Adopting Simple Telehealth (Flo) SMS reminders in general practice (UK)

Unlike its Pulse rival, GP Online is taking a more constructive approach to the matter of telecare, as evidenced by a (so far) two part series by Professor Ruth Chambers about how to use the Simple Telehealth (Florence, or Flo) SMS reminder system as part of a GP practice’s clinical pathway:
Adopting remote monitoring via telehealth in your CCG’s practices – part 1: hypertension
Adopting remote monitoring via telehealth in your CCG’s practices – part 2: inhaler reminders

How can we maximise the benefits of telehealth for patients across the UK?

Ileana Welte, Head of Bosch Healthcare in the UK, helps to re-frame the ‘Does telehealth work?’ question for readers of The Guardian, helped by a pertinent comment by George Margelis (General Manager, Australia, at Care Innovations) about the Whole Systems Demonstrator (WSD) approach. Still time for more comments on How can we maximise the benefits of telehealth for patients across the UK?

Are the benefits of telehealth a myth? (BBC item, UK)

BBC News (business section) has just published a classically balanced look at telehealth in the UK, with a passing mention of the O2 Help at Hand launch. It’s a pity the article does not have a commenting system as the conclusion may be debatable. Are the benefits of telehealth a myth? Heads-up thanks to John Guyatt via LinkedIn.

On a positive telehealth note, the Public Service website has published a brief item based on recent experience in Leicester, although the title sounds rather backwards! Cold weather keeps telehealth patients out of hospital.

Cisco survey on telehealth shows warming trend

The much-touted Cisco Customer Experience Report demonstrates, like spring in March, a definite warming trend towards consumer comfort with telehealth and online/mobile aspects of managing health using these tools by both consumers and clinical staff. In the global survey conducted in early 2013 among 1,547 consumers and 403 health care decision makers in ten countries, 70 percent of customers surveyed were comfortable communicating with their doctors via text, email or video rather than seeing them in person. Comfort, though, is not actuality. Consumer preferences of text, video consults, IMs, email and even that old standby the telephone, versus in-person visits, are still low, in the 19-23 percent range. Online usage questions hover in the 20-40 percent range–a low (to your Editor) 30 percent are using the internet to check for information. What is also interesting is a seeming contradiction: 63 percent of customers are comfortable storing medical records in the cloud, but 39 percent don’t trust internet sites for privacy and security of that same data. Perhaps it’s confusion about what the cloud is? (Cisco Infographic)

Editor’s Note: An interesting and misinterpreted stat is 76 percent ‘find access to care more important than physical human contact with their care providers’ (Cisco slide). At least one blog (HIT Consultant) in an otherwise useful article has trumpeted this as ‘76% of Patients Would Choose Telehealth Over Human Contact’. A look at the question indicates that in market research terms, this is worded as a ‘forced choice’ question–they’d rather have telehealth than no health (care). But overall, the survey indicates that however slowly, consumers and providers are building a level of comfort and acceptability on technology usage and data transfer as part of healthcare. Cisco report/release.

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MMR Global vs. Nehta, Round 2 (US/AU)

[grow_thumb image=”” thumb_width=”125″ /]Ding! The Australian reported last week that Nehta (National E-Health Transition Authority) is defending itself against charges by PHR company MMRGlobal that it has not responded to information earlier requested from and supplied by its operating company MyMedicalRecords and its licensee in Australia. MMRG is claiming that Nehta’s planned national PHR system will infringe upon patents held in Australia. According to The Australian article, Nehta’s chief Peter Fleming said that they learned of the claims only on 7 February and that MMRG had “nothing solid” to back them up:  “MMRGlobal has never contacted us at all and indeed our understanding is that they’re investigating a potential claim but have nothing solid” and “we’ve obviously taken a look at their patents, both from an architectural and a legal perspective, and have obviously briefed our lawyers to investigate, but certainly this company has not contacted us at all … We undertook very detailed analysis through third parties who put the standards in place around the world.”  The Australian (access via MMRGlobal website) Robert Lorsch, MMRGlobal CEO, has of course put on a full court PR press to counter this involving Australian singer Guy Sebastian and what appears to be a global awareness program to underscore the importance of a PHR–and their patents/IP–with Australian revenues being directed to a charitable foundation including charities Mr. Sebastian already supports. Guy Sebastian Speaks Out About MMRGlobal Patent Investigation in Australia (MarketWire via TTA recent related on MMRG: pre-HIMSS (26 Feb) and lawsuit update (20 Feb).

Quantified Selfing as…Show & Tell?

[grow_thumb image=”” thumb_width=”150″ /]James Wolcott in February’s Vanity Fair (!) tries on Quantified Selfing in an amusing and quite Gimlety take on the idée fixe of many Digital Health types. He tries out activity trackers FitBit, Jawbone Up (which maddeningly don’t correlate); the emWave2 Personal Stress Reliever; the Pivothead spy camera sunglasses to film the Movie of His Life.  He lightly lampoons the NYC Quantified Self Meetup (one of many all over the world) likening it to a geek version of Weight Watchers (5-10 minutes of individual Show & Tell, applause, huzzahs of ‘carry on’). “With its continuous data streams and hive‑mind chatter, Quantified Self is Weight Watchers exponentialized, an emerging neuro-cellular confraternity.”  How true, but at least with WW you did lose pounds. Witty observations abound, such as Quantified Selfing as an ongoing science fair (oh, those geeks again), and its historical roots in American self-improvement dating back to that QSelfer Ben Franklin tracking his progress on 13 virtues. The Gimlet Eye observes that Ben did not shun indulgence in beer, ladies (French and otherwise) or dangerous experimentations with revolutions and lightning, either.

Disappointingly–or ironically–at the end, in true VF style, he pirouettes to a volte-face, grasping for concluding points out of the kultursmog of politics, trends-on and philosophy, the weirdest being how Quantified Selfing may ultimately achieve Teilhard de Chardin’s Omega Point of supreme collective consciousness a/k/a Man Fusing With God. Now this the Eye does object to, believing far more in the Jungian collective unconscious, particularly after a gimlet (fresh lime, please) or two indulged in a pleasantly sociable watering hole, and that God’s last probable direct relationship with a Jawbone was empowering Samson to take one from a donkey and slay a few thousand Philistines with it. Wolcott’s real reason may be much more literal after his investment in all these ‘doodads’: “I better start getting my numbers up. Otherwise, I run the risk of my Fitbit telling me you suck, and the last thing I need is a personal heckler.”

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.

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A sensor to treat your aching back

[grow_thumb image=”” 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=”×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.