Anyone doubting the benefits of clinical mobile access, read on…

June 13, 2014 | by

Yes of course it is a survey produced by a supplier, so possibly a trifle biased, however EU News’s  item on the benefits of mobile access by community health people makes a very strong case for good access to clinical information when visiting patients that makes sense.

Notable quotes include:

Lack of access to patient information in real-time is affecting the ability of 88% of community health workers to perform their roles…

70% of participants said mobile working technology had resulted in greater patient involvement in care and the management of conditions, and had also improved the quality of visits, with more time focused on treatment.

Almost a fifth of respondents said they spent more than ten hours a week, the equivalent of more than two hours per day, on a combination of travelling back to base to file reports, and other administrative tasks – time that could be spent providing enhanced patient care or home visits.

mHealth: a salmagundi of items

June 8, 2014 | by

Overloaded with Horizon2020 proposal adjudication and conference management (including the first DHACA members’ day on 11th July), this editor has been unable to do much Telehealth & Telecare Aware blogging. However the interesting items have continued to attract my attention and Prof Mike short (especially), Alex Wyke and Nicholas Robinson have continued to add further to the pile (huge thanks to all). So much seems worth highlighting: where to start? Perhaps with the 18 factors to make telemedicine a success, enumerated by the EU-funded Momentum project. Telecare Aware readers will be unsurprised by all 18, which look pretty basic. However many will notice obvious absences, such as the need to adduce evidence of the success of the intervention. Gluttons for punishment will find much more (more…)

Medvivo comes of age (UK)

June 7, 2014 | by | 1 Comment

A year after this editor began his three year stint with Telehealth Solutions, we had a corporate near-death experience, as money got very tight waiting for that first big telehealth order (thankfully it came, courtesy of NHS Norfolk). In those days of reduced salaries, and few employees, we could only dream of becoming a full service remote healthcare monitoring organisation.

This week’s announcement of the acquisition of Magna Careline shows how things have changed in just five years. After being acquired by Moonray Investors, (more…)

Enterprise wearables for clinical health–and more

June 3, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/06/Evena-veins-620×454.jpg” thumb_width=”150″ /]This ZDNet story technically has only one wearable in health–the Evena Medical Eyes-On Glasses which help medical staff find that vein (left) and is being trialled at Stanford University Medical Center. The other four profiled are being used in businesses as wide-ranging as engineering, restaurants, retail stores and manufacturing, but they are being used in the ‘here and now’: Abeseilon work-stream video; Google Glass for reviewing/recording work, training and coaching; the Theatro Wearable Computer ‘targeted’ messager; and, somewhat Big Brother-ish,  the Hitachi Business Microscope, an RFID-like device the size of an ID card that captures employee interactions and collaborations. A savvy HIT developer or implementer could, as has been done with Glass, find different uses for the other three in hospitals, home care or practices.

And you’ll be surprised what made TechRepublic’s list of wearables’ 10 biggest flops. (Already!)

Apple Health, minus the ‘book’, announced

June 3, 2014 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/06/healthkit-apple-wwdc-2014-87_verge_medium_landscape.jpg” thumb_width=”170″ /]Breaking and developing… Apple announced their long-rumored health tracking app [TTA 22 Mar] this morning at their WWDC (World Wide Developers Conference) in San Francisco. The consumer app is called Health (not Healthbook) and the developer platform HealthKit which are both part of iOS8 for iPhones and iPads in the fall. HealthKit facilitates pulling in of health data from third-party developers so that all health-related information for the consumer user is in one ‘hub’, similar to what Apple’s Passbook app does now as a ‘virtual pocket’ for airline boarding passes, movie tickets and coupons. Apple’s Craig Federighi, senior VP of software (pictured, courtesy of The Verge), made the announcement of the app and platform as part of the broader debut of iOS8 this morning.

Already on board is Mayo Clinic with an app that logs information like blood pressure, tracking normal range and it appears from reports that a severe enough deviation will initiate a contact with medical professionals. Nike was prominently featured as an app provider, further confirming that it’s leaving the hardware to their close corporate partner now that it’s out of the FuelBand business [TTA 22 April]. Epic Systems, a leading large system (hospitals/practices) EHR, appears to be integrating integrating its personal health record (PHR) with HealthKit, “suggesting a framework for getting information collected via HealthKit into patients’ MyChart (Epic PHR–Ed.) app.”

Editor Donna wonders if the still-in-early-days Better iPhone health personal assistant app (PHA), developed in conjunction with and backed by the aforementioned Mayo Clinic [TTA 23 Apr], will prominently integrate into Health. (We’ll cover when this develops, as we think it will–but mum’s their word for right now.)

In Mashable, the news was applauded by the CEO of leading app MyFitnessPal as a big validation. In his opinion, Apple would work with the existing field of apps and devices. Leading fitness bands Jawbone and Fitbit had no comment. Fitbit was shown during the presentation: CNET (one of six pictures here) and The Verge (article below). The latter makes the excellent point that Jawbone, Fitbit and the Nike FuelBand have all been sold in Apple’s stores.

The speculation is that Health will be a key part of the features of the iWatch to come, but Mashable in quoting Skip Snow of Forrester Research does bring up a significant wrinkle. Bluetooth LE as a network protocol chews up a lot of battery power, and bigger batteries make for clunky devices. Not exactly the Apple design ethic. Could it be that what’s delaying the iWatch is development of a new, more power-efficient network standard?

Update 3 June: With iOS8 having apps communicating with each other, have the Apple-oids opened the door for a Happy Hacking Holiday?  Stilgherrian in ZDNet points out that the ‘attack surface’ in info security-ese just got a whole lot larger. A future ‘oopsie’?

Hat tip to Editor Toni Bunting

More information: Mashable can’t stop mashing stories: Apple Reveals iOS 8: Interactive Notifications, Health App and More, Apple Gets Into Fitness Tracking With Health App and HealthKit for iOS 8, Apple’s First Step Into Health Tracking Is Small But Powerful. Mobihealthnews gets into the act noting Epic’s involvement: Apple reveals tracking app HealthKit and partners with Mayo Clinic, Epic. The Verge positively is on said verge with Apple HealthKit announced: a hub for all your iOS fitness tracking needs.

Monday’s ‘in the news’ briefs

June 3, 2014 | by | 1 Comment

Proteus raises $120 million from “major new institutional investors based in the United States, Europe and Asia” for further development of its ‘smart pills’. Mobihealthnews. Previously in TTA here (starting in 2009!) It’s a long way from ‘tattletale pills’…..InTouch Health now has an FDA-cleared iPad app, CS for iPad, to support a digital stethoscope component on the mobile devices. The app is designed to assess heart and lung sounds in real time in acute-care settings particularly tele-ICU. MedCityNews…..In the mood to read your brainwaves? The Muse is here to help with neurofeedback. MedCityNews takes it on a test drive and if you don’t mind wiping your head down to get a good connection, it definitely points to the future of controlling computers with brain waves and in the meantime, pairing up health apps to get a correlation with those waves….And finally a ‘think piece’ in HeartSisters by Carolyn Thomas, “To just be a person, and not a patient anymore” is largely an impossible dream for those with chronic disease. It’s part of the basis behind non-compliance and other patient behavior that doctors have difficulty understanding. The experience of the patient–the frustration (the ‘perpetual battle of Stalingrad’) and the burden that person carries is the argument behind ‘Minimally Disruptive Medicine’. Must reading as those same patients will be pressed now even more to Quantify Themselves and also to keep track of every fluctuation in vital signs on their iPhone.

More Samsung ‘we try harder’ telehealth moves

June 2, 2014 | by

Is Samsung playing Avis “We try harder®” to Apple’s Hertz?

Samsung’s other, less noticed end-run in addition to the Simband reference hardware and SAMI ‘open ecosystem’  is an initiative creating a joint research center with the University of California, San Francisco (UCSF) called the Center for Digital Health Innovation (CDHI). It is being headed by Michael Blum, a medical doctor who is the UCSF assistant vice chancellor of informatics. From the statements made to The Atlantic, Dr Blum’s intent is to clinically validate the sensors and algorithms produced within the Samsung ecosystem. Already featured are four initial projects: CareWeb (a collaborative care platform built on Salesforce.com), Tidepool (infrastructure for diabetes apps), Health eHeart (clinical trial app on heart disease) and Trinity (‘precision team care’). On the frontier: ‘novel vital signs’ which he predicts will come out of the analysis of standard vital signs, “…new markers of health and wellness that come out of these large datasets.”  Is Samsung, rather than going head-to-head with Apple on Healthbook [TTA 22 Mar] is leapfrogging into something akin to Telehealth 2.0 or 3.0? Yet this Editor notes that we haven’t figured out, for the most part, the FBQs (Five Big Questions)* of 1.0….

* The Five Big Questions (FBQs)–who pays, how much, who’s looking at the data, who’s actioning it, how data is integrated into patient records.

Grant funds telemedicine for brain aneurysm

June 1, 2014 | by

A grant of $150,000 has been awarded by a charitable foundation to fund a telemedicine [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/06/The-Missy-Project-logo.jpg” thumb_width=”150″ /]programme to help patients with brain aneurysms. The grant from The Missy Project, a Texas non-profit founded in 1999 after the sudden death of 12-year old Marisa (Missy) Magel due to a brain aneurysm, is being awarded to the Dartmouth-Hitchcock Hospital Center for Telehealth.

The funding will enable brain aneurysm patients in northern New England to have rapid access to neurovascular specialists, according to Dartmouth-Hitchcock. This will be achieved through telemedicine platforms to access the specialists at Dartmouth-Hitchcock from local facilities and community hospitals in what will be virtual aneurysm clinics. Once a patient has had a CT scan they will be able to proceed to a specialist consultation faster and more conveniently under this programme. In addition to virtual aneurysm clinics, the Dartmouth-Hitchcock project will include a 24/7 emergency department telemedicine acute consult service for pediatric and adult patients with suspected subarachnoid hemorrhage (which accounts for half of all hemorrhagic strokes), and customized educational video content, according to the Dartmouth-Hitchcock.

The number of deaths each year in the United States due to brain aneurysms  is estimated to be 32,000, more than either AIDS or prostate cancer, according to The Missy Project and an estimated 1 in 50 people, or 6 million people in the US have an unruptured brain aneurysm according to the Brain Aneurysm Foundation, so this project brings telemedicine to an important area.

Dartmouth-Hitchcock Center for Telehealth was awarded nearly a $1M from the USDA in February this year (see USDA invests $16M in distance learning and telemedicine) to deploy telemedicine equipment and services in New Hampshire and Vermont.

Suicide-alert sensor for prisons – no wearables needed!

June 1, 2014 | by

GE_prison-suicide_sensor

GE Global Research has developed a non-contact monitoring system for prisons that aims to alert staff of a suicide attempt in progress. It works by tracking inmate’s movements and vital signs – but without the need for a wearable monitoring device! To achieve this the research team modified standard radar equipment to pick up the delicate movements of the chest caused by breathing and heartbeat.

The system which is designed to be mounted inside a prison cell could be an effective way to monitor at-risk individuals, without resorting to more expensive or more intrusive surveillance solutions. The US Department of Justice funded study proved to be 86 per cent accurate at determining whether someone required assistance.

The final technical report of the three part study is available in full at the National Criminal Justice Reference Service (NCJRS). GE is now exploring ways to commercialise the system in prisons and other settings. Read more: New Scientist; National Institute of Justice

Health funding cuts in Australia

May 31, 2014 | by

Health and science funding in Australia are facing huge cutbacks under the new Government [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/Australian-budget.jpg” thumb_width=”150″ /]of Prime Minister Tony Abbott leading to expectations that the existing telehealth programmes will be reduced or abandoned as a direct result. A raft of cuts include closure of health and science agencies, funding cuts to major research institutes and the introduction of co-payment for each GP visit.

The Guardian reported that a cut of $1.8 billion of planned health payments to the States will take place over the next four years and The Lancet reports that the government’s share of the health service funding will be cut by $15 billion per year by 2024. The treasurer for New South Wales has stated that NSW itself would need to find an extra $1.2 bn over the next four years. ABC reported yesterday that the South Australian Government is planning to shut hundreds of hospital beds in next month’s budget in what will be the largest cut in its history.

Where will this leave the Australian telehealth and telecare services which have been showing rapid take-up in the recent past, helped along by several far-sighted Government initiatives such as Medicare Locals and telehealth pilots? And what impact will there be on the recent One in Four Lives industry initiative?

 

Another Khosla pronunciamento: self-promoting but myopically correct?

May 30, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /] The Gimlet Eye returns and delivers some hefty weekend reading…. Like General Douglas MacArthur, The Eye had to return from my Remote Pacific Island sometime. What better reason than to deliver to our readers Mr Vinod Khosla’s, tech investor and now Health Futurist, latest pronunciamento via VentureBeat.

It is, as they said in 1950, a beaut. It’s apparent Mr Khosla need not even speak at conferences anymore, because he can publish on his investment company’s website a ‘Draft’ entitled ’20 percent doctor included: Speculations and musings of a technology optimist’. It is being treated in certain quarters like Moses toting The Big Tablets down Mount Sinai; at the bottom the DH3 (Digital Health Hypester Horde) swoon in the usual places.

Mr Khosla reiterates some of his bomb-thrower memes from a couple of years ago: 80 percent of doctors could be replaced by machines, doctors were clinging to ‘voodoo-like practices’ and eventually we will not need doctors because we’ll be weller through technology and Big Data anyway. But the Eye’s Review of the ‘Draft’–which Eye was prepared to give the Gimlety Treatment–is that his prior attention-getting statements are not only more qualified (or stated more gently), but also backed up with real data, examples and mostly memorably, legitimately forward thinking whch largely avoids blaming doctors and shifts it onto the laggard Medical Establishment. “In fifteen years, data will transform diagnostics, to the point where automated systems may displace up to 80-percent of physicians’ standard work. Technological developments will AMPLIFY physicians’ abilities (more…)

More on DARPA’s ‘brain chips’ for PTSD, TBI

May 30, 2014 | by

DARPA’s continued research on deep brain stimulation (DBS) implants to treat PTSD and TBI, as well as other neuropsychological conditions, is given the once-over in this Defense One article. New information from the time this Editor last wrote about it in December is that the SUBNETS program (Systems-Based Neurotechnology for Emerging Therapies), funded with $12 to 26 million, will work with the University of California at San Francisco, Lawrence Livermore National Lab and Medtronic to create an implant with electrodes reaching into the brain and which does not require staying still under a machine in a lab. The prototype development is expected to take five years. The article also points out the US Air Force initiative studying the effects of low amounts of electricity on the brain to boost alertness delivered by an external cap.

Samsung’s ‘shot over bow’ in health

May 30, 2014 | by

Watched closely as part of Samsung’s various moves in health (here in the US heavily promoting the S5’s heart monitoring capabilities) is their unveiling of a reference hardware called the Simband, a wristband designed for interchangeable body sensor modules yet in fact to be developed. Its platform is dubbed Samsung Architecture for Multimodal Interactions (SAMI) and is part of an open ecosystem which invites developers “to design and integrate their own sensor technology and, through the SAMI platform, develop applications and algorithms for wearables.” The design was in partnership with the biosensing institution Imec and will be available before end of 2014.(Gizmag) Coming before Apple’s Worldwide Developers Conference (WWDC) and the rumored announcement of the Healthbook iOS app [TTA 22 Mar]…the Samsung-Apple wars continue, and not in court. Also Gizmodo

‘Fashionable safety’ alert device for women

May 30, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/Guardian-Angel-necklace.jpg” thumb_width=”150″ /]Out of Singapore is a pretty silver necklace or bracelet that does more than adorn: with the press of its small silver button, it can help the wearer get away from an uncomfortable or harassing situation in a public setting (like the workplace, a bar or party) by sending that ‘nick of time’ fake call to your iPhone by Bluetooth LE. Or if held down for over 3 seconds in an emergency, it sends an SOS text, coordinates and a Google Map link via the phone to designated recipients (not law enforcement.) The Guardian Angel pendant was developed by ad agency JWT Singapore to support AWARE (Association of Women for Action and Research) in Singapore through a 10 percent per unit donation, and is available at local retailer My Room Retail or internationally via their website for US$120 (UK£71) plus shipping, handling and optional bracelets. What isn’t clear is if a smartphone is needed–the website indicates that an app must be downloaded from the Apple AppStore but the Daily Mail article says it works with any phone. Also PSFK review, ABC (US) News. What’s a little disappointing is that the first function (‘get me away from this creep’ self-call) is being more widely touted than the second (‘the creep is coming after me with handcuffs, and he’s not a cop’ SOS). This Editor also wonders how reachable the necklace in particular would be in a truly dangerous situation. But it is certainly better than the alternative. Hat tip to Editor Toni Bunting.

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/03/first_sign_clip-1.jpg” thumb_width=”120″ /]In TTA 6 March we covered another ‘fashionable safety’ item, the First Sign hair clip, which is more violent crime deterrence and recording-oriented. It senses impact and sends audio/video/GPS location to monitors plus designated recipients along with a pre-recorded announcement that it is gathering evidence. It succeeded in its Indiegogo financing round and is available for pre-order here for estimated November delivery at $50-75 plus monitoring. But so far, fashion hasn’t made its way into the maddeningly institutional PERS design (though Chubb has given it a whirl with its Glasgow competition recently.)

Addiction: Improving Outcomes using Computer-based Therapy

May 27, 2014 | by

Computer-Based-Behavioral-Therapy-Shows-Promise-For-Addiction-Treatment

A recent randomised control trial gives support to the use of computer-based therapy for treatment of addictions. The results were reported this week at the annual convention of the Association for Psychological Science in San Francisco, following publication in the American Journal of Psychiatry. Although the trial focused specifically on cocaine-dependent individuals, it replicates findings of a RCT carried out in 2008, in which participants had a wider range of substance addictions.

Results of this latest study show that those who received computer-assisted therapy were significantly more likely to attain three or more consecutive weeks of abstinence from cocaine as compared to those not receiving any form of Cognitive Behavioural Therapy (CBT) – 36% compared with 17%. And the effects appear to last; the control group also had better outcomes six months after treatment had ended.

Individuals who receive CBT learn to identify and correct problematic behaviours by applying a range of techniques.  Central elements of the therapy include anticipating likely problems, correcting harmful thought patterns, and developing effective coping strategies. The techniques enable people to counteract addiction’s powerful effects on the brain, so they can regain control of their behaviour and lives. (more…)

A random walk through ATA 2014

May 23, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/ATA_Button_color_filled.jpg” thumb_width=”150″ /] Editor Donna attended ATA 2014 on Monday only. This article is a set of impressions (mainly) of the exhibit floor and visits to a number of select booths.

Donna, it’s Baltimore. You’re not in NYC or Las Vegas.

Arriving after a long trip to a city you used to visit regularly, but haven’t been to in over 30 years, is disorienting, especially when you are heading on a fair spring day to a section that didn’t exist then. The Inner Harbor and Camden Yards resemble Atlanta, not necessarily a bad thing since the parts of ‘Charm City’ they replaced were largely past ‘gentrification’. The Baltimore Convention Center was unexpectedly huge, the distance to registration made longer by a taxi driver who dropped me off at another entrance two blocks away. Any resolve I had to drop in on the many educational sessions was dissuaded by the sheer length of the halls. The thick Exhibit Guide confirmed that the show floor filled two city blocks–a challenge to cover and spend time with my appointments before the close of the day.

Was it a hardware show, a software show or somewhere in between?

You could make a case for both views. One observer I walked with at the start compared it to a radiology trade show–all hardware. Yet a closer look indicated that the hardware–the PCs, tablets and smartphones–was there to show software that integrated: systems to track patients, distribute information, workflows, store and forward images and reports. It was about enabling secure consults, platforms, interoperability, two-way data flows, mitigating readmissions and putting telehealth, telemedicine and education into provider and patient hands. It was also about making the business case. It was most definitely NOT about gadgets and single purpose peripherals, though the latter were still quite visible. The old picture of telehealth closed systems, of proprietary monitoring devices feeding data onto a proprietary PC platform where it’s seen by a care manager, is so 2011.

Noteworthy: the growth in specialized services like telepsychiatry, teleneurology, teleradiology and teledermatology. Contrast: despite VGo‘s ubiquitous telepresence robots accosting you on the floor, a tablet-faced robot following a nurse down the hospital hall and ‘consulting’ with patients will likely still be a rarity.

Patient engagement on top

Traditional telehealth device makers are connecting their devices and opening up their reporting platforms to be accessible to patients. But there are bumps along the way in this transition. A&D Medical has gone ‘Wellness Connected’ with a mobile app (more…)