of the hoi polloi would do it, we’d avoid doctors and healthcare costs, the seas would part and we’d bounce to the Gates of the New Jerusalem with a gleam in our eye, driving our Fords with Allergy Alert SYNC. Well, this Eye has gazed Gimlety on this entire Movement for quite a while, to the raised noses of the Healthcare Digerati, and now has found a fellow nay-sayer and nose lower-er in the unexpected pages of The Atlantic. The Eye now slaps the Head for not thinking of the following.

Who were the early adopters of QS? Diabetics. From the late 1970s on, patients were handed glucose meters in the doctor’s office, stacks of reading material and told to go forth and self-manage. Are they happy? Empowered? In control? Au contraire, mon frere!

The fact that diabetics have been doing this for years, and that they largely loathe the experience (author’s emphasis), not only serves as a caution to the vogue of self-tracking. It also offers an opportunity, serving as an object lesson in what works, and what doesn’t work, when people track their health.

Loathing Can Be Quantified as in the 2012 BMC Health-published survey where diabetics told researchers that self-monitoring was the enemy, a Sisypheian task, a perpetual Battle of Stalingrad. No wonder why they are DEPRESSED. The sheer tedium of every day, several times a day, pricking fingers with crude monitors, making the decision on to eat, what, to inject or take pills, meds that get you sick, and never, ever being ‘in balance’, feeling wrong, guilty and scared, would depress The Eye more than sitting through a Jim Carrey movie. Fine to take away a few steps with LifeScan’s VerioSync and iBGStar to send the metering to the smartphone, or to Telcare’s system, and know that hovering in the future may be the non-invasive glucose meter and fully automated insulin pumps that work with your smartphone, but… Thomas Goetz’s point: don’t expect QSing to be a panacea as hyped, do expect that emotional baggage is in the trunk of the car, and that tracking for people is WORK that is really to be avoided. And as Editor Donna continually reminds The Eye, only undertaken when it is a solution to an unavoidable job to be done. And if they don’t see the job… The Diabetic’s Paradox

Your Friday robot fix: senior housing helpers, getting more humanoid

Care Innovations, which has no stakes (thus far) in robotics, highlights what robots can do and change in the senior housing area in this (sponsored) article in Senior Housing News. Featured: the ‘Hector’ assistance robot, developed by the EU’s CompanionAble Project [TTA 23 August]; ‘Monitoring Platform 3.0’  iPad and iPhone mobilizers such as Helios [TTA 2 Oct]; as ‘little armies of telepresence’ for non-emergencies (a small mention of telecare here); solving the worker shortage [TTA 19 May 11 on Robosoft and the Kompaï care robot, which Editor Steve has been following ever since, recently updated] and enabling independence [Robot & Frank, anyone?]

But a problem with more humanoid robots like Roboy is not developing arthritis but an inherent stiffness in the joints. COMAN, from the Italian Institute of Technology (IIT), mixes in compliant joints to make them less so, and safer (pulling a robot off the floor can be hazardous for your joints!) This Humanoid Robot Gets Pushed Around But Stays on Its Feet (IEEE Spectrum) Another hat tip to Toni Bunting, TANN Ireland.

Device vs. Device: a mobile health faceoff

MedCityNews pits unrelated mobile health devices and apps against each other in this series you may have overlooked last pre-holiday week. Some surprising winners in these eight short ‘n’ sweet matchups:

AliveCor smartphone ECG vs. DrawMD by Visible Health iPad app for general surgery patient ed

Related news: AliveCor names new CEO, experienced medical device and healthcare entrepreneur Dan Sullivan (Mobihealthnews)

Gauss Pixel App by Gauss Surgical (FDA cleared) to estimate surgical blood loss vs. BurnMedPro by Johns Hopkins Mobile Medicine

Welch Allyn iExaminer Adapter and app that connects to Ophthalmoscope (FDA cleared) vs HemaGo by NovoNordisk

MobiUS SP1 System by MobiSante, ultrasound imaging system (FDA cleared) vs. DoctorMole app by Mark Shippen

iHealth Wireless Blood Pressure Monitor companion app by iHealth Lab Inc (FDA cleared) vs. iBlueButton by Humetrix

Mobile Mim by Mim Software (FDA cleared) for image sharing vs Smartphone Breathalyzer by Breathometer

Diabetes Manager by WellDoc (FDA cleared) vs iTriage by Healthagen

AirStrip ONE by AirStrip Technologies (FDA cleared) vs Lab Counter by ZappyLab

A ‘shocking’ solution to India’s crime problem?

click to enlargeThree engineering students at India’s SRM Institute of Science and Technology in Tamil Nadu (Chennai) developed and won the 2013 Gandhian Young Technological Innovation Award given by SRISTI (Society for Research and Initiatives for Sustainable Technologies and Institutions) for a body-worn device designed to help defend women in the case of personal attack. The device is a camisole-type undergarment which is wired with sensors and electric shock circuit board at the bosom, insulated by a polymer, with attached GPS and GSM modules. Pressure in the bosom area, consistent with the usual frontal attack, triggers a 3,800 kilovolt shock [likely a notation error–probably 3.8 kV, see Comments–Ed. Donna]  up to 82 times and also activates the GPS.  The designers known collectively as SHE (Society Harnessing Equipment)–Manisha Mohan, Niladri Basu Bal, Rimpi Tripathi, the first and third listed are women–are to be commended.

India’s huge problem with male-on-female crime was highlighted at the end of 2012 with the assault of a young couple in central New Delhi, resulting in his severe injury, her rape and death. It also put an international spotlight on India’s wretchedly poor policing and law enforcement resulting in a reported reduction of tourism by at least 25 percent. The official Indian Government response was tepid at best–including ‘working on’ a prototype safety watch that would take photos and send texts in case of attack. It was TTA’s weekend outrage for 2 February for its ‘sheer howling incompetence’, stimulating quite a reader discussion. And no, this device won’t save or prevent the vulnerable (female and old) from attack, but the electrifying element of surprise may give an edge to the victim permitting a quick getaway. Digital Trends (India), Techpedia India (SRISTI), SHE team profile/submission Another hat tip to Toni Bunting, TANN Ireland.

The ‘virtual reality’ workout and a Spidey-Suit

click to enlargeAdding to the list of VR-driven workout platforms is University of Wisconsin-Madison’s CAVE (Cave Automatic Virtual Environment), which tracks muscle movements while you virtually walk (via goggles) through a room and pick up things. The CAVE researchers are using the EMG tracking information to determine what muscle movements are used in each action. (Hat tip to Toni Bunting, TANN Ireland) Not too far away in Illinois, University of Illinois-Chicago researchers have wired up a whole spaghetti-bowl of sensors from head to toe as ‘SpiderSense’ (left) which enhances spatial awareness–detecting that something is nearby for the visually impaired.

Previously in TTA, VR in physical therapy: Microsoft Kinect, West Health Institute, Fraunhofer, 15 January

GE, StartUp Health select their ‘Lucky Thirteen’

GE Ventures’ Healthymagination and accelerator StartUp Health announced, after a two-month screening process, their 13 (up from 10) companies for their joint three-year program. The 13 recipients will be mentored over the next three years  in exchange for 2 to 10 percent equity ownership by GE and StartUp Health’s Innovation Fund. They are a diverse mix including hand hygiene in hospitals, connecting patients to mental health professionals, integrating non-clinical home care observations into home health, and a device for gait and balance restoration. Short bios on companies via TechCrunch. GE/StartUp Health release (MarketWatch).

Previously on TTA, why GE is getting ‘imaginative’ with StartUp Health: 10 January, 7 March.

NHS needs better vision of digital patients

This item picks up on some of the issues raised by the recent NHS Innovations Expo. To quote one participant “innovations like telehealth can and will come for British NHS users — but only if the emphasis shifts from a focus on long-term care to incorporating it in the day to day running of hospitals, clinics and other patient contact points”. NHS needs better vision of digital patients Information Week UK

Whisper of the heart

Two app-related items spotted by TANN Ireland editor Toni Bunting. Connect the dots with the first to this TTA item and the second has potentially huge implications for understanding heart disease:

Related item on TANN Ireland: Gamifying meditative breathing with the Zen biosensor.

‘Wireless sensor networks’ at $16 billion by 2017

The ON World business intelligence group projects in its latest report that ‘wireless sensor networks’ (WSN) for health and wellness revenues will sharply rise to a 2017 global projection of $16 billion in revenue for 18.2 million systems shipped. This estimate excludes sports/fitness devices, which of late are hard to separate due to capabilities crossover, as we’ve seen with sleep monitoring. The report analyzed over 100 devices (list here) for aging in place, health condition self-management (60 percent of 2017 revenue, almost evenly split between cardiac and diabetes) but  general wellness will continue to lead numerically (41 percent of device shipments) for consumer and clinical use.  The 81 page report is based on 750 individual interviews/surveys with over 100 companies and 300 users, reviews back end comms standards (e.g. ZigBee, Bluetooth, ANT) and market sizing. It will be a tidy $1,999 budget item for a single user. ON World release, order page (including email info for free 12-page executive summary), shipment growth chart. FierceMobileHealthcare article.

click to enlarge

Healthcare BYOD unleashed, and the consequences

A just-published Cisco study estimates that nearly 89 percent of healthcare workers Bring Their Own Device–in this case, smartphones only, so really BYOS. For employers who largely do not subsidize usage, it’s a huge benefit–overall in the eight industries studied, 90 percent of employees receive no subsidy yet 92 percent use their smartphone for work weekly. But the employees don’t bring their own good security practices. In healthcare alone (classed as a ‘sensitive industry’): 41 percent do not password protect, 53 percent access unknown/unsecured Wi-Fi networks and 52 percent don’t disable Bluetooth ‘discoverable’ mode. And this does not include iPads, Android tablets and the like which are also often left unsecured. According to FierceMobileHealthcare, which referenced a late 2012 Amcom Software study, “more than 65 percent of responding healthcare facilities do not have a documented mobility strategy in place. What’s more, 37 percent of the survey’s respondents do not have plans to implement such a strategy in their organizations.”  It makes one long for the days of IT department-issued cranky CrackBerries. BYOD Insights 2013: A Cisco Partner Network Study  Hat tip to David Albert, MD of AliveCor @DrDave01 for the link via Twitter.

Is there a BYOD backlash? Ken Congdon of Healthcare Technology News spoke at HIMSS 2013 on the unstoppability of BYOD and counters the naysayers.