Not just one, but two major analyses of mHealth studies to date. Published in PLOS Medicine with the 42-study review of mHealth as used by health professionals [TA 18 Jan] is a separate review, by the same team, of 75 studies evaluating disease management outcomes and behavior change in health care consumers. Like the review of professional studies, the outcomes are inconclusive and inconsistent due to study quality. What was promising was perhaps the simplest: “Text messaging interventions increased adherence to ART (antiretroviral therapy) and smoking cessation and should be considered for inclusion in services.” The Effectiveness of Mobile-Health Technology-Based Health Behaviour Change or Disease Management Interventions for Health Care Consumers: A Systematic Review (PLOS Medicine) The much-discussed Scientific American article, App’d to Fail: Mobile Health Treatments Fall Short in First Full Checkup
Korean ‘nurse droid’ being tested in nursing homes. The KIRO-M5, which resembles a pint-size (3′) version of R2D2, can wake up residents, announce meals, schedule daily exercise–and can sniff the air to alert an aide or nurse when an elderly patient needs a diaper change. The KIRO also sterilizes and deodorizes the air, and totes supplies. Developed by the Korea Institute of Robot and Convergence. Korean nurse bot sniffs the air to detect soiled diapers (GizMag)
A polymer patch delivers vaccine. Designed by MIT, a dermal patch with microneedles slow-releases vaccine DNA rather than viruses or proteins, to allow the body to build immunity. Could this open up fresh horizons on drug delivery? And with a wafer-thin transmitter, can monitor it? Polymer patches could replace needles and enable more effective DNA vaccines (GizMag)
And finally the most amazing–a prosthesis mostly out of a 3D printer. A five-year-old boy, Liam, now has a workable hand with moveable fingers made using a Replicator 2 3D printer. The fingers are attached to a brace worn over the hand, and controlled via cables and return bungees. The designers who collaborated long distance from Washington state and South Africa, have also released the design into public domain. Inexpensive home-brewed prostheses created using 3D printers (GizMag)
Once the favorite of doctors and health professionals, now completely overwhelmed by Apple, the BlackBerry 10 is widely seen as the last chance for the now eponymous company. Coming in predictive word lookup touchscreen (Z10) and keyboard (Q10) versions (addressing the accuracy problem of touchscreens, not good in healthcare data entry), the BB10 also offers a dual-mode between work and personal information–very appealing to healthcare CIOs–with supposedly fast switching between the two. Despite design and handling raves from tough customers such as ZDNet (with the usual grousing about apps), the forecast is cloudy at best; BB’s enterprise base here in the US as of Q4 2012 dropped to a distant 6%–third–behind iPhone and Android OS phones. Curiously, the UK will be first to get the BB 10 in the touchscreen version only, which hints at a slow or ‘debugging’ rollout; March for the US. From the healthcare side, Mobihealthnews. From the tech side, ZDNet: Beautiful phone playing serious catch-up; It’s all in the name
A capital way to start 2013. According to the Dallas Morning News and an SEC filing, Texas-based Intuitive Health, which this past year was in pilot with AT&T and Texas Health Resources, obviously made their case to (undisclosed) investors with a raise of $3.8 million in an equity offering at end of 2012. The Intuitive Health system uses AT&T connectivity to send patient telehealth information to providers; AT&T touted Intuitive in their 2013 predictions [TA 6 Dec]. The Texas Health Resources pilot from April 2011 to August 2012 reduced chronic heart failure readmissions by 27%. One hopes that they use part of that $3.8 million to develop their website beyond a single page with a crawl at the page bottom. MedCityNews
Take two clever people and a personal need to co-ordinate care and communications for family members on different continents and you come up with another new service. The launch press release describes HomeTouch’s founders Dr Jamie Wilson and Daniel Mueller as ‘a former NHS physician’ and ‘an electrical engineer’ respectively. However, their About Us web page reveals that description to be extremely modest. The HomeTouch system is a monthly-fee-based software-as-a-service and has three linked components:
- a tablet application for older people, with basic services services including messaging, videocall, calendar and photo album
- a cross-platform (smartphone, desktop) application with dashboard analytics and services for families and carers
- an ‘intelligent’ server that monitors activity and manages communication between the two applications
At the moment they are offering some free trials – contact them through the HomeTouch website.
Let’s hope they have the funding and the nerve to make a success of it. Anyone with a decent product who is aiming at the ‘children of aging parents’ market that has yet to show any signs of taking off in the UK deserves some success. Ed. Steve
The Department of Health announced at the beginning of January [Sorry I missed it before. Ed Steve], a competition that may be of interest to some of the smaller telecare/telehealth companies. They are encouraging new products and services that will help improve the experience of people with mental health illnesses and people at the end of their life. The deadline for applications is 28 February 2013. Details here.
eHealth Ontario, which has been the subject of a maelstrom of negative publicity for several years owing to its poor management, still continues to cause controversy.:
This item is an oddity because it is undated and was part of a thesis written for someone’s Master in Laws (LLM) at Cardiff Law School. Although UK- and EU-focused, includes examples from the US and other places and it is a potentially useful reminder of the principles of law relating to the practice of telemedicine and telehealth. It covers topics such as consent, confidentiality and malpractice owing to equipment failure. Most interesting is the final paragraph which points out that once a particular way of working becomes the ‘accepted practice’ then doctors can be negligent if they choose not to use it – and that the adoption of technologies can become widespread quite quickly. Now that has interesting implications for telehealth and its adoption. Emedicine & Telemedicine Law Info.
It’s always been a gripe of ours that the telepresence/telemedicine carts used in hospitals were person-guided and therefore not ‘really worthy’ of being termed robots. However, according to the GizMag item (with video), iRobot receives FDA approval for physician avatar RP-VITA, iRobot “realized that they should not waste the time of either the physician or the hospital staff in guiding the robot around the hospital[so now] the doctor need only click on the location of the next patient to visit, and RP-VITA signals when it has arrived on site.” Oh, and there is that small matter of FDA approval.
We had earlier this month reported on Rock Health’s digital health estimate of $1.4 billion, up 45% vs. 2011 with 20% going towards the five biggest deals of the year [TA 8 Jan]. Now Austin, Texas-based Mercom Capital Group does its own slightly lower count of $1.2 billion in VC investment in what’s termed HIT, but this is 200% higher than their prior year total of $480 million. There’s overlap but difference in their five big companies: Castlight Health (provider comparison), 23andMe (personal genetics), GoHealth (health insurance comparison), Kinnser Software (home health clinical support) and the Practice Fusion EHR. Mercom also details the M&A activity topping $7 billion with McKesson being the most active acquirer. Finally, Mobile Health Market News did its own analysis and came up with $907 million, led by ‘health care IT service’, monitoring and consumer apps (although skewed wildly from Castlight Health in this category). What is also clear is that the pace slowed in 3rd and 4th quarters–and that the pace of 2013 investment very much depends on the US economic climate and the effects of government healthcare policy. Mercom: iHealthBeat (summary), MedCityNews, Healthcare IT News. Mobile Health Market News, mHealthWatch
Update on the 3ML site: Worcester has issued its Assistive Technology (including telecare and telehealth) Business Case Document.
London, 28 February 2013
The Royal Society of Medicine’s (RSM) tele- events are always well received by attendees. The next:
- Will give a good grounding in all aspects of teletechnologies in the health and social care world, including how they can be used in combination
- Has excellent speakers who are all experts in their fields
- Is not sponsored and so does not have a commercial agenda to follow: we will tell it how it is
- Is offered at an extremely low price as the RSM is the UK’s largest health educational charity
As part of the publicly-funded Trygge Spor research project, more than fifty people with dementia have been using GPS for periods from several weeks to up to a year. The results show that “localisation technology helps achieve an increased sense of security, freedom and quality of life, both for sufferers and their next of kin.” The results are being presented now at a major seminar held at Gardermoen, and will be followed throughout 2013 by scientific articles. Dementia sufferers benefit from GPS. SINTEF. It will be interesting to see over the coming months the types of technology they have tested and the different results received as well as their ideas on what a whole service will look like. Mike Burton, Telecare Officer, Hull City Council.
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)