Because epilepsy is such a distressing condition there will surely be a crock of gold waiting for whoever can produce a device that can reliably monitor the brain activity of people with epilepsy when at home, especially when asleep. Here is the latest effort from researchers in The Netherlands which, they say, has a (good) 90% success rate: Tele-Epilepsy and Remote Seizure Monitoring in the Netherlands Shimmer Research. (Whoever coined the term ‘tele-epilepsy’ should be sent to the naughty step until they say sorry!) Heads-up thanks to Toni Bunting.
The Chain of Trust Project is a two-year pan-European collaboration between researchers in six countries, Greece, Latvia, The Netherlands, Poland, and Portugal and led by the Norwegian Centre for Integrated Care and Telemedicine. (Website). It began in 2011 with a literature review (PDF), a survey involving patients and professionals, and country-based workshops. Its 45-page interim report Understanding patients’ and health professionals’ perspective on telehealth and building confidence and acceptance (PDF) was published in November. Unfortunately, it is not until Section 3 (page 10) that the authors who, in the previous pages frequently and consistently refer to ‘telehealth’, define the term. “Telehealth refers to the delivery of healthcare across a distance, using information and telecommunications technology and specially adapted equipment. It allows health professionals to diagnose, treat, care, assess and monitor patients without requiring both individuals to be physically in the same location” which, in our book, is mostly ‘telemedicine’. This is confirmed in the footnote to the definition which states “Telehealth is in turn an expansion of the term telemedicine”.
This lack of up-front clarity doesn’t invalidate any of the findings, of course, but it may alienate readers who feel that they have wasted half an hour trying to figure out the particular context when, with a little thought, the definition could have been placed in a box at the beginning. Grrr… [Related TA item from 4 years ago]
The European Commission last week issued a plan of action to address barriers preventing the full use of digital solutions in Europe. Measures covered by the plan include:
- clarifying areas of legal uncertainty
- improving interoperability between systems
- increasing awareness and skills among patients and healthcare professionals
- putting patients at the centre with initiatives related to personal health management and supporting research into personalised medicine
- ensuring free legal advice for start-up eHealth businesses [Editor’s emphasis]
The Commission has also pledged to issue a mHealth (Mobile Health) Green Paper by 2014 addressing quality and transparency issues. EU issues action plan for digital healthcare InnovateUK
“FDA approval of this innovative study design is a significant milestone. Pharmaceutical companies have been worried that the FDA would not accept telemonitoring in place of costly clinic visits,” said John Holland, senior vice president for research and business development at AMC Health. U.S. Food and Drug Administration Approves Remote Monitoring for Drug Trial. ThirdAge.com (3 pages)
A new survey by Philips reveals that one in four Americans trust mobile health resources as much as their own doctor…one in ten participants believed that without web-based health resources, they might already be dead or severely incapacitated. One in three participants believes that monitoring their health through mobile technology is the key to a long and healthy life…The implications of this information are far-reaching. Patients may not believe that their symptoms are worth the hassle of seeing their physician, and serious conditions may go undiagnosed. One quarter of Americans trust mHealth apps as much as their doctor EHR Intelligence item. Philips press release.
Something other than wine for device suppliers to be mulling over the Christmas holiday season: the MHRA’s consultation about proposed changes to the European medical device directives closes on 21 January 2013. The MHRA “has been engaging with the Commission to influence its proposals as they have been developed over the last four years. We are pleased to see that they include measures that will improve the transparency, traceability, vigilance, and governance of the system, as well as the performance of notified bodies. However there are also areas of concern in the proposed regulations, notably those provisions which place additional burdens on industry and healthcare systems without a credible evidence base of the public health benefit.” For more information start here, then go here.
In addition to its usual roundup of developments and events this month, the December 2012 Telecare LIN Newsletter (PDF) also looks forward: “From April 2013, The NHS Commissioning Board will be taking forwards a number of mandated policy initiatives to start to embed digital technologies into healthcare. This will be vital as the recent Nuffield Trust reports indicate a major financial gap developing in health and social care budgets over the next ten years. In addition, Personal Health Budgets are expected to move ahead and the Department of Health is consulting on a new GP contract which could reimburse telehealth services. The first 34 clinical commissioning groups in England have been authorised.” For the list of over a 1000 news links you need the separate supplement (PDF).
The much touted HIMTA (Healthcare Innovation and Marketplace Technologies Act, H.R. Bill 6626) as introduced by Silicon Valley’s Representative Mike Honda, if passed would establish an Office of Wireless Health at the FDA for starters. Then it adds layers, like cake: establish specific mhealth software responsibilities for the Health Information Technology Research Center (new?), ‘Challenge Grants’ and prizes for IT developers, an HHS department supporting mHealth developers on designing in line with privacy regulations, workforce retraining, provider loans and tax incentives. The intent is spelled out in the HealthWorks Collective article–Rep. Honda’s public statement is that it would only seek to clarify current regulations, especially privacy, for mHealth developers and reduce barriers to entry, but read to the bottom which then states the intent is to reshape the mHealth industry. Also see Rep. Honda’s press release.
In Editor Donna’s view, it only serves to add another gaggle of chefs in the mHealth government kitchen, which is already packed with FDA, FCC, HHS and NIH elbowing for burners and oven space.
But…there’s more. The FCC just announced their search for a new Health Care Director to head up their initiatives, involving a lot more than sorting out spectrum policy. There’s delicate maneuvering between more working groups with initials than pumpkin or mince pies at Christmas Eve dinner. There’s doling out the ‘Health Care Connect Fund’ for broadbanding providers including a pilot in SNFs (skilled nursing facilities a/k/a nursing homes), etc. But nothing about better, longer studies that might prove things like ROI and better outcomes necessary to gain adoption in the far bigger, wider private market.
Conclusion: The only companies which will be able to advantageously sort out this tangle are those with batteries of lawyers on call, thus putting paid to Rep. Honda’s stated objective of encouraging startups. The only small saving grace is that H.R. 6626 was introduced in a Congress that is ending in three weeks (thus will die and presumably be reborn next year). And there are far higher ‘cliffs’ that need climbing…out of.
Related: Speaking of cliffs, David Lee Scher, MD approaches the one with the HEALTHCARE sign, looks over the edge, and sees a pile of money tossed over it willy-nilly. The healthcare cliff.
Telecare, telehealth and socialization system developer GrandCare Systems announced today that they are the recipient of the 2012 Frost & Sullivan Best Practices award for North American Elderly Health and Wellness Customer Value Enhancement. The awards “recognize companies in a variety of regional and global markets for demonstrating outstanding achievement and superior performance in areas such as leadership, technological innovation, customer service, and strategic product development.” Editor Donna is pleased to see this recognition go to this independent pioneer (and former competitor) in the field! Press release (PR Newswire)
This short article in Senior Housing Forum (US) by Steve Moran, formerly a community developer and now in the telehealth field, scores neatly and briefly on what is wrong with the ‘hotel’ model of many senior communities. Basically the extent of ‘care’ is such that a premium is placed on entertaining the residents and not in purposeful activity connected to the outside world that provides psychological reward and literally a reason for living. He says it best here:
While I believe entertainment needs to a part of every community’s activity program, I don’t believe it should be the most important part, I would argue that it should be the least significant part.
Activities programs need to start with the premise that seniors want to learn, to grow, to create and are capable of doing so.
A ‘Smart’ and rather modest looking stethoscope may pack a big (figurative) punch. When medication does not break up kidney stones, shock wave lithotripsy is often used, but it is difficult to tell when the fragmentation process is complete. This device monitors the pulses as they echo off the stone, and by changes in sound (‘tock’ vs. ‘tick’) can confirm that the stones are shattered (any reference to Mick’s Group is unintentional but unavoidable). In clinical trials it has reported an accuracy rate of 94.7%, far above any existing tech. The Smart Stethoscope delivers no radiation, and can also be used as an assessment tool for probable response to lithotripsy. Developed by Prof. Tim Leighton (left) at University of Southampton with Guy’s and St. Thomas’ Foundation Trust (GSTT) and UK-based tech firm Precision Acoustics Ltd. which will be developing a commercial version. “Smart stethoscope” keeps an ear on kidney stones (Gizmag) Research study in Proceedings of the Royal Society A. University of Southampton announcement.
Adam Darkins, M.D., who is Chief Consultant, Care Coordination Services, Department of Veterans Affairs (VA), recently presented at the Connected Health Symposium on the efforts–and results–of the VA in what they call Clinical Video Telehealth (CVT=telemedicine), Home Telehealth (combined video and telehealth), store and forward (imaging), telemental health and more. This presentation is undated but is recent because of the Federal FY 2012 statistics cited (ending September). The VA is the largest user of telehealth services in the US with nearly 1.4 million consultations a year, over 900 sites of care and growing at 70% per year. 30% of their patients live in rural areas at long distances from VA facilities. They are also the largest database of outcomes over time, and what Dr. Darkins cites as Home Telehealth Savings is $1,999 per patient per year. Much more in this fact-packed 14 page deck. Telehealth Services in the Department of Veterans Affairs (VA) (PDF) VA telehealth services grow by 70 percent with significant utilization, cost savings (FierceMobileGovernment) Hat tip to Mike Clark.
Bio on Dr. Darkins reveals his UK roots as a trained neurosurgeon, early telehealth program director at the King’s Fund and founder member of the Royal Society of Medicine’s Telemedicine Forum.
Mindings (which allows family and friends to send personal captioned photos, text messages, calendar reminders, social media content and much more to a digital screen in a family member’s home) had a mixed reception from Telecare Aware readers when we mentioned it (references here) but has gone on to beat Just Checking, CareConnectMe, @UK, and Pintrack to £100,000 investment in a Dragon’s Den (Shark Tank for US readers, other country versions listed in Wikipedia) type session organised by Improvement East, in partnership with NHS Midlands and East. Innovation in Adult Health and Social Care Competition. Heads-up thanks to Toni Bunting.
Beyond the eye-catching headline for this pointer-to-the-future item, there are hints that these new chips being developed at the California Institute of Technology (Caltech) could be also used for detecting counterfeit drugs (if the manufacturers provided chemical markers, one assumes). Surely there are telehealth monitoring uses this could be put to? Microchip gives phones X-ray vision PSFK item. Heads-up thanks to Toni Bunting.
“Pressure-sensitive alarms that sound when a patient tries to get out of bed do not prevent falls or reduce injury, researchers have found.” This is a hospital-based study but there are implications for the use of bed monitors at home too. Hospital Alarms Fail to Prevent Injury, Study Finds New York Times.
Despite the title (we dislike the ‘game changer’ cliché) and the trendy infographics there are some good things about this free 36-page report produced by Deloitte. For example, their use of the terms telecare and telehealth are clearly defined early on – something many forget to do. The early parts are stuffed full of figures and projections, which may be useful. It is descriptive of the current situation in the UK and does not miss some of subtler aspects, such as the different approaches to telehealth that the four nations of the UK have taken. Parts 3 and 4 move on to describe the challenges to the adoption of telecare and telehealth and presents numerous case examples demonstrating the potential benefits.
In all, because the principal author, Karen Taylor, has pulled together and structured so much information it is a great resource that many people putting together business cases will plunder. However, it seems to this editor (Steve) that it lacks an audience and it lacks the bite of the HaCIRIC report featured earlier this week.
Download the report from the Deloitte UK Centre for Health Solutions web page Telecare and Telehealth.