#MedMo16 video highlights on YouTube (Day 1)

Courtesy of the MedStartr crowd-based healthcare investment fund and HealthTechTalkLive is the first day video of #MedMo16 from City Winery in NYC. It’s a tick over 7 hours of six Momentum talks, two final exams for Mega Challenge competitors in population health and devices/wearables plus three panels. Your Editor is running the presentations so you know the dastardly doer of any ‘goofs’ you see! Day One is on YouTube here. The finalist list in the Mega Challenge presentations differs from the program here–start times are in parentheses:

  • Pop Health, Payers and Pharmatech: Mymee, AudibleRx, EllieGrid, Agewell Biometrics US, Aloha Health (1:03:00)
  • Devices and Wearable Health Tech: GlucoSight, Rx Bandz, HeartIn, tonguenacity, Ceeable (4:56:00)

Day 2 will be posted tomorrow.

Digital Epidemiology: on-demand public health

Guest Editor Sarianne Gruber (@subtleimpact) reviews the meta-trend of digital epidemiology, which gathers ‘digital exhaust’ information through social networks, chat rooms and other online media, analyzes it at the population level and tracks localized outbreaks of diseases like the Zika virus and flu. It even has inspired new models of vaccine delivery and patient transportation such as Uber Health and Circulation.

The Internet has a rather detailed picture of the health of the population, coming from digital sources through all of our connected devices, including smartphones. This is digital epidemiology: the idea that the health of a population can be assessed through digital traces, in real time. Digital Epidemiology: Tracking Diseases in the Mobile Age. M. Salathé, J. Brownstein et al.

As a Harvard Medical School Professor and the Boston Children’s Hospital Chief Innovation Officer, the plights of patients and the hurdles in care are Dr. John Brownstein’s starting points for questions and discovery. When the Community Transportation Association study reported “an estimated 3.6 million patients the United States miss at least one appointment due to lack of access to transportation”, Brownstein was determined to make this challenge his own. This fall, he launched the first customizable patient-centric digital transportation system – Circulation – a new vision for non-emergency medical transportation. As a Klick Health Muse attendee and having had the privilege to speak with John Brownstein, Ph.D., co-founder of Circulation, I would like to share what I learned about his journey as an epidemiologist, public health educator, and innovator.

Social Media’s Big Data: Preventing Epidemics and Tracking Drug Safety
Digital epidemiologists think in terms of “digital phenotype” to understanding the health of individuals. Uncovering critical information about what is happening at the population level is collectively called “digital exhaust”. These digital traces that are left behind, help track local outbreaks around the world. “In fact, you don’t need surveys, just mine what people are saying online. We combine social media to get real insights as to what is happening on the ground: facts and sentiment. The ability to understand risk and population health is fantastic with these emerging technologies,” opened Dr. John Brownstein at the 2016 New York City KlickMuse event.

Social media mixed with disparate sources of health data was how Brownstein began solving public health risks. (more…)

Changing care models to connect better with care, age at home

While this Editor didn’t get to the second annual d.Health Summit in NYC this past May, the organizers Avi Seidmann, PhD & Ray Dorsey, MD [TTA 20 July] of the University of Rochester have conveniently distilled the day down to a 13-page policy paper on successful aging at home. The keynote speaker set the theme around the core needs of older people:

  • identity (“help me stay me”)
  • routine (“help me stay in control”)
  • sociability (“help me stay engaged”)
  • vitality (“help me stay physically and mentally fit”)

Innovation around healthcare delivery, mobility solutions, assistive technologies that adjust to a wide variety of needs, socialization outlets and home services can improve health and wellness while reducing costs for the healthcare system as a whole.  Impediments are regulatory, interoperability and that old devil, payments. It needs to move to ‘next generational care” where healthcare tech fully becomes an extension of the healthcare system. Can’t come soon enough. Download the PDF here. Also read contributor Sarianne Gruber’s perspectives on the conference in RCM Answers on 18 May and 24 May.

The State of the Connected Patient is a 21-page survey with plenty of bar charts of over 2,000 Americans taken in June by the Harris Poll sponsored by Salesforce, which we’ve noted here is partnering notably with Philips in the HealthSuite digital platform. Analysis is separated by boomers, millennials and Gen X.  62 percent of respondents would be open to some form of ‘virtual care’–and 52 percent of ‘millennials’ would prefer to choose a doctor who uses virtual care tools. Most are content with their primary care doctor, though that doctor may not recognize them in the street. Only a quarter actually keep track of their health records, digital and otherwise. Apps are used, but all age groups are split evenly in using a wearable if an insurance company or provider gave them to wear in exchange for (respectively) lower rates and health information access. Download PDF via EHR Intelligence.

A ‘next generation’ house call from the patient’s perspective

Guest editor Sarianne Gruber (@subtleimpact) attended May’s d.health Summit on Aging in NYC. She reflects on moderator Christina Farr’s (immediately prior) direct experience with a virtual visit (convenience, proactive care–and utter frustration with her payer) and what the telemedicine ‘next gen’ provider panelists see as their advantages in fixing a fractured healthcare system.

Christina Farr had a “Next Generation” house call for the first time. The on-demand doctor’s visit provided her care and resolved the possibility of a trip to the emergency room, and best of all she felt great. Ms. Farr, an award-winning health and technology journalist, happen to have had her encounter just days prior to the d.Health Summit. Coincidentally, she was to be the moderator for a panel of prominent telehealth business leaders on this very topic. Curious after having had this experience, she wanted to know whether most cases were like hers wondering if they should go to ER, or were the visits more for routine things like coughs and colds, or did people just want a prescription. The d.Health panelists included Damian Gilbert, Founder & CEO of TouchCare (@touchcarehealth), Oscar Salazar, Chief Product Officer and Co- Founder of Pager (@getpager), Dr. Ian Tong, Chief Medical Officer of Doctor on Demand (@drondemand), and Dr. Roy Schoenberg, Co-Founder, and CEO of American Well (@americanwell).  (more…)

Events last week beyond Brexit: London Technology Week, CE Week NYC

The world may have turned upside down (and around) with Brexit, but London Technology Week happened nevertheless. It’s exploded into 400 events and 43,000 attendees, with 300 attending an event at London City Hall on health tech within the NHS. (Attendees invited to contribute in Comments.) Designer Brooke Roberts, an ex-NHS radiographer who advocates the fusion of fashion and tech, debuted her brain scan-inspired knitwear, accomplished by translating scans into digital files capable of programming industrial knitting machines. According to GP Bullhound in their annual European Unicorns report, 18 of Europe’s 47 billion-dollar digital startups are now based in the UK. So who needs the EU?  TechCityNews, CNN, Yahoo Tech

click to enlargeOn the other side of the Atlantic, there was a disappointing absence of wearables and health tech at the Consumer Electronics Association’s NYC summer event, CE Week. It’s been a major feature since 2009 at International CES in January; the NYC summer show and the November CES preview had always featured a mostly local exhibitor contingent and conference content. None this year–a representative cited a mystifying ‘change in direction’. There was one lone wearable way back in the exhibit hall–MonBaby, which came in from 16 blocks uptown. The snap-on button monitor works with any garment (unlike the Mimo onesie and the Owlet sock) (more…)

mHealth Grand Tour: ‘magical’ for cyclists, clinical level information for diabetes

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From the HIMSS Connected Health Conference (CHC)/mHealth Summit

The last Executive Spotlight/keynote on Wednesday morning stepped outside most of this year’s CHC content, first for presenting a European mHealth program and diabetes patients not as overweight, inactive and co-morbid but as athletes. Presented by Benjamin Sarda, Head of Marketing for Orange Healthcare, the mHealth Grand Tour has developed in three years from a fully organized, challenging 2,100 km Brussels-Barcelona ride primarily (but not exclusively) for cyclists with Stage I and II diabetes as a test bed for blood glucose monitoring under extreme exercise, to a 1,500 km Brussels-Geneva three-stage tour with even greater ascent, extreme monitoring and also a full spectrum of vital signs feedback via smartphone to the riders. This past September, 24 riders accumulated 7 million measurements. The cyclists used these measurements (left) click to enlargeclick to enlargeto help manage their food intake, blood glucose, performance and overall wellness. The data is currently being analyzed by France’s Society of Diabetes (SFD), but an early result is that medication compliance was 97 percent. Some had difficulty (with a 22,000 meter climb, who wouldn’t?) but the app helped them manage their ride and what they can do that day. Orange’s interest as a telecom is obviously data but their work with multiple research and mHealth partners (including the Personal Connected Health Alliance which is part of the CHC) and with organizations like the JDRF are part of their big scale. It also represents a ‘jump shift’ in thinking about what is possible in living with diabetes.

What happened in between? Plenty! (More coverage to come.)

90% of industries have had PHI data breach: Verizon (HIMSS Connected Health)

Reporting from the HIMSS Connected Health Conference (CHC)

Cybersecurity is one of the three central themes of this year’s HIMSS CHC, and excellent timing for releasing the highlights of Verizon’s first ever PHI (Protected Health Information) Data Breach Report. This is a spinoff of their extensive, eight years running international Data Breach Investigations Report (DBIR). 

It’s not just your doctor’s office, hospital or payer. It will be no surprise to our Readers that the healthcare sector is #7 in breaches–but that a PHI breach may come from non-healthcare (in US, HIPAA-covered) sources. This Editor spoke with Suzanne Widup, the lead author of the PHI Report and an info security/forensics expert, and included in that 90 percent are workers’ compensation programs, self-insured companies, the public sector, financial/insurance companies and–as a damper on this highly competitive (but hard to gauge results) area–wellness programs. Most organizations, according to Ms Widup, aren’t even conscious that they are holding this information and need to specially protect it from intrusion, as “PHI is like gold for today’s cybercriminal.”

Consistent with other authoritative tracking studies like Ponemon Institute’s and ID Experts’, the threat is from within: physical theft and loss, insider misuse and ‘miscellaneous’ account for 77 percent of theft. And as Bryan Sartin, managing director of Verizon’s RISK team noted in his keynote today, attacks take over a seven-month period on average to even be noticed. The breaches are long term, start small and sneaky. 2/3 of organizations don’t find out on their own, only when it starts to affect other partners. (Surprise!) Despite the proven Chinese and Black Vine involvement in several high profile, high-volume data hacks (Anthem), and ‘brute force’ hacks that make headlines (iCloud last year), the average breach is an inside job where “assets grow legs and walk off” in Dr Widup’s words, or privilege misuse.

When I asked Ms Widup about the Internet of Things (which is moving high on the hype curve, from what your Editor has experienced to the nth degree at this conference), she confirmed that this is an area that needs extra cybersecurity protection. (more…)

Conference report: MedCityNews CONVERGE

Guest columnist Sarianne Gruber (@subtleimpact) attended Breaking Media’s annual MedCityNews CONVERGE two-day conference at Philadelphia’s Hyatt at Bellevue earlier this month, and has a few observations on the surface contradiction of innovation and health insurance.

Breaking Media rightly titled this year’s MedCity News conference “Converge”. Listening to the speakers, meeting the founders of new startups and talking to presenters, it became clear that today’s healthcare ecosystem is interdependent on the all the players to move the needle for better quality health. It was fascinating to learn was how innovation is breaking down the old silos of engagement, and is emerging from all the industry players, as well as joining at new intersections. The proliferation of better products, methodologies and engagement is closing the gap with more data, technology and ideas.

When you think of your health insurance company, usually two words comes to mind, cost and coverage. Keynote Speaker, Daniel Hilferty, President and CEO of Independence Blue Cross, wants to change the focus to consumer and care. Hilferty paralleled the new ventures at Independence to the work of the great innovator, Thomas Edison. Not only did Edison invent the light bulb, but his work is evidenced in the scalability of electricity that changed the world and how we now live.

In what directions is Independence Blue Cross converging? (more…)

AdhereTech’s smart pill bottle gets a new retro design

click to enlarge My visit to CEWEEK in NY at the end of June was, in contrast to the 2014 edition, light on compelling health tech. One that stood out, for all the modesty of their display, was NYC-based AdhereTech. It’s a med reminder system pushed to the max: a pill bottle that dispenses normally, but collects and sends adherence data in real-time, with a system that analyzes and records the data. If a dose is missed, they send out customizable alerts and interventions to patients, using automated phone calls, text messages and other reminders. It also uniquely measures the level in the bottleso it can automatically notify the patient, provider and pharmacy about a refill.

When last we saw them, they had just won a spot in the inaugural (2013) Pilot Health Tech NYC program. They have redesigned the bottle to have a more compact, retro med bottle-like shape along with a brighter light and chime. (more…)

Health Datapalooza 2015: more data, better health

Guest columnist and data analytics whiz Sarianne Gruber (@subtleimpact) sat in on the Health Data Consortium’s 2015 edition of Health Datapalooza last week in Washington, DC. It was all about the data that Medicare has been diligently harvesting. Also see the US-UK connection on obesity.

Health Datapalooza 2015, now in its sixth year, welcomed more than 2,000 innovators, healthcare industry executives, policymakers, venture capitalists, startups, developers, researchers, providers, consumers and patient advocates. Health Datapalooza brings together stakeholders to discuss how best to work the advance health and healthcare,” said Susan Dentzer, senior policy adviser to the Robert Wood Johnson Foundation and a member of the Health Data Consortium. The Consortium promotes health data best practices and information sharing; and works with businesses, entrepreneurs, and academia to help them understand how to use data to develop new products, services, apps and research insights. This year’s conference was held on May 31 through June 3 in Washington, DC. And how best to celebrate is with the gift of more data!

New Medicare Data Means More Transparency
The Centers of Medicare and Medicaid Services (CMS) released its third annual update to the Medicare hospital inpatient and outpatient charge data on June 1, 2013. (more…)

ATA’s hottest trend: advancing to Healthcare 2.0 via personalized healthcare

Guest columnist Dr Vikrum (Sunny) Malhotra attended ATA 2015 earlier this month. This is the third of three articles on his observations on trends and companies to watch.

For those who attended the American Telemedicine Association‘s meeting in Los Angeles, the overarching trend was how a personal healthcare system is taking shape. The three pillars include: care anywhere, care networking and care customization.

The ATA stage opened with a keynote speech by Dr Sanjay Gupta about celebrating new innovation and technology advancements. This is the year where healthcare models are being built around patients in the home to support patient autonomy.These three pillars of personalized healthcare are being made possible by disruptive technologies, wearables/implantables, social networks and analytic technologies to automate remote care. Wearables and biosensors allow patients to move anywhere without interfering with day to day schedules while allowing for optimized data collection.

Access to care anywhere has been a challenge and is becoming realized through providing cheaper wireless tools that takes it to far corners. Dr Gupta focused on the use of telemedicine for delivery of care and its utility for improving access. He endorsed it as a tool for providing care for those with limited healthcare accessibility and locally for more a mainstream solution to a larger healthcare problem. We have seen telemedicine become mainstream (more…)

The Future of Medicine – Technology & the Role of the Doctor in 2025 – a brief summary

The following is a brief summary of a joint Royal Society of Medicine/Institute of Engineering & Technology event held at the Academy of Medical Sciences on 6th May. The event was organised, extremely professionally, by the IET events team. The last ticket was sold half an hour before the start, so it was a genuine sell-out.

The speakers for the event were jointly chosen by this editor and by Prof Bill Nailon, who leads the Radiotherapy Physics, Image Analysis and Cancer Informatics Group at the Department of Oncology Physics, Edinburgh and is also a practising radiological consultant. As more of those invited by Prof Nailon were available than those invited by this editor, the day naturally ended up with a strong focus on advances in the many aspects of radiology as applied to imaging & treating cancer, as a surrogate for the wider examination of how medicine is changing.

The event began with a talk by Prof Ian Kunkler, Consultant Clinical Oncologist & Professor in Clinical Oncology at the Edinburgh Cancer research Centre. Prof Kunkler began by evidencing his statement that radiotherapy delivers a 50% reduction in breast cancer reappearance, compared with surgery alone. He stressed the importance of careful targeting of tumours with radiotherapy – not an easy task, especially if the patient is unavoidably moving (eg breathing) – Cyberknife enables much more precise targeting of tumours as it compensates for such movement. Apparently studies have shown that 55% of cancer patients will require radiotherapy at some point in their illness.

This was followed by Prof Joachim Gross, Chair of Systems Neuroscience, Acting Director of the Centre for Cognitive Neuroimaging & Wellcome Trust Senior Investigator, University of Glasgow, talking about magnetoencephalopathy (MEG), which enables excellent spatial & temporal resolution of the brain. However it currently uses superconducting magnets that in turn require liquid helium, so is very expensive to run. He then showed an atomic magnetometer which apparently is developing fast and will be a much cheaper alternative to MEG – he expects people will be able to wear sensors embedded in a cap soon. He then went on to show truly excellent graphics on decoding brain signals with incredible precision; he explained that the 2025 challenge is understanding how the different brain areas interact. Finally he described neurostimulation, using an alternating magnetic field with the same frequency as brain waves to change behaviour; whence the emergence of neuromodulation as a new therapy. Both exciting, and just a little scary.

Dr David Clifton, Lecturer, Dept of Engineering Science & Computational Informatics Group, University of Oxford, followed with a talk on real-time patient monitoring. He began by explaining the challenges that clinicians face with this wall of patient data coming towards them: only “big data in healthcare” enables all the data generated by patients to be analysed to identify the early warning signals that are so important to minimise death and maximise recovery. (more…)

“Mainstreaming medical apps; reducing NHS costs; improving patient outcomes” – a brief summary

What follows is a brief summary of the presentations given at the Royal Society of Medicine’s third “Appday”, held on 9th April 2015. All three events have been sell-outs.

Anne Hayes, Head of Market Development at BSI, opened the event with an excellent presentation on the then shortly-to-be-finalised PAS 277 on mHealth apps (now available, free, here). She particularly welcomed the opportunity to present to clinicians, as too often her audience was primarily technologists. The presentation was especially impressive because Anne had only agreed to do the presentation the previous Friday, following realisation by both MHRA & NICE that proximity to the election meant neither could present. Anne explained that PAS 277, as a Publicly Available Specification, is not mandatory – it is essentially a checklist for developers and purchasers of medical apps to consider.

Julie Bretland, CEO of OurMobileHealth, then presented on the preliminary conclusions of the NIB Workstream 1.2 on how best to approve medical apps. (more…)

ATA trend #2: is this the ‘second generation’ of remote patient monitoring?

Guest columnist Dr Vikrum (Sunny) Malhotra attended ATA 2015 last week. This is the second of three articles on his observations on trends and companies to watch.

During the course of the ATA conference, I was inundated with the concept of “dumb” data whereby biosensors track patient clinical data and will alarm to clinical staff if outside designated parameters. However, the call center filter between the patient’s data and physician is often a primary cause of increased unnecessary admissions. The Sentrian Remote Patient Intelligence Platform (Sentrian RPI) received recognition for its advancement in utilization of sensors, enabling healthcare providers to utilize this “dumb” data and make it “smart”. For clinicians like myself, this was a new way of looking at an age old problem: “How do we safely and comprehensively support physician decision making at a standard high enough to detect pathologies earlier and more accurately?”

Sentrian has used machine learning to support the work of a dedicated clinical team by monitoring patient data 24/7 to detect subtle signs that warn a family member or care provider of future problems through biometric patterns of thousands of patients, comparing their medical histories, vitals and health information. This novel approach to remote monitoring won Sentrian the ATA President’s Innovation Award. (more…)

ATA trend #1: Is a sustainable RPM infrastructure fact or fiction?

Guest columnist Dr Vikrum (Sunny) Malhotra attended ATA 2015 last week. This is the first of three articles on his observations on trends and companies to watch.

The advancement of remote patient monitoring is a visible trend from the American Telemedicine Association’s 2015 meeting, with care moving from the doctor’s office and being shifted to the patient’s home. A more diverse range of data is being collected for patients to facilitate more informed decision making at the patient visit and after the patient is away from the practice. As information is being collected and monitored on a more comprehensive basis, we have seen creative modalities to view a broad array of data points that would typically have been collected in a doctor’s office with the hopes of early diagnosis and preventive care, versus reactive care.

Patient autonomy has now come to the forefront and network infrastructure is being built to support that shift. Wearables, implantables and home based lab/ urine diagnostic kits are becoming smaller, cheaper, less invasive, wireless and cloud-based so that patients can be monitored without interfering in day to day living. (more…)

ELabNYC Pitch Day 2015

Thursday 3 April, Microsoft’s NY Technology Center, Times Square NYC

click to enlargeThe third annual Pitch Day for the now 20 startup/early-stage life science, biotech and healthcare technology companies in the ELabNYC (Entrepreneurship Lab Bio and Health Tech NYC) is a culmination of their year-long program participation in this NY Economic Development Corporation (NYCEDC)-supported program. The entrepreneurs in the ELabNYC program primarily come from from the doctoral and post-doc programs from New York’s many universities, from CUNY to Columbia, from many parts of the world, and most have experience within the city’s multitude of major health research institutions from The Bronx to Brooklyn. New York is also a center of funding for life science and health tech ventures; it’s #2 with NIH awards totaling $1.4 billion. For the past few years, NYEDC has also supported these companies with finding access to capital, specialized space (e.g. wet labs such as the million square feet at Alexandria Center alone, plus Harlem Biospace and SUNY Downstate in Brooklyn) and partnerships with major companies such as Celgene, Eli Lilly, Pfizer and GE Ventures.

This Editor will concentrate on health tech companies–eight, up from five last year [TTA 17 Apr 14]. Each company pitched for five minutes on its concept, its current state of advancement (including pilots/customers), its team and a funding timeline. It was a very different mix from last year’s class, which focused on compliance, diagnosis, dementia and concussion. These companies focused on niches which are either not being served well or to substantially reduce costs. Nearly half the entrepreneurs were women, a substantially greater number than one usually sees in the biotech/health tech area. Short impressions on our eight, with links to their Executive Summaries on the 2014-15 ‘class page’: (more…)