click for non-demo site

Editor Donna’s Picks for October 2010

My ‘must-reads’ for October are:

On Mobile Health Expo–thoughts on a conference that concentrated on the ‘here and now’ business models with public health distinctly secondary. TA was a sponsor and I was a panel moderator, so our view was up close. Time to find our places in this market.

‘Robotics making strides’–the difference that mobility to a person makes for the elderly, disabled and war casualties, and doable within 1-2 years

WellDoc’s alliance with AT&T–a neon-lit pointer to the future

‘When your protected health information isn’t’–an issue that cuts to the heart of not only data security but HR practice.

Happy reading!

Donna

Editor Steve’s picks for October 2010

On an international level, the announcements that Microsoft and Bosch Healthcare had joined the Continua Alliance, and the launch of the first Continua Certified mobile phone seemed significant. In the UK posts, the ones I’d not miss are:

  • the announcement of the long-awaited results of the Kent telehealth trial
  • the small series of video interviews with Dave Tyas, Service Improvement Manager for Self Care and Long Term Conditions for the NHS in Cornwall and the Scilly Isles
  • the posts concerning the matters raised around NHS North Yorkshire and York’s £3m+ procurement of Tunstall equipment and services, but for the whole view on this, see the readers’ comments on the main site

Steve

Video interview: Snippets about Cornwall WSD

8½ minutes over 5 videos

Following a presentation at the Beyond 2010 conference 23 October, Dave Tyas, Service Improvement Manager for Self Care and Long Term Conditions for the NHS in Cornwall and the Scilly Isles is interviewed on videos posted to YouTube about the Whole Systems Demonstrator (WSD) programme there. The interview is broken into 5 short videos covering…

  1. an outline of what telehealth and telecare are (3:24)
  2. the areas covered (0:45)
  3. benefits (2:03)
  4. obstacles (1:25)
  5. potential savings (0:40)

Mobile Health Expo: pointer to a ‘real world’ future

[Editor Donna will be reflecting on last week’s Mobile Health Expo in a series of articles starting here. The MHE consisted of six major keynotes, 60 breakout sessions plus a small expo floor and other ‘scenarios’ – plus Las Vegas itself. Donna moderated six sessions plus interviewed and spoke with numerous key figures in the industry. The long days—plus, amazingly zero hotel connectivity—meant she wound up not filing during the conference, which was just as well as no one person could have covered it all. This is her POV snapshot.]

MHE confirmed for me the fast maturing of mobile health—in a less than two year time frame. By ‘maturing’ I mean interest moving away from prototypes, ‘wowza’ gizmos not-yet-in-market and large doses of lofty system theory, to real-world products and services that have business models and are finding their markets plus partners. The emphasis was on case studies and applications for products in market, not on ‘what ifs’ or endless discussions of products needing FDA approval and financing to get into the market—and some other key indicators like… The desire to connect. Because this was a first-year, smaller conference in a very large place, the Caesars Palace Convention Center (which was the opposite of your usual drafty convention hall), the manageable size and select group facilitated mixing and at-length discussion for the hundreds there, whether in the main expo room, in the (endless) hallways going from session to session, or at the coffee breaks or social events after the program. Practical connecting and partnering was a distinct thread in most of the sessions and keynotes.

It’s a huge market, but it’s time to find a place. Three major and competitive wireless companies–T-Mobile, AT&T and Sprint–spoke together at the opening keynote on how they are targeting the healthcare market (quite differently). There are still a lot of ‘solutions’ looking for homes and that overlap. One approach–see ‘desire to connect’. What was also clear: mobile health is literally ‘ageless’–Stage 1 diabetes youngsters, expectant moms, young Iraq/Afghanistan vets, 50+ with chronic conditions, independent 65+ adults–and doable in the developing world.

‘Early days’ people are shifting their efforts—and being rewarded, finally. Pioneers like Dale Alverson, M.D., who heads up the American Telemedicine Association and University of New Mexico’s Center for Telehealth and Cybermedicine Research, are seeing their models—in this case, rural telemedicine–recognized, duplicated and redeveloped not only in the US but internationally (Nepal–and Iran). Other commercial products like GrandCare Systems and healthimo, in market for some years, are moving forward technically, developing and finding their markets.

‘Lather, rinse, repeat’ discussions of security, privacy, integration, supply chain. None are whiz bang or ‘sexy’ but a sure indicator of readiness of selling in the real world.

Dealing with government, policies and politics—from FDA to FCC, DOD to VA, CDC to NIH, HHS to CMS— yes, we are going to have to deal with them, yes, we will need to manage the process, no, it will not ‘save us’. Key indicators: the keynotes and breakout sessions on public policy and the aptly captioned ‘what you don’t know will hurt you’; the presence of counsels like Bill Jones and Fred McClure; the honest assessments from distinguished veterans in the process such as Ward Casscells, M.D., lately Assistant Secretary of Defense (Health Affairs). The industry is also dealing with another wild card–EHRs, which are on an unachievable two-year track–which further complicate ‘where does the data go, who actions it’ (Q 3, 4 of the Four Big Questions).

As one keynoter put it, we have entered the Wild West. But I would qualify that we are beyond the true ‘wild’ part of empty prairies, cattle roundups and cowboys shooting up all in sight, to building towns with a sheriff, boarded sidewalks, a semi-respectable saloon, the railroad….and look…aren’t those the Harvey Girls arriving to open up a restaurant?

We’ll be exploring the town in the coming week or so.

[Final Ed. Note: Before writing the above, I deliberately avoided any other coverage of Mobile Health Expo to this point (FierceMobileHealthcare—Wendy Johnson and Neil Versel—and Healthcare IT News’ Mike Miliard were reporting thru most days)—but their comments will be referenced into later articles.]

NYY PCT responds to Telecare Aware item: The £3+ million telehealth spend that has achieved…what?

In a statement sent to Telecare Aware yesterday, NHS North Yorkshire and York responded to the points in last week’s item The £3+ million telehealth spend that has achieved…what? [Original with comments] Readers can read the whole for themselves as the points are helpfully interspersed into the original item. Download or open it here (PDF). The PCT has also provided a new press release setting out progress and benefits so far. Advent of Telehealth brings 40% reduction in emergency hospital admissions (PDF)

The only substantial point that Telecare Aware got wrong was that we had said that the £3.2 million cost of the procurement had been split two-thirds to the Strategic Health Authority (SHA) and one-third to the PCT. In fact the SHA’s contribution to the cost was only £1m. This still throws no light on how the [heavily overspent] PCT could find £2+ million for the purchase and ongoing costs, or why the deal was structured as a one-off purchase instead of planning a series of incremental purchases in the wake of a successful rollout.

In addition, in the accompanying email, the PCT’s spokesperson said: “I’d like to make clear that although David [Cockayne] was leading the Telehealth project, the decision to award the contract to Tunstall was made by the Board of NHS North Yorkshire and York, on which David was a non-voting member. David was not present at the Board when the decision was made.”

WellDoc alliance with AT&T

AT&T and WellDoc [TA 18 Aug and prior on FDA approval] announced on Wednesday a strategic alliance to market and sell WellDoc’s Diabetes Manager eventually into payors, self-insured employers and disease management organizations. Initially, WellDoc will be trialed through select AT&T employees through 2011. According to the release, ‘AT&T will expand and scale WellDoc’s solution by utilizing AT&T’s mobility expertise, providing application hosting and creating a highly secure infrastructure to host critical health data. Commercially, AT&T will also support the solution with sales and marketing, customer care, provisioning and billing.’ BusinessWire release This follows AT&T’s announcement on 7 October in supporting eCardio Diagnostics with M2M wireless data and mobile connectivity for remote monitoring of cardiac patients. eCardio reports that they have over 10,000 devices in the market. Release. AT&T is also supporting Vitality GlowCaps’ med manager [TA 25 August]; it seems that softly, they are building relationships and a position in mobile health.

Robotics making strides…

…for those who can’t. This SmartPlanet article rounds up four exoskeleton-type systems that assist users in walking and climbing stairs. What they have in common are true mobility and that, with FDA approvals and right financing, can go to market within 1-2 years: eLEGS from Berkeley Bionics, the ReWalk from Israel’s Argo Medical Technologies, Honda’s Stride Management belt and Walk Assist Legs and New Zealand’s Rex Bionics. And Robosoft’s Kompai is also mentioned [TA 14 Sept]. For the real robot uprising, look to the disabled.

Local paper questions PCT about the £3.2m spend

The PCT’s local paper has picked up the story and raised the point about the delay. £3.2m Telehealth units ‘delayed’.

[We are still waiting for Received 18 Oct: the statement that the PCT's Communications Department said on Tuesday that they would send, disputing some of the facts set out in the item. Read it here.]

Kent TeleHealth Evaluative Development Pilot: The full results

Last week, owing to the limited launch information, we were only able to make a passing reference to the headline result of the 2005-2007 Kent TeleHealth Evaluative Development Pilot which involved 250 patients with long term conditions. Now we have received a copy of the full 148 page report, we can tell readers that it is a veritable cornucopia of positive results and encouraging news and lessons learned that should help any organisation about to embark on a sizeable project of this kind. Most of the length comprises the detailed results tables and analysis, leaving the narrative at a much more reader-friendly length.

If you need a reason for taking some time out to read it, head for the Executive Summary heading ‘What Happened?’ on page 15 of the PDF (1.4MB). It’s good reading through and through.

However, I suspect that when they read it, some Telecare Aware readers with long memories will be pondering the basic ethical dilemma: do good ends justify doubtful means?

They will recall that, pre-dating the NHS PASA Telecare National Framework Agreement, the procurement of equipment, technical support and training from the manufacturer for this £1+ million project was driven through without an open competitive tender. Equipment from the USA was commissioned which needed further work to meet UK standards at the time (it even says so in the report, Section 6.2.5, page 60) and non-CE marked equipment was initially installed in people’s homes. Furthermore, the purchase happened after staff from Kent County Council had travelled for an exploratory trip to the USA to visit the Veteran’s Administration project and its equipment supplier – which became Kent’s supplier – Viterion TeleHealthcare, a division of Bayer.

Robert Bosch Healthcare joins Continua Alliance

Isn’t it odd to see the news announced of something you always assumed was the case, anyway? Robert Bosch Healthcare Joins Continua Health Alliance.

The £3+ million telehealth spend that has achieved… what?

Ladies and gentlemen: the story you are about to read is true. Not even the names have been changed to protect the innocent. That’s because, as far as I [ed. Steve] know, no one involved in these events has done anything illegal, so they are all innocent. In the words of Dragnet’s Joe Friday “All we know are the facts, ma’am”.


The easily available public facts

Fact 1) A trial using 100 telehealth units had started in parts of the area covered by NHS North Yorkshire and York (ex. North Yorkshire and York Primary Care Trust, the largest PCT in England) in September 2009 and was due for evaluation in April/May 2010. (See timeline on the final page of this PDF.)

Fact 2) At the end of January 2010 a reporter for a local newspaper reported that the PCT was heading for a deficit of £8million at the end of March, its financial year end. She also noted that it was planning to introduce the use of 100 telehealth units. (TA note)

Fact 3) A Tunstall press release in June 2010 states “NHS North Yorkshire and York unveiled plans to purchase a further 2,000 Telehealth systems… Tunstall, was awarded the contract to provide the additional 2,000 systems following a competitive tender process.” (Longer, undated Tunstall version of the release.)

Fact 4) The PCT’s website (reflecting the plan set out in 1, above) currently says: “The Telehealth project in North Yorkshire and York is being rolled-out in two phases. The first phase runs until September 2010 and involves an investment in 120 Telehealth systems. In June 2010 we announced that the second phase of the project will involve the purchase of a further 2,000 Telehealth systems.”

The not so public facts

Fact 5) Pre-empting the outcome of the future evaluation, preparations for the additional procurement were being made in October/November of 2009: the invitation to tender was issued (not openly advertised) within the context of the old PASA Telecare National Framework Agreement in mid-December 2009. Three companies participated.

Fact 6) The £3.2 million procurement (two thirds funded by the Strategic Health Authority, the rest by the PCT) was completed in March 2010.

Fact 7) In addition to the upfront cost, the PCT committed to paying a substantial sum [believed to be in the order of £500,000] in annual maintenance and other charges.

Fact 8) The Tunstall RTX units do not meet requirements specified in the bid invitation. Specifically:
• to enable clinical staff to teleconference directly with a patient.
• to allow for the use of multi users in community settings, such as nursing homes and extra care schemes
The units are also several times the cost of alternatives that are in this marketplace.

Fact 9) The PCT’s invitation to tender had the standard ‘get out clause’ which stated that it reserved the right not to award all or any of the business to the service provider that scored best against the criteria.

Fact 10) Of the 2,000 RTX units only 5 have been put to use since they were purchased. [Source: an anonymous insider.]

And finally…

Mr David Cockayne, who was Director of Strategy at NHS North Yorkshire and York at the time of the procurement and whose name keeps popping up in the above news items left the employment of the PCT in July and took up employment with Tunstall yesterday, 11 October 2010. [This is a fact. But before readers jump to conclusions I wish to point out that there is no evidence that Mr Cockayne's employment is related to any of the above in any improper way and it should not be construed as such.]

Comments from named readers are welcome. If you feel moved to comment anonymously, please first refer to our Anonymity Policy – scroll down the right hand sidebar.

Combined telehealth approaches may aid with severe asthma: survey

According to a survey of 21 studies, just published by the Cochrane Library, various types of telehealth and telemedicine (including video conferencing and text messaging) may be helpful to patients with severe asthma. According to the researchers there was a significant reduction in hospitalizations over a 12-month period, with the effect being greatest with those having more severe asthma managed predominantly in secondary care settings. The end recommendation was somewhat ambivalent, with further trials recommended. CMIO

Telemedicine improves diagnosis of pediatric heart conditions: study

An 11 year study of telemedicine diagnosis of pediatric echocardiograms led to earlier diagnosis and treatment of heart conditions in children. 99% of the images were judged to be complete and adequate in quality (both the early ISDN and later digital). While 74% of tests were judged normal, 13 indicated major abnormalities and the early diagnosis permitted faster treatment. The review was done at Children’s Mercy Hospital in Kansas City, MO and transmitted from St. John’s Medical Center 160 miles away in Joplin.? iHealthBeat. HealthDataManagement.

Taxonomy of usability requirements for home telehealth systems

Taxonomy of usability requirements for home telehealth systems is an item from the proceedings of the 11th International Conference of the New Zealand Chapter of the ACM Special Interest Group on Human-Computer Interaction. It’s paid content, but readers might like to know it is available.

Telehealth project report shows savings. Kent (UK)

At a launch last week Kent County Council unveiled the results of a large telehealth project that, conducted in 2006-07, predates the Whole System Demonstrator Programme. According to the Kent website, rolling out telehealth could save Kent £7million a year. Now, extrapolate that to the rest of the NHS… “The work that has been done during the trial, and which is now being rolled out as part of Kent’s regular business, could bring forward a closer working relationship between health and social care.”

Aircel Apollo Mobile HealthCare (India)

Indian mobile provider Aircel has announced the launch of a health consultation service for people in India in association with the Apollo Hospitals Group. It will provide structured medical advice and a disposition [sic] will be available round the clock from Apollo clinicians. Brief report.

Review of the 2nd Mobile Healthcare Industry Summit, London, 21-22 September 2010

David Doherty on the 3G Doctor blog has pulled together his thoughts and observations on the conference. There’s lots to delve into, as the information is organised by the companies attending. Review of the 2nd Mobile Healthcare Industry Summit, London, 21-22 September 2010.

Pinhead-sized gyroscope for smartphones and medical devices

A pointer to the future for mobile monitoring devices? Researchers develop pinhead-sized gyroscope for smartphones and medical devices.

Forty Spanish pensioners get free GPS mobiles

A short item on a website for English people in Torrevieja, Spain. The recipients were people on the waiting list for conventional telecare. Pity about the photo. Forty pensioners get free GPS mobiles. Supplier’s website: Idi Eikon.

Continua releases 2010 design guidelines, adds new member Microsoft

It must be a sign of the austere times: two announcements for the price of one. The Continua Alliance makes two significant announcements in a lash-up (ecosystem?) of a press release. Continua Health Alliance Releases 2010 Design Guidelines, Adds New Member Microsoft.

Webcam-based health monitoring mirror

Researchers at MIT aim to push down the cost barrier on mirror-based health monitoring technology, as described in this video.

YouTube code LyWnvAWEbWE

More details to this pointer to the future on the Gizmag site.

Allscripts releases mobile EHR system for home care

Home care has tended to be behind the curve in technology–but one area that’s been eagerly adopted (for efficiency and profitability) is staff management via mobile time, tracking and schedule compliance systems developed by companies like Sandata, Kronos and Cerner. Allscripts has combined these functions with a mobile smartphone-based EHR that is targeted for specific types of homecare (physical therapy, hospice) to encourage nurses and aides to document in-home. Release (as announced at NAHC earlier this week). Allscripts Mobile Homecare page.

‘Accountable care’ a way forward for eHealth?

‘Accountable care’….what is it? It’s generally defined as a local healthcare organization that is able to provide a continuum of care for patients across different institutional settings. It allows doctors to team up with each other and hospitals in new ways, and would include outpatient and inpatient hospital care through post-acute and home care. What does this mean for eHealth? Conceivably plenty. If ACOs emphasize outcomes and wellness, with patients self-managing, with a more bundled pricing model, then eHealth could find a place. Not happy: insurers, medical device manufacturers, small practices. But coming in 2012 (maybe). Kaiser Health News.

When your ‘protected health information’ isn’t

A hospital system CIO found out the hard way that having a certain type of medical condition can get you fired from your job. According to an article on HealthsystemCIO.com, the CIO had taken a medical leave of absence to deal with a family calamity and as required, provided a physician’s letter. Despite assurances of confidentiality, her EHR was accessed by her own co-workers–under orders from other executives–and her history of (managed) depression was revealed. Upon her return from leave, she was fired despite years of excellent performance reviews. Which leads to certain conclusions: 1) mental illness, no matter how well managed, is stigmatized; 2) don’t get treated in the system where you work; 3) HIPAA is not worth a hill of beans in a court of law (the article states that ‘don’t bother’ was the legal advice). When EHRs can be shared across systems, insurers, employers and locations, will there be any shred of confidentiality left? For anyone? [Personal note: Ed. Donna's brother is a psychiatrist and all of these issues are hot buttons to him.] This is a pointer to the future that no one needs. Comments requested! CIO fired after others may have accessed her EHR.

Telehealth may help treatment of depressed older people

Is depression treatment a neglected area for telehealth? Early findings of a Weill Cornell Homecare Research Project/Rhode Island Hospital/University of Vermont Telemedicine program indicate that telehealth (called variously telemedicine and even telecare in article) can be used to improve treatment of depression, prevalent in older adults in home care. Reports from the NAHC* annual meeting, where this was presented, vary but the gist is that the project integrated depression care into existing telehealth programs. They partnered with three home health agencies in New York, Vermont and Florida to use the Depression TeleCare Protocol and in the small group of patients (19) depression was improved from ‘markedly severe’ to ‘mild’.? Healthcare IT News Read also a 2006 Weill Cornell Homecare study in Clinical Geriatrics on the prevalence of depression in the elderly, the need for screening and treatment. *National Association for Home Care and Hospice (US)

Health 2.0 Challenge connects

The Health 2.0 conference, 6-9 October, part of San Francisco’s Health Innovation Week, will be culminating in the Developer Challenge awards on 7 October. The team and company list is extensive (starts here) for each of the sponsored challenges and the combinations of companies and projects show the kind of innovation needed for managing health and connecting online. For instance, Communication Software and Razoron are teaming up for the Practice Fusion EHR challenge with the concept ‘Baby’s First Health Diary’. Conference website.

Lansley announces £70m support to help people in their homes after illness or injury (UK)

Headline? So far so good. The rest of the iSOFT press release? Typical large company fluffery built around a slim Ministerial announcement and compounded by an abysmally difficult to read light grey font colour. [Which I have maintained in the PDF I converted it to, Steve] However, it is redeemed by some unintended humour – yes, we know that hospitals and prisons share some characteristics, but if I’m a patient I’d prefer to think I’m being discharged rather than released…

UPDATE 8 October: Here is a press release with more measured response to Andrew Lansley’s speech from the Telecare Services Association. (PDF)

First Continua certified mobile phone to be unveiled at, CEATEC Japan 2010

The first mobile phone created using Continua’s design guidelines will be unveiled this week at CEATEC, in Japan. The new phone will manage and transfer health data collected by healthcare equipment that is also Continua certified. Press release for more. [Apparently it's made by Fujitsu, but everyone seems to be waiting for a photo and other details. Ed. Steve]

Mobile Health Expo updates: sponsorship available

mhx_logo_vertical croppedSome updates on the Mobile Health Expo, Las Vegas on 19-21 October (Telecare Aware is a media partner; Editor Donna will be a moderator on all three days):

Keynotes:?

Topics include M2M in healthcare; mobile applications for phones, tablets and hand-held devices; mobile devices, mobile people, mobile services; mHealth and health inclusion in developing nations; telepresence and telemedicine in healthcare; mobile health in the military; mobile wallets and benefits management

Speakers from AT&T, Sprint, Verizon, Johns Hopkins, Vidyo and more.? Closing keynote session features?mobile health and military expert Dr. Ward Casscells, former Assistant Secretary of Defense (Health Affairs) now with the University of Texas Health Science Center.

Mobile Health Expo also?includes an innovative event feature called The Scenarios. Technology providers will demonstrate mobile health solutions in real-life situations tied to the market-driving themes that are influencing mobile health:? aging at home, disease management,?Health Inclusion? for developed and developing countries, provider education, patient education, healthcare gaming and educating tomorrow’s physicians and caregivers. At the end of the event, one scenario from each of the eight themes will be selected for production of a documentary in the field that will be shown at the 2011 Mobile Health Expo.

Click on the advert to the right for more information on registration, speakers and hotel reservations which are going quickly.

Sponsorship:? Time is drawing near and this is still available!? Your logo will be featured as a sponsor of Editor Donna at this conference.? In addition, you will be a sponsor of the post-conference report.? ?Email Steve?for details.

Silver Chain and Docobo expanding telehealth across Australasia

An interesting symbiotic relationship appears to be developing between UK telehealth equipment and Silver Chain, an Australian charitable care service provider. Not only will Docobo be introducing Silver Chain’s services to the UK, but Silver Chain will be promoting Docobo’s equipment in Australia and New Zealand. Press release (PDF) for more details. [It's good to see Docobo diversifying away from the UK market. Ed. Steve. Disclosure: Docobo has advertised on Telecare Aware in the past.]

September/October’s Telecare LIN eNewsletter published (UK)

Just published, the eNewsletter covering September and October (65 pages), and billed as “the most comprehensive public telecare and telehealth news listing available.” Main items are:

  • Results of the Kent Telehealth Pilot (2005-2007) covering 250 patients
  • Buying Solutions framework [no new info]
  • Telecare and telehealth map updates, including new colour coding
  • Summary CQC telecare figures 2010 (performance of the 152 social care authorities)
    [Interesting snippets:
    LA and LA with partner agencies, planned new telecare users in 2009-10 : 143,031. Outturn: 129,232
    31 authorities plan to
    decrease their additional users in 2010/2011
    There is no CQC count planned for 2011]
  • News from the West Midlands
  • WSDAN report from the 30 June event including economics issues around telecare and telehealth
  • Conference information

PDF download (2.7MB)

‘Simple’ phone aids senior safety in India

Today’s Harvard Business Review blog features the S5 cell phone developed by Munoth Communications of Chennai It’s designed to be simple yet the features are a wish list of both safety features and basic telehealth most useful to older adults. Here’s an easy to read phone, large buttons and digital screen, loud audio–plus a built in GPS locator, a torch (flashlight) and an SOS button that activates an audible siren, preset text messages to up to ten designated recipients, then displays a link on screen to your pre-loaded online medical information. But wait..there’s more….full medical records can be put online. Diabetic? Get health, dietary and wellness reminders for a year–free–and 67 cents per month thereafter. The need is significant–the communal family care model is in decline, more older family members are on their own, rural villages have spotty health resources and (probably) police coverage. As a marketer, I can relate to the positioning?and these near-poetic hot buttons:

Fight a burglar in a deserted zone;
Survive a stroke when you are alone;
Feel secure with Munoth’s S5;
Press a button and bravely live on your own.

HBR article, Munoth Communications S5 web page

Home health telemonitoring overview

Alan Cohen, Medical Practice Director of?LogicPD design and engineering, recently published an article which is a useful and simplified overview on what telemonitoring systems are all about. It contains some nifty charts and diagrams that can come in handy when you are speaking to investors, grantors or your children about what you do all day! MEDS Magazine (Medical Electronic Device Solutions)

HHS announces $68 million in senior/disabled ‘navigation’

Another rollout from ‘healthcare reform’ is $68 million in grant money from the Affordable Care Act, parceled out to all states, territories and 125 tribal organizations, to help seniors, the disabled and their caregivers better understand and navigate their options for long-term care. According to the press release from Health and Human Services (HHS), it will also be distributed among four programs. Because it is spread so thinly, one wonders about its effectiveness–and reading closely, it funds agencies and ‘outreach’, not direct care or assistance to seniors and the disabled. In other words, it’s hard to pin down how it will directly help older adults or the disabled–or does it just fund the current system? Where is telecare, telehealth, mobile health? Is it tilted to process, not results? And is that the point? HHS release. Hat tip to Anthony Cirillo’s ‘Who moved my dentures?’ blog on aging issues.

Telenephrology in the American Indian community

He is no newcomer; Dr. Narva was with the Indian Health Service for 25 years (profile) and still affiliated; he is presently the Director of the NIH’s National Kidney Disease Education Program. This short observation from USTelecom’s NextGenWeb is all we could find specifically on his talk. You might find this passage as saddening as I did: ‘Dr. Narva is one of the only doctors using telehealth methods on tribal lands. He uses broadband to connect American Indians on rural tribal lands to doctors and nurses in real time. Healthcare professionals even have access to electronic health records.’ Perhaps some of that $68 million in HHS grant money funding agencies and outreach, not care or means to improving care, could be better spent in this area. Perhaps West Wireless Health Institute, Cisco or USC could work some innovation here? ‘Telehealth in the American Indian Community’.

[For our non-US readers, a quick note on terminology. Steve remarked on the correctness of 'American Indian'. Some research I've done is that both this and 'Native American' are controversial, with the latter less accepted nowadays. The governmental and legal term is 'American Indian' which was used in the article; Indian Affairs uses this joined with 'Alaska Natives'. (They do not include Native Hawaiians or Pacific Islanders.) Tribal names are consistently preferred above all. Ed. Donna]

Docobo Telehealth Implemented in Australia

In response to Steve’s comment regarding Australia’s focus on technology, we can confirm that UK telehealth is already receiving considerable interest in Australia. UK telehealth company Docobo Ltd has worked with Silver Chain, a not for profit charity, that provides district nursing and care service throughout Western Australia, to implement telehealth both within its own organisation and also signed an agreement for Silver Chain to distribute the product. After conducting a global investigation of telehealth solutions in 2008/9 they concluded that the UK Docobo solution best met their needs for the management of co-morbidities through its ability to support the holistic needs of a patient, rather than a focus on one disease/area.

As an indication of the country’s interest, the Australian Government have commissioned a research trial for remote monitoring in COPD – the results of which should be available very soon.

Furthermore, it is refreshing to work with an organisation willing to embrace this technology and who can see the overwhelming benefits to both patients and providers without the ‘local evidence’ demanded so frequently in the UK.

Silver Chain and Docobo have now also signed their first significant deal in New Zealand and aim to expand use of telehealth across Australasia.

Coast and Country HomeCall (UK)

Why a post featuring two press releases from Coast and Country HomeCall, a relatively small UK telecare provider? As regular readers know, I frequently complain about mind-numbing, jargon-laden, press releases full of company puffery so it is a pleasant change to be able to point out that these are not that. The first, Homecall Helps Epilepsy Sufferer Live Life, starts by focusing on an individual user and the benefit that telecare has brought him. The second, Homecall Launches New Dementia Support Partnership, is interesting for industry-watchers because Coast and Country is the first we have heard of to have introduced the ‘St Bernard’ person tracking service from Halliday James (PDF info) that was launched at the TSA conference 11 months ago. When Coast and Country upgraded its monitoring centre equipment back in January (TA item), it announced that the intention was to ‘introduce innovative services’. From the evidence of these press releases these were not the empty words we have become used to so often.