Out now, the January edition of the Telecare LIN newsletter. It contains “news of a new telehealth and telecare strategy from Scotland and aspirations of a paperless NHS from English Health Secretary, Jeremy Hunt. There are new grant announcements as well as adult social care and public health funding programmes for local authorities…[changes to the NHS]…predictions about telehealth and mhealth for 2013 including some links to the recent Consumer Electronics Show which featured digital health.” There is also a comprehensive list of news links in the separate supplement. PDF download.
Despite all the discussion of inexpensive apps turning everyone into ‘quantified selfers’, adoption of tracking technology is still surprisingly slight among those who are already tracking their health indicators and exercise routines. The latest report from the Pew Internet & American Life Project surveying over 3,000 Americans indicates that 69% are already tracking a health condition for themselves or a loved one, but 49% keep the information in their heads (!), 34% use paper and 21% use technology–but that can include Excel and not necessarily an app or device with attached program such as FitBit or a PHR. Among the smartphone users, 19% have downloaded a health app for exercise, diet and weight management. According to Suzannah Fox of Pew, “We’ve been looking at health apps since 2010, and health app uptake has been essentially flat for three years.” and that the low adoption continues to surprise. Most Adults Not Using Technology To Monitor Health (iHealthBeat) Pew Internet release
Should virtual patient-doctor visits (termed here telehealth rather than telemedicine) have taken a page from the US e-commerce model to stimulate adoption? That is, to make them popular, provide an economic advantage over in-person visits? (In the US, online sellers such as Amazon initially grew because purchases largely circumvented state sales taxes, costing less.) Dr. David E. Williams proposes that payers now emulate this economic advantage by charging consumers nothing or very reduced co-pays for online visits, and/or incentivize physicians to move in-person visits to online. Aside from the cross-state licensure and medical records access problems, most payers (other than a few such as the adopters of American Well, and of course the VA) have not included or downplayed online visits in their benefits, perhaps fearing a spike in utilization as Dr. Williams mentions. But the good doctor misses a key factor–that this is not a one-way street, and that the consumer demand hasn’t materialized, despite the additional parallels of saving time and travel, which is why his argument seems to be a ‘past tense’ one. Perhaps virtual visits need to be taken outside payers into a concierge care, worksite, pharmacy clinic (enabled through a kiosk such as HealthSpot Station) or single pay model, maximizing convenience at the time of need. And we should find out why the appeal seems to be lacking–much like health app adoption. What Amazon can teach us about telehealth adoption (HealthBusinessBlog)
The latest, if not the last, word on Cormwall’s telecare and telehealth arrangements with BT: Cornwall council’s privatisation compromise The Guardian.
Firefighters in Australia are testing a new plastic-coated pill that tracks their vital signs while on duty. The EQ02 LifeMonitor capsule (from UK-based company Equivital) contains a thermometer and a small transmitter. Victoria’s Country Fire Authority health and wellbeing officer Peter Langridge told News.com.au: “…There is no set formula for how long a person can fight a fire before they start suffering from heat stress or dehydration and management is the key to protecting our fire fighters.” Ingestible pill monitors firefighter’s vitals to ensure safety. PSFK item. Heads-up thanks to Toni Bunting.
There are indications, with a patent application by Apple for a shoe that uses an embedded sensor to monitor wear [hmm!] that it is thinking about wearable tech for the future – which will inevitably mean at least a foray into health monitoring. Apple Patent Application Tips ‘Smart Shoe’ from PC Magazine.
Thinking about wearable sensors and health starts us down the ‘Quantified Self‘ train of thought. Editor Steve only twigged recently [duh!] that this is an extremely geeky play on words referring not only to measuring one’s activity, but that ‘quantifying’ is something done by ‘quants‘ – “experts in mathematics, physics and computer science who brought sophisticated quantitative approaches to the world of Wall Street”.
If you think that the recent announcement that the Government wants a paperless future for the NHS is just a blue sky aspiration, then you haven’t read the official press release as written by Julian Patterson on the NHS Networks site: The world’s most digital health service “A government spokesman said: ‘We’re excited about the future – and surveys suggest that more people than ever would like to experience it.” Brilliant! Heads-up thanks to Katherine Barbour of Wessex HIEC.
A US study has found that older people with hearing loss experience 30-40% greater cognitive decline over six years than their peers, bringing forward the onset of significant cognitive impairment by over three years. The connecting link seems to be social isolation… Hearing loss ‘linked to dementia’ GP Online item.
Just out on the 3ML website, a one-page document that answers questions TA readers have been asking about the 3ML Pathfinder sites, such as how they were selected, timescales, the procurement processes they will use, and how they will be evaluated. Pathfinders Update (PDF).
Press release from inHealthcare about a new addition to their range, the Watch BP Home A device which was developed by Microlife and measures blood pressure and pulse and, at the same time, detecting the abnormal rhythm which indicates atrial fibrillation (AF) – an abnormal rhythm that is responsible for 20 per cent of strokes, and significantly increases the risk of a stroke in the people that have it.
Editor Steve never posts links to items that he has not checked out…but here, for the very first time, are two. The first is an article by Prof. James Barlow. The second is a report by the Digital Policy Alliance. I anticipate that one will be interesting and one will be the ‘Same old, same old’. Am I right? Someone please read them and tell me!
First ever trial to measure how much longer people with dementia can live in their own homes with telecare (UK)
We missed the announcement by the Department of Health (DH) just before Christmas about the UK’s first ever trial (‘The ATTILA Trial’) to measure how much longer people with dementia can live safely and independently in their own homes when they are provided with a specialised telecare package. Kings College London and sites in London, Birmingham, Manchester, Newcastle, Oxford and Norwich will be involved in a £1.8m four-year randomised controlled trial, with publication expected in…2018. DH announcement. Trial details here and here. Heads-up thanks to Celia Price of JustChecking.
Following the recent announcement of their new partnership, a copy of a section of this month’s Saga Magazine courtesy of GrandCare’s blog reveals how Saga is working with GrandCare to develop a service for use by families in the UK: “We are currently piloting it in 20 or so homes and aim to have our system available in parts of the UK in the first quarter of this year and nationally by the summer.
“The UK version will have similar functionality to its American cousin, ie: a touch screen in your loved one’s home that allows them to:
- See messages, photos and videos that you, or anyone authorised by you, send them
- Make video calls (such as Skype)
- Use websites that you set up for them – at the touch of a single button
- See (and hear) medication reminders
- Take readings of things such as weight, blood pressure or glucose levels and share them with the appropriate people
“The system can also record movement around the home and send alerts – such as a text message to tell the carer on the receiving end that, say, a back door has been opened after 10pm.
“The system can be monitored using any device – a laptop, smart phone or iPad – so that family and carers can keep in touch wherever they are in the world.
“We envisage that the touch screen will cost the same as a basic PC – around £300-£400 – with a low monthly charge for the service.”
It seems but yesterday that Telecare Aware readers were flagging up that the £3.2 million procurement by NHS North Yorkshire and York PCT (NYY) of Tunstall telehealth monitoring equipment (including ‘free’ implementation consultancy services but plus ongoing costs of £1.7m per year) looked too hasty, too large and too soon.
But no, it is over two years since NYY PCT responds to Telecare Aware item: The £3+ million telehealth spend that has achieved…what? was published.
So it gives editor Steve no pleasure at all to point you to the following article that appeared in the Yorkshire Post today: Telehealth revolution in tatters after snub by doctors. In short, the failure of the project to take off is causing the local Clinical Commissioning Groups (CCGs) that take over responsibility for it in April to question its future. The journalist dissects the issues so I shall leave it to him or her to do that for you.
However, if the CCGs do pull the plug on the project it will be interesting to see what happens with the taxpayers’ unused telehealth equipment that Tunstall has been paid for but not yet had to deliver. Does the contract entitle them to pocket the difference? Or perhaps one of the CCGs could take delivery of the remaining equipment and make it available to other Telehealth Pathfinder sites. One final question lingers… Where is Ernst & Young (Tunstall’s implementation consultancy subcontractors) [TA Jan 2012] and its reputed £1m fee in all this?*
* “For over two years now Ernst & Young have played a major part in deploying telehealth at scale in a number of NHS regions.” E&Y press release.
From one of our frequent commenters known as “Up North and to the Right’ or UNATTR:
Tonight at 19:30 GMT on the news programme BBC Inside Out South East:
One of the challenges facing the NHS is how to care for people with long-term illnesses such as diabetes, heart defects and chronic lung problems. These patients make up around 30% of patients yet account for 70% of the NHS’s costs.Telehealth is a new scheme where patients with long-term conditions monitor themselves at home using technology rather than going into hospital.
Kent is at the forefront of the scheme with around 800 patients using telehealth. But some doctors are not convinced, citing fears over increased GP workloads and concerns about whether patients will be able to use the computer technology. Others say the NHS reforms will also make it harder for telehealth to happen.
Inside Out asks whether the government’s plans to get more people onto telehealth are likely to succeed.
BBC Inside Out South East is broadcast on Monday, 21 January on BBC One at 19:30 GMT and nationwide (for readers in the UK) on the iPlayer for seven days thereafter.
Mobile health becomes very compelling to the consumer when it has to do with safety. This IEEE Spectrum interview (transcript/podcast) with Dr. Aydogan Ozcan of UCLA follows up on our recent coverage of the smartphone-linked iTube attachment for assaying potential harmful allergens in food, but also returns to the Ozcan microscope and its multitude of uses in developing countries. Both when fully developed have the great potential to reduce costs of medical testing equipment and speedier results. Information and reporting can also lead to safety. The New York City Police Department has also gotten on the app wagon with a free citizen crime information and reporting app for iPhone. You can look up statistics, most wanted and nearest precinct information–but another feature captures anonymous tips on crime. Editor Donna wonders if this technology could be sold to other major cities such as Newark NJ, Chicago, Sao Paulo and London, where crime rates are high, to engage the citizenry and further geo-map crime faster. Springwise.com A tip of the hat to Toni Bunting of TANN Ireland