IBM Watson working on medical license, practicing and shrinking (US)

The IBM Watson data analytics/decision-support tool now in test advising doctors on oncology at New York’s Memorial Sloan-Kettering, Los Angeles’ Cedars-Sinai and other hospitals is being prepped for the US Medical Licensing Examination, which is a three-part series which licenses medical school graduates for practice.  It’s also making progress on shrinking–not going for its psychiatry boards, but reducing its physical size: from a master bedroom to bathroom to possibly a projected smartphone size by 2020, if you can think that far in advance.  The next big step appears to be integrating ‘big data’ into Watson’s computing capabilities leading to an entirely new stage of cognitive analytics, but right now ‘Dr. Watson’ is busy digesting a big oncology data meal, according to this article:  600,000 pieces of medical evidence, two million pages of text from 42 medical journals and clinical trials. It’s also busy practicing its capabilities of sifting through 1.5 million patient records representing decades of cancer treatment history to provide to physicians evidence based treatment options. Computerworld

Eric Topol, M.D. to appear on ‘Colbert Report’ (US)

For our US readers, health tech/mHealth advocate and cardiologist Eric Topol, M.D. will be guesting on the Stephen Colbert talk show/humor (?) program on Comedy Central Tuesday 26 March. Check your local listings for times. For our ex-US readers, it will probably hit YouTube in a flash. Some good mainstream publicity for mHealth, but one hopes that Dr. Topol will avoid the ‘celeb doc’ syndrome that’s working against Dr. Mehmet Oz. San Diego U-T. This was in the news the same week as Dr. Topol’s whipping out his trusty AliveCor heart monitor on a New Orleans-Houston flight to aid a woman in distress; the AliveCor snap-on electrode ‘case’ to the iPhone+app provides a clinical-grade ECG (snapshot of the actual ECG below). At $199 why this isn’t part of the medical kit on commercial aircraft escapes your Editor.

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/03/heart_1_t940.png” thumb_width=”200″ /]

A sensor to treat your aching back

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/03/thimblebioelectroncis.jpg” thumb_width=”150″ /]Wafer-thin sensors are popping up all over in wearables (Misfit Shine being the buzziest) but here’s one that could help that twinging knee or whingeing back. The Thimble patch uses a reasonably smart looking adhesive patch with a central sensor that delivers Transcutaneous Electrical Nerve Stimulation (TENS) to relieve pain. It will be controlled via Bluetooth by a smartphone app for pain tracking and management. CEO and developer Shaun Rahimi, a medical device designer, conceived of this as a way to deal with his own back and arm pain. Target date for release is later this year, but your Editor needed this badly last week. Job alert–CEO Rahimi is seeking iOS designers for the mobile app: Contact info. Gizmag

Mobile, flexible–but not joint–military healthcare (US)

If two areas of the government have made a great deal of progress in telehealth and mobile health, it is the Department of Defense (DOD) and Veterans Affairs (VA) which jointly are the leading users (and developers) of telehealth. Your Editor has often mentioned the US Army’s Telemedicine and Advanced Technology Research Center (TATRC) as a leader. Of their current 15 mHealth projects, one of the largest is MobileCare. Working jointly with the University of Miami’s William Lehman Injury Research Center at Ryder Trauma Center (where it is being piloted) and University of Central Florida, MobileCare is a smartphone interface for patient documentation into EHRs using intuitive data entry and voice recognition; mobile learning and point-of-care information; and telemedicine (audio/video consults). Miami’s staff designed the user interface, learning content and programmed interfaces, while an IT team at the University of Central Florida is assisting with mobile development.  Mobile Healthcare Is Solving Major Problems for Military Doctors and Nurses (FedTech)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/03/Flexible-Electronics-on-Plastic-425×303.jpg” thumb_width=”175″ /]The Army Research Laboratory (ARL) located at the Flexible Display Center at Arizona State University is pioneering flexible, thin, low-power plastic displays, about 1/16 inch thick, for use in battlefield devices. These are designed to be worn on every soldier’s sleeve, on the side of an armored vehicle or used in monitors that need no ruggedizing–produced using commercial methods and thus (relatively) inexpensively. The potential for medical devices, smartphones and tablets is substantial if translated quickly to commercial use. Imagine Samsung’s flexible smartphone at CES 2013, the much-heralded iWatch/iPhone combo and even the cutely colorful and crowdfunded EMBRACE+ bracelet smartphone notifier on steroids. Future Soldiers Will Have Flexible Electronics Everywhere (Armed with Science)

Thus it is doubly disappointing when DOD and the VA, who declared their fine intents to develop an integrated EHR (iEHR–another acronym) to be implemented by 2017, have declared to Congress that the project has come to a screeching halt after 1 billion in taxpayer dollars. DOD might use the VA’s Vista EHR–or not. As the Magic 8 Ball says, ‘hazy, try again’. DOD, VA Face Questions Over Halting of Joint EHR Project (iHealthBeat)

Telehealth Soapbox: Protecting your IP and patents online

This is the second of an occasional series on US law and intellectual property (IP) as it affects software and systems used in health technology. This article is an overview of the issues surrounding and actions you should take to protect your proprietary website, software and patents. Especially for early stage companies, the last has grown in importance with ‘patent trolls’ demanding settlement fees for claimed infringement.

Mark Grossman, JD, has nearly 30 years of experience in business law and began focusing his practice on technology over 20 years ago. He is an attorney with Tannenbaum Helpern Syracuse & Hirschtritt in New York City and has for ten years been listed in Best Lawyers in America. Mr. Grossman has been Special Counsel for the X-Prize Foundation and SME (subject matter expert) for Florida’s Internet Task Force. More information on Mr. Grossman here.

Imagine if you found a portion of your proprietary software or your website in cyberspace. The only problem was that it wasn’t located at your Internet address. Let’s say that it was smack in the middle of someone else’s website and/or made available for download. You would fume and want justice.

No License to Steal
The Internet, like many technologies, promises substantial consumer benefits and, at the same time, invites fraud and deception. The technology is such that it’s all too easy to steal software or a whole website with a mere click.
For businesses and consumers to continue to fuel the growth of the Internet we must aggressively address the protection of intellectual property (IP) rights online. Any good business plan maps out a strategy to maximize opportunity and to handle calculated risk. So protecting your IP rights must be a core part of your business plan.
You should consider taking the following steps to minimize your company’s risks. (more…)

Why GE is getting imaginative about startups

The latest permutation of GE Healthymagination, beyond an ad slogan, is a $250 million Silicon Valley-based fund, complete with a brace of imported VCs. According to new CEO Sue Siegel, the partnerships with StartUpHealth (along with a slice of its companies; TA 10 Jan) and Rock Health are only the start. Their rounds begin at a thrifty $250,000 and they are targeting five areas: personalized (precision) medicine, clinical decision support, life sciences and cellular therapeutics, minimally invasive guidance and patient monitoring. Ms. Siegel notes GE’s current presence but that it needs to go ‘more mobile.’ (Is Care Innovations still in their thoughts, or plunged off the edge of their world?) For a GE, like pharmaceuticals a while ago, it’s evidently easier to buy than to instill innovation, but the investment cash is welcomed in starving health tech. A happily not-firewalled article in the Wall Street Journal’s Venture Capital Dispatch.

Where HIT implementation hits a brick wall

While HIT-ers are commiserating about the latest and greatest, and touring the refined establishments of the Vieux Carré during HIMSS13, Sean McCown, a heavyweight IT and database (SQL) consultant as well as contributing editor for InfoWorld, hangs out the unmentionables that he’s experienced in the average HIT area–and why he’s leaving again.

A short summary of his points and a few choice quotes: (more…)

The ongoing cost of the NYY telehealth project exposed (UK)

At the end of this month NHS North Yorkshire and York (NYY) – a Primary Care Trust (PCT) – and the Yorkshire and the Humber Strategic Health Authority (YHSHA) that oversees it, will be no more. They will be replaced by four Care Commissioning Groups (CCGs).

NYY and YHSHA together spent £3.2million capital money on Tunstall telehealth equipment in 2010, with the PCT paying ongoing support fees and depreciation costs. The procurement was intended to provide 2,000 devices for a project to deliver telehealth to people in the area. It was a pre-cursor of the 3millionlives (3ML) campaign but the local GPs had to be persuaded to participate without the benefit of knowing the Whole System Demonstrator (WSD) results.

The NYY project has had the aspect of a slow motion car crash for everyone apart from (more…)

Telehealth’s first 90 day refund

A notable first for telehealth (certainly for this Editor) is the 90-day, 100 percent refund guarantee made by New York-based AMC Health at HIMSS13. As reported in MedCityNews and other sources, AMC “would refund 100 percent of all costs incurred during the first 90 days of the program if the 30-day readmission rate doesn’t decline by at least 10 percent compared to a risk-matched reference population receiving the usual care.”  For our international readers, US hospitals are now being penalized for same-cause readmissions by the Centers for Medicare and Medicaid Services, and key to reduction are post-discharge programs integrating home care.

But the actual guarantee is a little different. In the words of (more…)

The regulatory landscape for mobile apps (audio)

mHealth regulatory expert Bradley Merrill Thompson of the Epstein, Becker & Green law firm and Bakul Patel, Policy Advisor for the Center for Devices and Radiological Health, FDA, will be discussing mHealth regulation on the mHealthZone program on BlogTalkRadio tomorrow (Thursday, 7 March) from noon to 12:45 pm (US) Eastern Time. The interview will be available later as a podcast at the same link.

Timeline: the WSD evidence so far, as set out by Pulse (UK)

Given that GPs are so heavily reliant on technology these days – for medical records, for communications, for finding patients’ homes when undertaking visits, etc. it is somewhat surprising that the medical profession is represented as being so hostile to telehealth monitoring by one of their major publications, Pulse. One would assume from the benefits the doctors get from technology that their stance would be to encourage their patients and the patients’ carers to benefit from the technology now available. Perhaps its a doctor-patient power thing. Or perhaps they are insensitive to the disruption caused to the people who have struggled along to the waiting room for something that could be dealt with by phone, SMS or email. Or perhaps it is a symptom of the profession’s current displeasure with all things Government-endorsed. Whatever the reason, Pulse has now published an index of its articles on the subject of the Whole System Demonstrator (WSD) programme – Timeline: the evidence so far on telehealth, telecare and telemedicine. UPDATE: Friday 8 March – This article now seems to be accessible only if you register on the site.

Just Checking – now for the direct-to-public market (UK)

Somewhat overshadowed this week by the high profile O2 launch, but highly complementary to it, was the launch of Just Checking’s (JC) new version for the general public. For many people concerned about relatives living with dementia the JC system of in-home sensors and text or email alerts triggered by various events or non-events will have great appeal.

Until now, JC systems have been primarily sold to services for assessment purposes. The new version is designed for easy self-installation and online management by carers and can be set up to trigger an alert under the following conditions:

  • Exit property: if an exterior door is used and no activity is detected in the property.
  • Not up and about: if there is no sign of life by a specified time in the morning.
  • Visitor late: with carers expected at certain times an alert can be sent if the front door is not opened as expected.
  • Door left open: if a door is left open for longer than a specified time. This will send an alert if the door has not been shut securely.

It does not have an alarm button and it does not track the person when outside – but there are other systems which can do that.

Product launch information. Information about the Your Voice campaign for carers launched alongside the product launch.

Follow the ‘Read more…’ link to see a video from 2010 showing ease of Just Checking self-installation. (more…)

O2’s mobile care – in a shop near you (UK)

It is just over five years since Paul Gee, then CEO of the Telecare Services Association (TSA), flagged up to members in a prescient article that the time would come when it would be possible to buy a mobile telecare device in a supermarket [Telecare Soapbox: Tesco Telecare]. The question he posed was ‘How far away?’ Now we know. It took five years, but it arrives today. The telecare suppliers of the time did not respond to the wake-up call and they have now been overtaken by O2, the mobile arm of Telefónica in the UK. At the press conference in London yesterday O2 announced the next stage in the development of its Help at Hand service and several points struck this editor as particularly interesting: (more…)

Tuesday’s telehealth short takes: CommonWell, Medikly, accelerators, mHealth savings, Televero

In HIMSS13 news, healthcare/EHR/practice management heavyweights Cerner, McKesson, Allscripts, athenahealth, Greenway and RelayHealth are forming the CommonWell Health Alliance to foster interoperability and care integration, enabled by ‘data liquidity’ (a term new to this Editor, but perhaps the result of ‘data exchange’). With Cerner and Allscripts taking some heat for lobbying for Federal stimulus funds that helped fuel the explosive growth of EHRs [TA 20 Feb], diverting to this albeit necessary issue seems to be a good move. HealthcareITNews

Medikly raises $1.2 million in series A financing from Easton Capital: A recent graduate of the Blueprint Health accelerator in New York City, it springboards data analytics on multiple touchpoints of physician behavior and preferences, enabling pharma companies to more effectively distribute content, achieve cost efficiencies and perhaps in the long run, change behavior. It also doesn’t hurt to be on track to have $5.6 million in revenue in 1st Quarter, according to their CEO. TechCrunch

Accelerators, and what to look for in them, are the subject of this California HealthCare Foundation report, “Greenhouse Effect: How Accelerators Are Seeding Digital Health Innovation”.  They do the most good when focused on business models–and whether they meet the survivability test, utilize health subject matter experts for guidance, narrowcast their sector and customer type, work closely with sponsors and partners, and tailor programs by stage of development.  White paper PDF

Update 8 March: And if you’ve experienced the frustration of applying to an accelerator, there is a video parody on the usual clip from the Hitler-last-days film ‘Downfall’ which sends up the whole process as well as some of the Silicon Valley figures in the tech funding area: Dave McClure of 500 Startups and The Gimlet Eye’s favorite VC, Vinod Khosla. Cautions for Hitler, profanity, raving, German uniforms and your tolerance for yet another ‘Downfall’ takeoff.  

mHealth saving over $400 billion by 2017:  Released at Mobile World Congress in Barcelona last week, the GSMA/PwC study ‘Connected Life’  calculated that mobile health could save developed countries $400 billion by 2017 four ways: detection of sudden incidents, remote medical home monitoring, mobile EHR access by physicians and nurses, and the (good old reliable) SMS (texting) for appointments, reminders etc. Gigaom, link to study PDF (see pages 5-8). 

Waldo has left the building: Waldo Health is now reinvented, according to an announcement by CEO Vincent Salvo, as Televero Health. Based on the website, there is more focus on patient population management and visualized analytics than on individual adoption. Waldo Health debuted at ATA 2010 and combined telehealth, telemedicine, med reminders and patient education into an easy-to-use touchscreen monitor format. Last year, they also made news when they licensed Bosch Healthcare’s patents to settle infringement issues [TA 30 Apr 2012]. Mr. Salvo is also an operating/venture partner with TEXO Ventures, a main investor, and joined the company in late 2011. Founder and original designer Sam Fuller has left the company.

The billion-dollar valuation horizon

When will a health tech company hit the magic billion-dollar valuation?  A survey of nearly 140 entrepreneurs and over 50 health care information technology VC investors, conducted venture capital firm InterWest Partners, showed (probably naturally) far higher expectations by the entrepreneurs that several companies would hit that mark within five years. Using the most negative measure–none of the companies would hit a $1 billion valuation–only five percent of entrepreneurs agreed, while nearly 25 percent of VCs did.  Likely companies agreed by both  groups were free EHR Practice Fusion, employer health management platform Castlight Health and doctor appointment setter ZocDoc in the top three, with AirStrip, TelaDoc and FitBit just behind. ‘Big data’ (whatever that is) equals big investment, but they split on where the rest of the funding goes: VCs liked insurance exchange/benefit selection, care coordination and clinical decisions; entrepreneurs preferred telehealth and mobile diagnostics.  Investors are from Mars. Entrepreneurs are from Venus (plus charts in The Health Care Blog) When will we see more billion-dollar health tech companies? (Gigaom)