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)

Safety, fast (US)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/03/splitsecnd_table_top-small.jpg” thumb_width=”150″ /]What, no OnStar? Plug Splitsecnd into the cigarette lighter (or utility outlet) of your MG, 1938 Buick or 2013 VW Beetle, and if you have a serious collision, the M2M back end uploads the car’s location, alerts a response call center and establishes two-way voice contact. Have a problem–health or otherwise–in the car? Push the ‘help’ button and get in touch. Is your daughter reenacting ‘Corvette Summer’? The Family Finder feature maps her location online or on smartphone. Available in US only, $199 with $14.99 monthly fee, online sales only at present. The two developers started working on Splitsecnd while at Vanderbilt University, and the company accelerated at Nashville’s JumpStart Foundry. Splitsecnd calls for help when you can’t in a car crash (VentureBeat)

WebMD goes mobile, at last, with Qualcomm

Timed for the HIMSS annual conference kickoff today in New Orleans, health information giant WebMD announced a collaboration with Qualcomm Life’s 2Net platform to integrate mobile device data for consumers with WebMD’s information resources. The press release phrases buzz and buzz:  “drive mass adoption of a quantified-self environment” (yes), “apps, devices and tools… to better understand and manage their health”, “connected, automated and seamless data collection experience”, “first-in-class health channels to enhance our multi-screen experiences.”  But given WebMD’s sinking relevance as the go-to place for consumer and provider health information,  and its PHR (which may or may not be included with this) under fire for patent infringement by MMRGlobal [TA 20 Feb], is all this added “context and insight” too little, too late? (Even with Eric Topol, MD now Editor in Chief of WebMD’s Medscape)  WebMD/Qualcomm press releasemHIMSS

Royal Marine veteran can access telemedicine help from home at touch of a button (UK)

A local news item from the Bradford Telegraph and Argus shows just how publicity can be a two-edged sword – or should that be Marines’ dagger? On the ‘up’ side is the first paragraph: “Airedale General Hospital’s telehealth hub is helping its 1,000th patient – a 101-year-old former Royal Marine.” However, it then reveals that he does not really need it: “‘I haven’t used the telemedicine kit yet as I haven’t had much wrong with me apart from a chesty cough – I like to keep myself fit,’ said Mr Joyner”. Hmm… Royal Marine veteran can access telemedicine help from home at touch of a button.

Doro launches mobile telecare phone (EU)

Doro has revealed its latest handset – the Doro Secure 681.” According to an item in Mobile Magazine, the phone will launch in the second quarter of this year and is “aimed at people who currently rely on the support of a fixed-line telecare services, allowing them greater mobility outside the home.” The 681 is said to be the first mobile phone to feature an embedded ‘class one’ telecare radio receiver that is compatible with Doro’s wearable wrist, neck and fall sensors. Alerts can be sent to monitoring services via the internet or SMS. To this editor, if the photo in the above item is to be believed, the clamshell design and screen/keyboard layout is going to be too complicated for many people in the target market. It also looks like big-boy Doro has been learning a few lessons about the need to check and report battery charge levels automatically from UK small-guy Carephone. However Doro will have the advantage of being part of Bosch’s offering to the public. It will be interesting to see which gets traction with the public first, the Doro/Bosch combination or O2’s Health at Hand.

Practice Fusion EHR buys a ‘nudger’

Practice Fusion, a leading US EHR which is free to practices, bought predictive modeler 100Plus. Besides sharing a founder (Ryan Howard) and a focus on healthcare data, 100Plus uses individual data to ‘nudge’ (there’s that word again) people into healthier behaviors. The interest of Practice Fusion of course, is that it is awash in patient data–but HIPAA privacy regulations limit direct, identified use. 100Plus plans to stay safe by focusing on medication adherence and tools that doctors and patients can use together to encourage engagement. Forbes

What it takes to deliver sustainable global health: sustainable financing

The mHealth Alliance and consultant/research company VitalWave have published a globally-oriented study detailing what holds back mHealth from scaling up in low to middle-income countries, centering on financing. Hundreds of projects are in the field, but practically all are dependent on short-term financing or grants, and few have viable plans beyond the next grant. Projects also by their nature are stand-alone and don’t integrate in their design and delivery with other often similar projects. This study evaluates five financial models and transferring from external funding to a revenue stream from buyers. Case studies include VillageReach (maternal SMS/phone support), Switchboard (free calling network for health workers), Sproxil (drug verification), SMS for Life (SMS for anti-malarial drug distribution) and Changamka (affordable health care). Sustainable Financing for Mobile Health (42 pages)

Smart tech=dumber people?

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/03/bincam_l.jpeg” thumb_width=”220″ /]Is the real goal of ‘smart gadgets’ not to help solve our problems or keep us from harm, but to fix, per the Google paradigm, the “broken” place that is the real world and the bad behavior of fools like us? (For example, not recycling properly, having too much trash, eating too fast,  too much chocolate? Then tattling to our Facebook friends so they can chide us?) Evgeny Morozov, in this discomfiting Wall Street Journal article, cuts through the Silicon Valley hype around gadgets that marry cheap sensors, software and social networks to ‘nudge’ (that hateful word)/reward/shove us to the New Jerusalem of social engineering and some developer’s nannyish idea of ‘better behavior’. Yes, there are ‘good smart’ devices that help us make decisions, lifesaving tech such as gait sensors that monitor the elderly for propensity to fall, and breath analyzers that cut the car’s ignition when the driver’s had too much alcohol, but these are being drowned out in both the public consciousness and the VC wallet by shame-making trash cans and HapiForks. Rather than empowering us, it may be… Is Smart Making Us Dumb?

Another perfect example of condescension to the end user is observed in Google’s Sergey Brin’s recent remarks during his endless flogging of Google Glass, now just Glass. Now looking down at your smartphone is ’emasculating’ (interesting choice of words) because you are ‘walking around hunched up, looking down, rubbing a featureless piece of glass’ rather than interacting. Aside from the fact that you can put it away, and that Google’s made a fair amount of coin from Nexus smartphones and tablets, it’s obvious that Glass is meant to be worn ALL THE TIME, serving up whatever Google wants you to have ALL THE TIME. Surely the California TEDx folks raved at this maximum cool, but this Editor is skeptical that this world will be actually be better with all Google, all the time. In other words, enough. Google’s Sergey Brin rips smartphones, shows off Glass (Computerworld)

Rewiring the brain through electrical stimulation on the tongue

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/02/PoNS-e1362016577311.jpg” thumb_width=”200″ /]We don’t think much about it, but the rich network of nerves (and musculature) on the human tongue is also a direct route to the brain.  Now the U.S. Army Medical Research and Materiel Command (USAMRMC), collaborating with the University of Wisconsin-Madison and the NeuroHabilitation Corporation is developing and testing the Portable NeuroModulation Stimulator, or PoNS, for treatment of brain injury and related disease: TBI, stroke, Parkinson’s and multiple sclerosis. The PoNS is an electrode-covered oral device which is used for 20-30 minutes of stimulation therapy, called cranial nerve non-invasive neuromodulation (CN-NiNM). Specific stimulation patterns are paired with physical, occupational, and cognitive exercises customized for each patient. Effectively it helps to rewire the brain’s neural pathways and mitigate damaged functioning. NeuroHabilitation will be commercializing it but the US Army is testing it at hospital and veterans’ facilities, and will be spearheading FDA approval. Three articles with different looks at this: the US Army website, Popular Science and GizMag.

Health apps finally get a certification body (US)

Happtique has now published the standards it will use to certify apps under what they have dubbed the Happtique Health App Certification Program (HACP). The published final guidelines include both the Certification Standards and associated Performance Requirements, which assess operability, privacy, security, and content. Happtique, a subsidiary of GNYHA Ventures, has also brought in initial HACP Partners to serve as subject matter experts for evaluating apps: the Association of American Medical Colleges (AAMC), CGFNS International, and Intertek. While Happtique is not yet ready to evaluate medical, health or fitness apps, companies can register for a submission form and be notified when the application portal is opened for submissions.

Effect of telehealth on quality of life: Another WSD research publication (UK)

Quick on the heels of the telecare study from the Whole Systems Demonstrator (WSD) Programme reported here today, comes another research report, this time from the BMJ: Effect of telehealth on quality of life and psychological outcomes over 12 months (Whole Systems Demonstrator telehealth questionnaire study): nested study of patient reported outcomes in a pragmatic, cluster randomised controlled trial.

Here are a few quotes from the abstract:

Objective: To assess the effect of second generation, home based telehealth on health related quality of life, anxiety, and depressive symptoms over 12 months in patients with long term conditions.

Conclusions: Second generation, home based telehealth as implemented in the Whole Systems Demonstrator Evaluation was not effective or efficacious compared with usual care only. Telehealth did not improve quality of life or psychological outcomes for patients with chronic obstructive pulmonary disease, diabetes, or heart failure over 12 months. The findings suggest that concerns about potentially deleterious effect of telehealth are unfounded for most patients.

So can we now not even say ‘Never mind the business case, that can be improved – it’s very good for patients’ sense of well being’? Heads-up thanks again to Mike Clark who is keeping an updated list of the reports as they are published.

UPDATE Thurs 28 Feb: Pulse does its usual thing with this study, but note the comment from the GP at the end: DH-commissioned report finds telehealth fails to improve quality of life.

February Telecare LIN newsletter published (UK)

Out now, the February edition of the Telecare LIN newsletter. It, together with the separate supplement, contains “over 1200 news and events links over the last month” and a reminder that if you have not registered for the ALIP showcase event in Liverpool on 5/6 March or the Healthcare Innovation Expo on 13/14 March you need to act quickly. The newsletter has more details. PDF newsletter. Links supplement. NHS reforms supplement.