Calling all digital health people in the North of the UK (and the South)

Sadly the DHACA Day in Leeds on 27th April had to be cancelled because of competing events on that day – readers are reminded of the next DHACA Day now in London on 21st June – agenda still to be set.

Elsewhere, Nesta has updated its European Digital City Index, showing the position at the end of 2016
of the top 50 cities in Europe for start-ups. Not digital health-specific though very interesting, nevertheless. TechCity have produced a more detailed website exploring why the UK is the Tech Nation of Europe, which is excellently animated. Though with little mention of digital health it is nevertheless an excellent read, and resource…and something to make those of us who are involved in the UK digital scene proud of our achievements. And if you are a supplier looking for opportunities to capitalise on the UK’s standing, what better than to attend Healthcare UK and NHS Digital’s International Digital Health Opportunities event in London on 25th April?

If you are still feeling international though less interested in exporting, perhaps you might like to attend (more…)

How to unblock that health data in your EHR? Blockchain. (UK)

The solution to that huge pile of patient-generated data, blocked and stymied in those non-interoperable EHRs [TTA 15 Mar], may be a system based on blockchain. DeepMind, Alphabet’s AI ‘skunk works’, is building a tool that it calls Verifiable Data Audit. It will be tested first in UK hospitals with which DeepMind is already working, including London’s Royal Free Hospital. What VDA will do is use cryptographic math to keep an accurate record of data used in the past to see exactly who is using health-care records, and for what purpose. When data is used, it generates a code based on all past activity. Any alteration to one part of the data alters the others and is quick to spot.

The UK test results will be interesting because, according to the MIT Technology Review article, patient records are considered to be highly fragmented. Another issue that DeepMind had in the UK was the NHS oversharing data with it for other projects, such as AI systems to diagnose eye disease, early warning signs of illness, and machine-learning approaches to guide cancer treatment. The VDA approach would, ironically, create an audit trail of that data. Another reason why we may be moving from Data Despare to Hope. Hat tip to contributor Sarianne Gruber of RCM Answers.

Innovate UK’s £12m innovation challenge; Chiaro gains £4.8m for women’s health tech

The Innovate UK Biomedical Catalyst program now has a £12m challenge program for innovative projects in several healthcare areas, including:

  • stratified healthcare (both therapy and diagnostic components)
  • advanced therapies (cell and gene therapy)
  • diagnostics
  • digital health
  • enabling medical technologies and devices

The fund was established by Innovate UK, the Medical Research Council and Scottish Enterprise. Deadline for challenge registration is midday 31 May. A few more details: projects must be led by an SME either working alone or with others; projects can range in size from £250,000 to £4 million and to last between 12 and 36 months; businesses could attract up to 70 percent of their project costs. Innovate UK/Gov.UK page.

‘Fem-Tech’ is a new term to this Editor, but it perfectly describes Chiaro with its smart pelvic floor exercise tool and app, Elvie. It was originally grant-funded by Innovate UK, but has gained an additional £4.8 million from Octopus Ventures and Allbright for a total funding of £9.6 million. It is profitable with direct sales of £800,000, which is another proof that innovators ‘playing the niches’ in the current fragmented environment may be the smartest of all. Plans include building on current major retailers including John Lewis and Amazon, developing three more smart female health products and expand into 25 countries. Innovate UK/Gov.UK page  Hat tip for both Innovate UK items to our Eye on Tenders, Susanne Woodman.

Tender alert: London Hillingdon 24/7 telecare monitoring (due 5 May!)

Our Eye on Tenders, Susanne Woodman, has located a just-published telecare tender for the London Borough of Hillingdon UB8 1UW.

Description: The London Borough of Hillingdon (the Council) is inviting tenders from suitably experienced organisations capable of providing a Telecare emergency alarm system and 24- hour telephone support for the Council (the Services).

The specification is split across two service requirements;
A. Social Alarm and telecare 24/7 monitoring services;
B. Provision of an out of hours emergency answering service.

The London Borough of Hillingdon (the Council) currently operates 21 sheltered housing developments across the borough, consisting of 838 units. All sheltered housing accommodation is connected to the current Telecare call handling system provided by Jontek.

The current system is monitored by Council staff 24/7; this would switch 24/7 monitoring to an outside sole contractor. It is a three-year contract starting 1 September and ending 31 August 2020, with an extension of one year. The estimated value is £1.5m.

Application deadline is 5 May. More information is on the Gov.UK Contracts Finder page.

Health tech overstatement of the day: ‘a contact lens that tells you when you’re sick’

click to enlargeThis Editor likes Gizmodo, and doesn’t want to seem overly cynical or critical, but here we go again with an article that gives the impression that biosensing contact lenses are just around the corner. Our Readers will recall Google’s much hyped glucose-sensing lens developed with Novartis/Alcon dating back to 2014 [TTA 27 Mar 15]. This research is out of Oregon State University and is testing a transparent biosensor which will detect glucose levels in tears. The biosensor contains a transparent sheet of IGZO (gallium zinc oxide) transistors and glucose oxidase, an enzyme that breaks down glucose. In breaking down the glucose, it causes the pH level to shift and generate a measurable change in the electrical current going through the IGZO transistors. The researchers project that 2,500 of these transistors could be embedded in the lens, enabling multiple sensors detecting multiple chemicals which could lead to disease detection.

Why raise the yellow flag? If the lenses are to be used for continuous monitoring or even short term, thick lenses (like the old hard plastic or gas-permeable) require a period of wear-in to get the cornea habituated to it, and even after, there is the hazard of corneal abrasion. Irritation is especially hazardous for diabetics, who have a greater likelihood of eye injury and also related vision problems. Animal testing of the current version is over a year away. They don’t yet have a way to power the lens sensors. Contact lenses with sensors for various problems (e.g. Sensimed’s lens for glaucoma intra-ocular pressure) and Samsung’s Gear Blink embedded camera have been prototyped for years and none have made it into commercial release. Cost is a major unanswered question. While the researchers are to be applauded for the approach and applying it to other chemicals detectable in the eye, disease-sensing contact lenses will take years to be commercially available, if ever, and the article largely makes them seem just around the corner. Thin films applied to the skin for vital signs monitoring seem so much more…wearable [TTA 3 Feb]. Research to be presented at the American Chemical Society‘s annual meeting today (4 April). Photo is artist’s depiction of lens, courtesy of OSU

Independent For Longer website debuts (UK)

The Independent for Longer website has been profiled on the website magazine Ucan2, which highlights mobility aids, assistive technologies, and techniques for better management of a wide variety of disabilities, including learning and autism spectrum. The website showcases real-life TECS (technology enabled care solutions) in the form of seven ‘case studies’ spanning ages from 20 to 79: brain injury, stroke, epilepsy, collapse, ill health, heart failure, and learning difficulties. Each leads the viewer through how a home can be enabled through the selective use of equipment to support independent living. The eighth section is about ‘Billy the Dog’, the Dementia Dog funded through JustGiving in memory of Tynetec’s Billy and Lisa Graham. The ‘Interested in Telecare’ page, where the user can find a service provider, links to the ‘Consumers and Carers’ page of the TSA website, where the first tab is ‘Find a Service’. This website is funded by Tynetec, which is part of Legrand Assisted Living and Healthcare–but is unbranded. Tynetec and Legrand are long-time supporters of this website.

higi kiosks get ‘vitamin B’ from BCBS Venture Partners, acquires EveryMove fitness incentive app

higi, the wellness kiosk + consumer engagement program, received an infusion of ‘vitamin B’–as in Series B–from Blue Cross Blue Shield Venture Partners. The exact amount is undisclosed in reports. This adds to their Jan 2016 $40 million venture round (Crunchbase). BCBS Venture Partners is the investment arm of the BlueCross BlueShield trade association, which licenses the BCBS names to insurers.

They also took the opportunity to announce their acquisition of the EveryMove fitness tracker/wellness incentive app primarily marketed to employers. The tie-in is that higi’s wellness program also integrates data from 80 different devices, wearables, and apps, plus the kiosk locations. higi claims 11,000 locations at places like RiteAid, Publix and Stop&Shop; 36 million users, 4.5 million who’ve signed up for a higi account and 200 million screenings. Where they need improvement is the number of sticky users who stay with them over time, which is where an employer-based program like EveryMove fits. Built in Chicago, PRNewswire release

The Theranos Story, ch. 38: take our shares, but don’t sue us; Murdoch writes it off

click to enlargeWhat? They’re not toast yet? Far from it. We’ve missed the impossibly twisty soap opera called Theranos, and our latest episode holds to the previous high standard.

CEO and controlling shareholder Elizabeth Holmes is offering shareholders, supposedly from her personal holdings, about two additional shares for each one purchased. This has been offered to the investors in the 2014-2015 $600 million round who bought in at about $15-17/share (ch. 27), such as Cox and Bechtel. The deal dilutes their share cost to about $5. The caveat? Don’t sue Theranos. According to the Wall Street Journal‘s report (Yahoo Finance as WSJ is paywalled), it was approved by Theranos’s board in February, and most investors have ‘signaled that they will sign off on it’. Others are the family of US Education Secretary Betsy DeVos, the Waltons of Wal-Mart Stores Inc. and John Elkann, the Italian industrialist who controls Fiat Chrysler Automobiles NV.

One who is washing his hands is News Corp. executive chairman Rupert Murdoch. He reached a separate settlement for a nominal sum–rumored to be $1–to sell back his shares and legally write off his $125 million investment.

Others are not so lucky. Early investors before that round are not included. (more…)

16 or 27 million 2016 breaches, 1 in 4 Americans? Data, IoT insecurity runs wild (US/UK)

What’s better than a chilly early spring dive into the North Sea of Health Data Insecurity?

click to enlargeAccenture’s report released in February calculated that 26 percent of Americans had experienced a health care-related data breach. 50 percent of those were victims of medical identity theft and had to pay out an average of $2,500 in additional cost. One-third (36 percent) believed the breach took place in hospitals, followed by urgent care and pharmacies (both 22 percent). How did they find out? Credit card and insurer statements were usual, with only one-third being notified by their provider. Interestingly, a scant 12 percent of data breach victims reported the breach to the organization holding their data. (You’d think they’d be screaming?) The samples were taken between November 2016 and January 2017. Accenture has similar surveys for UK, Australia, Singapore, Brazil, Norway, and Saudi Arabia. Release  PDF of the US Digital Trust Report

So what’s 16 million breaches between friends? Or 4 million? Or 27 million?

  • That is the number (well, 15.9 million and change) of healthcare/medical records breached in 2016 in 376 breaches reported by the Identity Theft Resource Center (ITRC), a Federally/privately supported non-profit. Healthcare, no surprise, is far in the lead with 34 percent and 44 percent respectively. The 272 pages of the 2016 End of Year Report will take more than a casual read, but much of its data is outside of healthcare.
  • For a cross-reference, we look to the non-profit Privacy Rights Clearinghouse which for many years has been a go-to resource for researchers. PRC’s 2016 numbers are lower, substantially so in the number of records: 301 breaches and 4 million records.
  • HIMSS and Healthcare IT News insist that ransomware is under-reported, (more…)

A near-miraculous treatment for acute sepsis needs help with further validation

Can health tech help? Sepsis, according to the CDC, is “a complication caused by the body’s overwhelming and life-threatening response to infection, which can lead to tissue damage, organ failure, and death.” It often happens when another underlying condition is occurring, but which cannot be located, but the sepsis is overwhelming and must be treated first. The sepsis has to be treated quickly, or else the patient winds up being a statistic, or worse, disabled or dead. The UK Sepsis Trust estimates 37,000 annual deaths (derived from an extrapolated dataset provided to the UK Sepsis Trust by the Intensive Care National Audit and Research Centre (ICNARC) in 2006) with an estimated 200,000 cases per year. In the US, the estimate is over a million cases a year (NIH). Worldwide, it may be 15-19 million cases. The odds are that sepsis may have touched you, a family member, friend or someone you know. (For this Editor, two in the past six months–and one did not make it.)

There may be a treatment that is both effective and cost-effective, a combination that is hard to beat. It was developed on the ICU front lines at Sentara Norfolk General Hospital (Norfolk General), located in Norfolk, Virginia. An ICU physician, Dr. Paul Marik, who is also chief of pulmonary and critical care at Eastern Virginia Medical School, had read journal articles on treating sepsis with IV infusions of vitamin C. For a patient sinking fast, to the vitamin C infusion he added hydrocortisone to bring down inflammation. (more…)

Tender Alert: Innovate UK has £400,000 for tech to aid inflammatory bowel disease patients

Susanne Woodman, our Eye on Tenders, is advising our Readers of a substantial Innovate UK project in the form of a competition–and it is coming up quickly. From their web page:

NHS Scotland, working with Highlands and Islands Enterprise and Scottish Government, has up to £400,000 to invest in projects that use technology and digital platforms to support and manage inflammatory bowel disease.

The competition is looking for proposals that:

  • help patients manage their health from home
  • promote independence and support people to be more involved in decisions about their care
  • facilitate easier and quicker communication with clinicians

This competition is funded under SBRI (the Small Business Research Initiative) and will have 3 phases – feasibility study, prototype development and pre-commercial testing.

The competition opened on 20 March 2017, and the deadline for registration is at midday on 10 May 2017. There’s a briefing being held in Inverness on 4 April 2017. More information and application link on the Gov.uk website.

Now Publix supermarkets getting into telehealth (Tampa, Florida)

On the lighter side, as you’re doing your food shopping this weekend, think about the lucky souls of the Tampa Bay area who soon will be able to fit in a virtual doctor visit between picking up a dozen eggs and the laundry detergent! The BayCare Health System will be installing private rooms at select Publix supermarkets with video conference capability plus some medical diagnostic equipment, including stethoscopes and blood pressure cuffs. BayCare currently provides telemedicine and consults using the BayCareAnywhere app. The telemedicine system they are using is not disclosed.)

Publix is no stranger to telehealth/telemedicine, having earlier piloted with The Little Clinic (now owned by Kroger supermarkets) in a dozen locations, exiting in 2011. BayCare will also partner with the higi wellness stations already in some Publix markets to send patient results to BayCare physicians (their app system is not mentioned). Based on the BayCare Anywhere pictures, their target market are busy families, young singles and couples, and older children where the supermarket is convenient and often 24/7. (But where are the older people, quite populous in FL year round, who don’t have to be online or download an app?) WLRN (radio and TV)

PwC: your job at risk by robots, AI by 2030?

click to enlargePwC‘s latest study on the effect of robotics and artificial intelligence on today’s and future workforce is the subject of this BBC Business article focusing on the UK workforce. 30 percent of existing jobs in the UK were potentially at a high risk of automation by the 2030s, compared with 38 percent in the US, 35 percent in Germany and 21 percent in Japan. Most at risk are jobs in manufacturing and retail, but to quote PwC’s page on their multiple studies, robotics and AI may change how we work in a different way, an “augmented and collaborative working model alongside people – what we call the ‘blended workforce’”. Or not less work, but different types of work. But some jobs, like truck (lorry) drivers, would go away or be vastly diminished.

The effect on healthcare? The categories are very broad, but the third category of employment affected is administrative and support services at 37 percent, followed by professional, scientific and technical at 26 percent, and human health and social work at 17 percent. Will it increase productivity and thus salaries, which have languished in the past decade? Will it speed innovation and care in our area? Will it help the older population to be healthy and productive? And the societal effects will roll on, but perhaps not for some. View this wonderful exchange between Jean Harlow and Marie Dressler that closes the 1933 film Dinner at Eight. Hat tip to Guy Dewsbury @dewsbury via Twitter

A analysis–and challenging takedown–of the RAND telehealth cost study (updated)

A must read on telemedicine and telehealth cost. One of our Readers, Bruce Judson, commented on our earlier coverage of RAND Health’s new study published in Health Affairs [TTA 8 Mar] finding that telemedicine virtual visits (here called telehealth) drove up utilization of care by 88 percent and cost by $45 per year for respiratory illnesses that typically resolved on their own.

He has written his own analysis based on the full study. Telehealth Costs: RAND’s Questionable Rant (Huffington Post), considers the full study and compares it to a 2014 RAND study by the same authors. Mr Judson notes inconsistencies in sampling and definitions; the illogical attachment of a waiting period cost (77 minutes=$30) to a telehealth visit (perhaps to level it with an office visit?); the misinterpretation of results; small sample size; and the fact that the CalPERS sample is ancient (2011-13), representative of a time when telemedicine (here provided by Teladoc) was a new notion. There are inconsistencies with an earlier RAND study based on the same data! (He does not count in costs outside the study such as lost time at work or the cost of spreading infection to co-workers.)

Mr Judson, after many years in publishing, digital marketing and strategy (from when it was called ‘new media’), and currently an advisor to a UK firm investing in IoT, has cast his lot with us in health tech, heading a firm in the Hudson Valley of NY, Telehealthworks, which markets an employer telemedicine and wellness program called freshbenies. While he discloses that he’s not a disinterested observer or researcher, he has that in common with most of our Readers, who are very interested in determining the truth about costs and savings. He gives many reasons to be skeptical of the RAND findings.

Jawbone gets its day in California Superior Court versus Fitbit

It looks like the long-running Jawbone v. Fitbit trade secrets show will continue in California Superior Court. Judge Richard Ulmer on Friday (24 Mar) in San Francisco ruled that the scope of the Jawbone-initiated lawsuit, charging that Fitbit and five former Jawbone employees stole trade secrets, was far larger than the dismissal handed down last October by the US International Trade Commission (ITC) in Washington, DC, rejecting Fitbit’s claim. To Bloomberg Technology, a Jawbone spokesperson crowed, “We look forward now to focusing on presenting our case to a California jury, which will not be bound by the strict procedural limitations that we faced in the ITC. We will push the case to trial as quickly as possible and are confident that justice will be done.” Fitbit is expected to appeal, but this is not good news for them if this drags out–their share price is down 72 percent from a year ago (Marketwatch)–and threatens their IP which is key to a pivot to the clinical monitoring market.

A sidebar to this is Business Insider’s recent report that one of Jawbone’s law firms, Susman Godfrey LLP, has withdrawn from three pending cases citing ‘professional considerations’, remaining on two. This Editor cannot confirm whether Susman Godfrey is representing Jawbone in the above case, as Plainsite records indicate that Skadden Arps is their counsel. The California courts website has not been updated for the case (Aliphcom Inc. v. Fitbit Inc., CGC15-546004). Previous TTA coverage 9 Feb.

MedStartr’s ¡Viva La Evolución! evolves on Wed 5 April (NYC)

click to enlargeAfter an intense and overflow attendance Hospital Innovation Programs Roundtable last Wednesday hosted by NYC’s largest urgent care, CityMD, and with eight speaker/panelists from Mount Sinai, NY-Presbyterian, Northwell, and Startup61/Melbourne Australia Health Accelerator, what could be better than doing it again in two weeks?

Wednesday 5 April’s MedStartr/Health 2.0 NYC presentation on healthcare’s evolution will be a little more relaxed with three panelists so far, but they are rare ‘gets’: Greg Downing, DO is the Executive Director of Innovation at the US Department of Health & Human Services (HHS), an institution much in the news with Federal changes in healthcare. Jay Parkinson, MD, MPH developed the first commercial cloud-based EHR, Hello Health, back in 2008 and founded his current telemedicine company, Sherpaa Health, five years ago. Rich Park, MD is both host and the founder-CEO of CityMD. All have different views of how healthcare is evolving, so it should be both an interesting and full evening. It begins at 6 and wraps up at 9pm, with plenty of networking time.

Tickets are $35. Advance reservations are required due to building security. Ticketing is being done through the Meetup Group Health 2.0 NYC here. If you are not a member, please email MedStartr directly at members@Medstartr.com.

Videos are now online for the 22 March Hospital Innovations program and 1 March’s Rise of the Healthy Machines (#RISE2017). The latter includes keynotes, panels, and the six pitches for the Challenge. December’s #MedMo16 is also online.

TTA is a MedStartr and Health 2.0 NYC supporter/media sponsor since 2010; Editor Donna is a host for this event and a MedStartr Mentor. Check the MedStartr page to find and fund some of the most interesting startup ideas in healthcare.