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…)
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…)
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…)
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…)
Thursday 3 April, Microsoft’s NY Technology Center, Times Square NYC
The 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…)
One of the surprises for this Editor, and for others attending the mHealth Summit, was to see the sizable presence of Qualcomm Life on both the exposition floor and during the sessions. From a near-nil presence at ATA 2014 and gone dark on news, the floodlights snapped on last week with new partners and a new emphasis: coordination of chronic and transitional (hospital to home) care management (CCM/TCM).
On the show floor, the spotlight was on the partner companies which mixed the established with (mostly) the early and mid-stage. Readers will recognize names such as AliveCor, Telcare, OMRON, Nonin and Airstrip; not so well known are Vaica, Orion Health, Monitored Therapeutics, IMPak Health, Vital Connect, Care Connectors, toSense (CoVa), Dexcom, InteliChart, TruClinic, ForaCare, VOXX, vitaphone (outside of Europe), Propeller Health and Noom Health (a NYeC Digital Health Accelerator 2014 graduate). The partners occupy different parts of the management continuum, integrating communications, record sharing, population health management, sensor-based monitoring, traditional and non-traditional vital signs monitoring, medication management, behavioral change methodologies and PHRs. The 2net Hub is still present for data transmission, sharing and storage, but more prominent is Qualcomm Life’s HealthyCircles platform which provides the clinical management ‘glue’: secure communications, record sharing and care team coordination. HealthyCircles was purchased in mid-2013. Founder James Mault, MD, FACS joined Qualcomm Life as VP/Chief Medical Officer.
We had some post-mHealth Summit reflection time by telephone this Wednesday while Dr Mault was in Boston. (more…)
mHealth Summit this year had an abundance of digital health company news announcements, not only from the conference but also timed to coincide with the heightened interest around it. Your Editor looks over the most interesting of them, briefly. Thanks to Ashley Gold of Politico’s Morning eHealth (@ashleygold, daily reports archived here), Stephanie Baum of MedCityNews (@stephlbaum) and Anne Zieger of Healthcare Dive for their coverage and their company in the press room!
Partners HealthCare researches, Validic expands, AliveCor and Omron ally, Happtique sells out, Doctor on Demand is telemental, Orange goes dental, VA Innovation Rocks
- Partners HealthCare/Center for Connected Health’s cHealth Compass will use panel and other research to help companies, device manufacturers, startups and investors determine what end users–consumer and provider–want out of personal health tech. Focus groups, interviews and usability testing will help to determine product design, evaluation, assess applications and feasibility as well as interim/final product testing. Partners is already organizing in Massachusetts a 2,000-patient database which rewards participants $50 on registration and $110 annually to be in a monthly survey panel. cHealth Compass website, BetaBoston (Boston Globe)
- Health data connector/aggregator Validic demonstrates the attractiveness of Anything Big Data on with new clients including the Everyday Health consumer/professional website and the adidas Group’s sport and fitness apps. Recently they added WebMD, Pfizer, University of Pittsburgh Medical Center (UPMC), NexJ Health and MedHost to their client list. The company claims that their ‘ecosystem’–probably the most popular buzzword at this year’s conference–of healthcare companies and tech developers now reaches over 100 million people with devices such as Omron, Alere, Qardio, Telcare, Jawbone and Withings. Release
- AliveCor accentuates the retail with Omron. AliveCor, which developed the first FDA-cleared ECG for smartphones and gained clearance for an atrial fibrillation algorithm in August, is collaborating with Japanese device manufacturer Omron on developing its retail presence. Omron’s devices are available in major drugstores such as Walgreens, RiteAid and Walmart so certainly AliveCor is due to benefit. AliveCor is also part of a revived QualcommLife (more on this in an upcoming article) Release, Mobihealthnews (Your Editor had the pleasure of meeting at last AliveCor’s CMO and founder Dr. Dave Albert.)
- Happtique sold to SocialWellth. Last year’s floor talk was about Happtique’s first class of certified apps and a security expert’s untimely discovery of major flaws (more…)
The New York eHealth Collaborative’s fourth annual Digital Health Conference is increasingly notable for combining both local concerns (NYeC is one of the key coordinators of health IT for the state) and nationally significant content. A major focus of the individual sessions was data in all flavors: big, international, private, shared and ethically used. Another was using this data in coordinating care and empowering patients. Your Editor will focus on this as reflected in sessions she attended, along with thoughts by our two guest contributors, in Part 2 of this roundup.
The NYeC Conference was unique in presenting two divergent views of ‘Future IT’ and how it will affect healthcare delivery. One is a heady, optimistic one of powerful patients taking control of their healthcare, personalized ‘democratized medicine” and innovative, genetically-powered ‘on demand medicine’. The other is a future of top-down, regulated, cost-controlled, analyzed and constrained healthcare from top to bottom, with emphasis on standardizing procedures for doctors and hospitals, plus patient compliance.
First to Dr Topol in Monday’s keynote. The good side of people ‘wired’ to their phones is that it is symptomatic, not of Short Attention Span Theatre, but of Moore’s Law–the time technology is now taking for adoption by at least 25 percent of the US population is declining by about 50 percent. That means comfort with the eight drivers he itemizes for democratizing medicine and empowering the patient: sensors, labs, imaging, physical examination, records, costs, meds and ‘Uber Doc’.
Guest columnist Sarianne Gruber (@subtleimpact) also attended the NYeC Digital Health Conference and reflects on what to do with all that data patients and devices are generating–a natural for her as she is a consultant in data analytics for Encore Health Resources.
The New York eHealth Collaborative hosted its fourth annual Digital Health Conference at New York City’s Chelsea Piers on November 17 and 18. There I was joined by 850 health-related professionals to listen, engage and see how life science meets digital technology. No doubt we have become a digital culture. Even seated on an airplane, I noticed the gentleman next to me wearing a Fitbit, and we strike up a conversation on step and sleep data and our dislike of the new dashboard. At the conference, Keynote Speaker Dr. Eric Topol, a Cleveland Clinic cardiologist and a leading practitioner of digital medicine, shared with us his thoughts on what it means be a part of this digital revolution as a patient and a doctor. Technology changes the scope of individual care. Advances in genomics now gives us answers based on our DNA that will genetically determine the success of medications and treatments. Epigenomics, a molecular diagnostics company, can prescreen an unborn baby of a mother with cancer with a simple blood test, sequencing the DNA, to manage her therapy. I was fascinated to hear that a genomic signal sensor can detect heart attacks and warn you of this possibly fatal event, and that necklace for heart failure patients can monitor fluid status averting repeated readmissions for these patients. Dr. Topol believes that digitized 24/7 patient health data will shift the patient–doctor relationship. Bringing in your self-monitored data, eliminates “the how are you feeling questions” and instead the doctor can confirm diagnosis and start treating the patient. “Patient owning data is a foreign concept and the digital revolution ushered this in.“ (more…)
11 November, New York
The annual event that is CES Unveiled in New York City is meant to be a nanoparticle-scale preview of International CES in Las Vegas, 6-9 January. It’s a smörgåsbord of what used to be called ‘consumer electronics’ and now is all about innovation–a taste of everything from ever-smarter video and audio to sensors, smarter homes with IoT (the cutely named Internet of Things), Big Data, robotics and (drum roll) Digital Health and the Quantified Self (QS). This Editor regrettably missed the opening briefing by Shawn DuBravac, CEA’s Chief Economist and Senior Director of Research which would likely touch on his areas of the innovation economy and disruption along with the other four 2015 trends to watch: big data analytics, immersive entertainment content, robotics and digital health. (CEA helpfully provides the 30-page white paper here.)
The exhibitors at the Metropolitan Pavilion did not fully represent the trends, however. (more…)
AAL/Bucharest, The Guardian and Kings Fund
As previously highlighted on Telehealth & Telecare Aware, last week was indeed the week of connected health events. This editor made it to three:
As very much of a supporting act – presenting to researchers on how to do business with the different health organisations across Europe – my principal challenge was getting to the city after the ‘information’ kiosk in the airport told me the hotel I was booked into didn’t exist. Thankfully they were wrong. What I saw of the conference looked good, though there were some bizarre rules on who could have free WiFi.
Wednesday evening brought the Guardian information sharing event which proved especially interesting. (more…)
Last Thursday, the 11 winners of the second annual Pilot Health Tech NYC program were announced at Alexandria Center, NYC. A joint initiative of the New York City Economic Development Corporation (NYCEDC) and Health 2.0, it provides early-stage health tech companies based in NYC a ‘test bed’ in partnership with many of the most prestigious metro area healthcare organizations, and another platform to keep health tech growing in the city. Each project represents a distinct need in the spectrum and a common theme is integration of care into workflow. Some needs are obvious: senior care, pediatrics, rehabilitation, cardiac disease and diabetes management. Others are less so: vision, medication adherence, data analytics, blood donation and social support.
The winners are supported by $1 million in funding to operate and report results from the individual pilots which will take place starting in late summer through end of year. An interesting fact from the announcement release is that the Pilot Health Tech inaugural class companies [TTA 1 July 2013] have raised over $150 million in private investment since their win: AdhereTech, eCaring, Rip Road, Vital Care Services, BioDigital, Flatiron Health, Sense Health, Bio-Signal Group, Opticology and StarlingHealth (acquired by Hill-Rom).
The winners (some of which we’ve been following like GeriJoy, NonnaTech and eCaring) and their partners are:
- Smart Vision Labs / SUNY College of Optometry
- GeriJoy / Pace University
- QoL Devices, Inc. / Montefiore Medical Center
- Urgent Software, LLC / Mount Sinai Health System
- Nonnatech / ElderServe
- Fit4D/ HealthFirst
- AllazoHealth / Accountable Care Coalition of Greater New York
- Canopy Apps / Visiting Nurse Service of New York (VNSNY)
- Healthify / VillageCare
- Tactonic Technologies / NYU Langone, Rusk Rehab Center
- Hindsait, Inc. / NY Blood Center
More information in their release. Many thanks to NYCEDC and Eric Vieira of ELabNYC (another NYCEDC initiative) and CUNY.
Related reading: ELabNYC Pitch Day in March
CEWeek NYC, Metropolitan Pavilion/Altman Building (@CEWeekNY)
The Consumer Electronics Association (CEA) stages events in New York twice yearly–at the start of both summer and winter, the latter as a preview of International CES in January. CEWeek NYC is a bit of an overstatement–it’s Tuesday-Thursday. It was apparent on today’s main day (Wednesday) visit that beyond the lead dogs of ever-larger HDTVs, in-car audio/smartphone integrators and marvelous audio speakers small and large, something else was different. Health tech was right behind them in prominence, including related areas of robotics and 3D printing. (This builds on CEA’s own trumpeting of the 40 percent growth of the ‘digital health footprint’ at this year’s CES. Hat tip to Jane Sarasohn-Kahn.)
Presentations got the Gordon Ramsay treatment and were re-plated as bite-sized sizzling steak tips. Also different was the format. Instead of a long, dozy general press briefing several flights up at the huge top of the Met Pavilion at 9am, then rushing to the show floors before the crush of buyers, the floors opened to press only for a generous two hours. Then fast-moving keynotes and conference presentations of no more than one hour started at 11am in an intimate downstairs room. Alternatively, the centrally located demo stage between the show floors hosted 15 minute presentations. Other than occasionally having to wait in a narrow hall as the downstairs room emptied between presentations, both were wise moves. Very workable and very low on the Tedium Scale. Three of the eight Wednesday presentations were robotics or health tech-related, not including the closing FashionWare wearable tech show. The proportion is the same on Thursday.
Notable on the show floor:
The latest fitness band/watch is not a brick, mercifully. Withings formally debuts tomorrow the Activité watch (left) which looks like a fine Swiss analog chronometer, not a slab on the wrist. It’s a man’s watch size on a woman, a bit slimmer and simpler than a Breitling, and connects to your smartphone using the Withings HealthMate app to track activity, swimming and sleep monitoring. You also get time (analog, yes!) and alarm clock, all powered by a standard watch battery so none of the recharging shuffle. Available in the fall at $390, but if you are a dedicated QS-er with style…. Also VentureBeat. (more…)
CEWeek NYC, Metropolitan Pavilion/Altman Building (@CEWeekNY)
Over in FashionWare-ville….
The Healbe GoBe 100% Automatic Body Manager turned out to be a big draw at this pavilion, for reasons that to the casual visitor were not apparent. Its claim: it automatically estimates both calorie intake and calories burned through measurements taken by an impedance sensor to measure tissue resistance, based on blood glucose being converted to liquid in tissues and the amount of liquid released. Having been through the now-vanished-into-thin Airo affair (with its fictional mini-spectrometer for detecting nutritional blood metabolites from food consumption, TTA 23 Nov 13), I was skeptical of Healbe’s claims and told co-founder and managing director George Mikaberydze (left) just that. He patiently explained how it works to me and seemed to be sincerely understanding of my skepticism. He briefly demoed the display on his smartphone, which was hard to track as it indicated negative caloric burn and was partly in Cyrillic, but these numbers were relative to…?
It turned out that I was not the first to question, and he was well prepared.
Healbe turns out to be quite controversial. The company raised over $1 million on Indiegogo this March/April, prominently featured in its well-produced GoBe materials and in its PR communications. It’s promising delivery in September. On researching this, (more…)
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…)
Tuesday 13 May, presented at NYC MedTech-the NYC Medical Technology Forum, at Troutman Sanders LLP, Chrysler Building, New York City
In a packed (agenda and attendees) two hour evening meeting, three presenters detailed the latest research on the clinical signs of chronic traumatic encephalopathy (CTE), along with new technologies for detecting it as it happens and diagnosing it plus monitoring recovery: Robert Stern, PhD, professor of neurology and neurosurgery at the Boston University School of Medicine and a leading clinical researcher on CTE (as our long-time readers know) ; Isaiah Kacyvenski, head of the sports segment of electronics designer MC10 which developed the Checklight head impact indicator for Reebok; and Uzma Samadani, MD, PhD, co-founder of Oculogica which presented at ELabNYC a few weeks ago.
Dr. Stern’s presentation reviewed his clinical work with primarily NFL players in how CTE manifests in both behavior patterns and the brain. His focus remains on sub-concussive trauma, the ‘bottom of the iceberg’ in his analogy, and its cumulative, long-term effects. Repetitive brain trauma–neuronal shearing which is produced by linear, lateral and rotational forces to the head–produce a cascade of brain changes leading to destruction of brain tissues that show as dark patches on post-mortem samples and scans. These differ from Alzheimer’s disease in the abundance of tau protein distributed fairly early in life around the brain’s blood vessels and in the depths of the cortical sulci, where Alzheimer’s signature beta amyloid does not locate. Dr. Stern’s research also incorporates the behavioral changes that precede diagnosis: the emotional ‘short fuse’, the difficulty in memory, accidents, suicide, drastic changes in behavior and impulse control. There are many examples of degeneration and early death among players [TTA 6 Dec 12 which also refers to Dr. Stern’s research published in Brain; also see TTA 5 June 2013 on his German Center presentation which has additional background on his and his team’s research.]
In addition to the work he has done relating to (American) football (he is on the NFL Players Association brain injury committee and his research was instrumental in the PA’s lawsuit against the NFL), he studies other contact sports such as hockey (brain injury clusters (more…)