News roundup: MHS Genesis EHR completes US rollout, telehealth selective savings by disease, CarePredict’s $29M funding, Amazon Alexa *Spying on You*

July 14, 2023 | by

At least one part of Oracle Cerner’s work is done. The Military Health System (MHS), which covers 9.6 million active duty beneficiaries and 205,000 medical providers, announced yesterday that the rollout of the Genesis EHR is complete in the continental US. The final go-live was at Wright-Patterson Air Force Base, which covers 6,800 clinicians and providers in military hospitals and clinics across Ohio, Virginia, Maryland, Indiana, Texas, and Kentucky. It was also deployed at the National Oceanic and Atmospheric Administration, NOAA Corps, which is under the Department of Commerce. The final 14% of the MHS system is overseas. That rollout will start in September 2023, including Landstuhl Regional Medical Center in Germany and Royal Air Force Lakenheath in the UK. Bases in Guam, South Korea, and Japan will follow in October. DOD’s one joint facility with the VA, the James A. Lovell Federal Health Care Center in Chicago, will deploy in March 2024. All other VA healthcare centers are on hold indefinitely. With the wrapup of MHS Genesis and the pause on VA’s Millenium rollout, Oracle has reportedly laid off over 500 staff on these Federal projects [TTA 16 June]. DVIDS release

 Telehealth’s selective savings. A new study out of the University of Texas-Austin McCombs School of Business found, like other studies such as Epic Research’s, that telehealth visits reduced future outpatient visits, in their study within 30 days, by 14%. This saved $239 per patient in outpatient costs. But telehealth was more effective for some specialties than others. It had the most impact on cost reduction for behavioral health, metabolic disorders, dermatology, and musculoskeletal (MSK) disorders, with a significant reduction of 0.21 outpatient visits per quarter (an equivalent cost reduction of $179). This suggested to the researchers a substitution of telehealth versus traditional clinic visits. But telehealth’s impact was nearly nil when it came to circulatory, respiratory, and infectious diseases, not significantly reducing the number of future visits or costs. The study sampled hospital-based outpatient clinics in Maryland from 2012 (not a typo) to 2021. Becker’s, UT News, Informs Pubonline (abstract only)  

Senior living monitoring system CarePredict adds $29 million from four main investors. This is a Series A-3, which one assumes adds on to an existing Series A, which was $9.5 million in 2019. The round was co-led by SV Health Investors’ Medtech Convergence Fund and Aspire Healthtech Partners with existing institutional investors Secocha Ventures and Las Olas Venture Capital plus private family offices and individual investors. CarePredict pioneered a wearable bracelet, the Tempo, that wirelessly tracks residents’ activities of daily living (ADLs) in assisted living (AL), independent living (IL), and continuing care (CCRC) settings. Interpretation of ADLs in a platform can predict changes in health and wellbeing leading to better health and extended residence. CarePredict has expanded its platform reporting with other tracking such as context beacons, visitor and wander management, PinPoint digital contact tracing, and family communication apps. CarePredict release, Mobihealthnews

How much does Amazon have on you? If you are a user of Amazon’s Echo system, you already know that Alexa is always listening to you. What you may not know is that Amazon stores that information in a database, including parts of overheard conversations that have nothing to do with Alexa, since Alexa is always on. Even if you (like your Editor) don’t have an Echo but have a Kindle (unlike your Editor) or use the app residing on most smartphones, Amazon knows what you read, what you flip through, and your start and stop times. The Amazon Sidewalk mesh network, used with Alexa and Ring cameras, extends the reach of your router and shares your network with your neighbors. This is in addition to your shopping and even what you look at. In the context of the rollout of Amazon Clinic pending, delayed to 19 July [TTA 27 June], where Amazon is 1) only an intermediary to providers but 2) demand access to all your PHI and PII before allowing access to them, can we as professionals admit this is a glaring privacy violation and that the FTC is actually right?

Kim Komando, well known for her radio and online shows advising non-techies on tech, has an excellent article on how Amazon is piling up information on us all. This is based on a 2021 Reuters investigation and also contains a link to her interview with the two Reuters reporters. The article also describes how to find out what Amazon has on you. Warning–they don’t make it easy. She also addresses the Amazon clinic issue in a FoxNews article.

Will Matt Hancock be a refreshing change for NHS? Or another promise unfulfilled? (updated)

July 26, 2018 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2018/07/matt-in-a-binder.jpg” thumb_width=”200″ /]Matt In A Binder? With the sudden departure of Jeremy Hunt from the Department of Health and Social Care in the Cabinet’s ‘change partners and dance’, the new Secretary of State Matt Hancock comes over from heading Digital, Culture, Media and Sport. A couple of weeks in, it can be determined that he is a big advocate of technology and looking forward, not back (which Mr. Hunt spent a great deal of time doing):

Technology has a proven ability to radically change the world for the better – be it in finance, in education and in transport. But nowhere does technology have greater potential to improve lives than in healthcare. (Statement on Gov.UK/Health Service Journal 12 July )

And he glows again about increasing the use of apps within the NHS, though Digital Health goes a little overboard in calling the Rt Hon Mr. Hancock ‘app-happy’ even though he’s built his own this year so that his West Suffolk constituents can keep track of his activities. 

In his maiden speech, Mr. Hancock promoted a drive to replace pagers with smartphone apps as part of a £487 million funding package and connecting Amazon Echo with the NHS Choices website. It was overshadowed by a seeming walking back of the 95 percent four-hour A&E treatment target. Telegraph

Much of the criticism comes from those who see his appointment as yet another step in the privatization and regional devolution of the NHS due to campaign donations from the chair of pro-market group the Institute of Economic Affairs (IEA). However, Mr. Hunt faced the realization that NHS trusts are $1.2bn in debt and sought workarounds such as adoption of an ACO-type model (which in the US has a strong element of public incentive) and increased use of private health insurance to cost-shift. He wasn’t a technophobe, having inked a deal with the UK Space Agency to repurpose space tech for health tech and funding innovators in this conversion up to £4 million–which can be said to be ‘out there’.

Mr. Hancock also announced this week the £37.5 million funding of three and five ‘Digital Innovation Hubs’ over the next three years. These will connect regional healthcare data with genetic and biomedical information for R&D purposes.

Will he last? Will there be positive changed fueled by technology? Will the May Government last? Only time will tell.

What are your thoughts? (If you’d like to post anonymously, write Editor Donna in confidence)

Here’s select opinion from across the spectrum:

Don’t be fooled, Matt Hancock will be no better for the NHS than Jeremy Hunt was (The Independent)

New health secretary Matt Hancock received £32,000 in donations from chair of think tank that wants NHS ‘abolished’ (The Independent)

Roy Lilley’s always tart take on things NHS extends to the new Secretary dubbed ‘No18’. A deft wielding of Occam’s Razor and a saber on reflexive phraseology such as ‘driving culture change’ (it can be cultivated not driven–this Editor agrees but the tone and structure need to be set from the top), dealing with suppliers, and the danger of creating an electronic Tower of Babel due to lack of interoperability. (Does this resonate in the US? You bet!) (See NHSManagers.net if the link does not work.)

Margaret McCartney: Health technology and the modern inverse care law (BMJ) — to paraphrase, that the greatest need for healthcare is by those least likely to have the right care at the right time available. She points to Babylon Health, which counts Mr. Hancock as a member, as not only unproven, but also not needed by those able to afford other options. (But didn’t we know that already?)

News roundup for Tuesday: room at the top at VA? (updated), Philips integrates teleradiology. 3rings Care premieres Amazon Echo service

March 27, 2018 | by

Updated. Who’s the Leader? At the Veterans Administration, the soap opera plot accelerated on the continued tenure of Secretary David Shulkin who, after a strong start (and coming from within VA’s tech area), has stumbled over charges of inappropriate spending and staff turmoil since the beginning of the year. Journalist Christopher Ruddy, CEO of Newsmax, who speaks regularly with President Trump, indicated in an interview on ABC’s This Week on Sunday that Dr. Shulkin will likely be the next Cabinet departure. The fact that VA Choice 2.0 did not make it into the huge ‘omnibus’ budget bill indicated a disillusion with him on Capitol Hill. The lack of closure on replacing VistA with Cerner is also not in favor of a longer stay. The replacement may come from the VA House committee, the defense contractor community, or DoD. Why it’s important? VA is the largest purchaser of telemedicine and telehealth in the US, and has set the pace for everything from EHRs to info security. And there are those 9 million veterans they serve. Stay tuned. POLITICO Morning eHealth…..

By the next morning, a press secretary was saying “At this point in time though, he [President Trump] does have confidence in Dr. Shulkin. He is a secretary and he has done some great things at the VA. As you know, the president wants to put the right people in the right place at the right time and that could change.” But one of Dr. Shulkin’s biggest thorns-in-side at the VA, Darin Selnick, shuffled off last year to the Domestic Policy Council, will return to a post at the VA.

HIMSS continued to support VA’s and Dr. Shulkin’s efforts to increase veteran patient record sharing through changing the consent requirements authorizing the VA to release a patient’s confidential VA medical record to a Health Information Exchange (HIE) community partner. Letter.

Philips has entered the integrated teleradiology field by combining Philips’ Lumify portable ultrasound system and Innovative Imaging Technologies‘ (IIT) Reacts collaborative platform. It combines a compatible smart device that enables a two-way video consult with live ultrasound streaming. How it works: “clinicians can begin their Reacts session with a face-to-face conversation on their Lumify ultrasound system. Users can switch to the front-facing camera on their smart device to show the position of the probe. They can then share the Lumify ultrasound stream, so both parties are simultaneously viewing the live ultrasound image and probe positioning, while discussing and interacting at the same time.” Release

Following up on 3rings and their integration into the Amazon Echo virtual assistant system [TTA 18 Oct], Mark Smith from their business development area has told us that they have formally launched this platform earlier this month. The person cared for at home can simply ask Alexa to alert family and caregivers that they need help via voice message, text or email. Care staff or family can also use Echo to check through the 3rings platform by simply asking Alexa if that person is safe and OK. 3rings is now actively seeking to partner with innovative health, housing, and social care organizations. Overview/release.

3rings goes Internet of Things with ‘Things That Care’ (UK)

October 18, 2017 | by

3rings is launching another extension of its smart plug sensor that monitors daily use of a key appliance like a tea kettle or TV with a multi-sensor IoT system. [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/10/3rings-IoT-hub-and-Sensors.jpeg” thumb_width=”250″ /]’Things That Care‘ uses proprietary ‘things’ (sensors) to monitor patterns of activity and the home environment to create a safety net for an older adult, perhaps growing frailer, usually living at home alone, so that family or caregivers can ‘look in’ to see if all is fine. It also integrates the Amazon Echo interactive personal assistant as announced in June [TTA 27 June].

The other 3rings development is the system’s ability to analyze data for trends and insights (screenshots below). The introduction of self-learning algorithms to detect potential changes in activity that may be early signs of a change in health is a proactive care advance similar to capabilities in the far more complex and expensive QuietCare and Healthsense (now Lively) but affordable for families. It also puts the 3rings system into the professional space for councils and sheltered housing. According to 3rings CEO Steve Purdham, “our new platform gives professionals real time information to support efficient care planning and delivery, and provides a cost effective means of managing risks and providing tailored care to people to enable them to stay independent at home.” Again, we wish 3rings the best with these new developments. Release (PDF)  

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/10/patterns.jpg” thumb_width=”200″ /]   [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/10/trend-analysis.jpg” thumb_width=”200″ /]

It’s all hackable by Black Hats: pacemakers, Amazon Echo, trains, heart monitors, prison cells!

August 2, 2017 | by

It’s the servers, stupid! Unlike the economy, where people comprehended the problem, it seems we are automating more and securing less. The annual Black Hat Conference, where participants see this as a challenge, and the news are serving up some prime examples.

In Las Vegas, Lucas Lundgren, a senior security consultant at IOActive, scanned away–and was able to open prison doors, gain access to alarm systems, an oil pipeline, a German train controller, pacemakers, heart monitors, and insulin pumps. These communicate with servers through an open-source messaging protocol known as MQTT used in home and industrial systems. The problem is that access to the servers is not protected through a user name and password, much less two-factor authentication. “Not only can we read the data — that’s bad enough — but we can also write to the data.” Scary when you contemplate a hospital with insulin pumps, BP monitors, and multiple surgical devices all going haywire.  ZDNet 

Similarly, easy hacking pickings have turned up in IoT cameras–over 175,000 inexpensive cams made by Chinese manufacturer Shenzhen Neo Electronics’ as NeoCoolCam and distributed worldwide, discovered by BitDefender. Older Amazon Echo devices can be physically tampered with and malware uploaded to be turned into listening devices, according to MWR InfoSecurity.

And Anthem gets no respect. After suffering its 2015 data breach of 80 million members–and spending $115 million to settle the lawsuit–there’s a third-party contractor, LaunchPoint Ventures, who decided that no one would notice if 18,500 patient records were sent to a home email a year ago. Actually, it was noticed after the contractor was nabbed for unrelated “identity theft-related activities” this past April. More ‘splainin’ to do to HHS, surely, after filing their July 24 report. At least it’s not an IoT breach! Healthcare Dive

AI good, AI bad. Perhaps a little of both?

August 1, 2017 | by

Everyone’s getting hot ‘n’ bothered about AI this summer. There’s a clash of giants–Elon Musk, who makes expensive, Federally subsidized electric cars which don’t sell, and Mark Zuckerberg, a social media mogul who fancies himself as a social policy guru–in a current snipe-fest about AI and the risk it presents. Musk, who is a founder of the big-name Future of Life Institute which ponders on AI safety and ethical alignment for beneficial ends, and Zuckerberg, who pooh-poohs any downside, are making their debate points and a few headlines. However, we like to get down to the concretes and here we will go to an analysis of a report by Forrester Research on AI in the workforce. No, we are not about to lose our jobs, yet, but hold on for the top six in the view of Gil Press in Forbes:

  1. Customer self-service in customer-facing physical solutions such as kiosks, interactive digital signage, and self-checkout.
  2. AI-assisted robotic process automation which automates organizational workflows and processes using software bots.
  3. Industrial robots that execute tasks in verticals with heavy, industrial-scale workloads.
  4. Retail and warehouse robots.
  5. Virtual assistants like Alexa and Siri.
  6. Sensory AI that improves computers’ recognition of human sensory faculties and emotions via image and video analysis, facial recognition, speech analytics, and/or text analytics.
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/08/AI.jpg” thumb_width=”200″ /]For our area of healthcare technology, look at #5 and #6 first–virtual assistants leveraging the older adult market like 3rings‘ interface with Amazon Echo [TTA 27 June] and sensory AI for recognition tools with broad applications in everything from telehealth to sleepytime music to video cheer-up calls. Both are on a ‘significant success’ track and in line to hit the growth phase in 1-3 years (illustration at left, click to expand).

Will AI destroy a net 7 percent of US jobs by 2027? Will AI affect only narrow areas or disrupt everything? And will we adapt fast enough? 6 Hot AI Automation Technologies Destroying And Creating Jobs (Forbes)

But we can de-stress ourselves with AI-selected music now to soothe our savage interior beasts. This Editor is testing out Sync Project’s Unwind, which will help me get to sleep (20 min) and take stress breaks (5 min). Clutching my phone (not my pearls) to my chest, the app (available on the unwind.ai website) detects my heart rate (though not giving me a reading) through machine learning and gives me four options to pick on exactly how stressed I am. It then plays music with the right beat pattern to calm me down. Other Sync Project applications with custom music by the Marconi Union and a Spotify interface have worked to alleviate pain, sleep, stress, and Parkinson’s gait issues. Another approach is to apply music to memory issues around episodic memory and memory encoding of new verbal material in adults aging normally. (Zzzzzzzz…..) Apply.sci, Sync Project blog

3rings smart plug moves to IoT through Amazon Echo (UK) (updated)

June 27, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/02/3rings-logo-only.jpg” thumb_width=”150″ /]Updated. Good morning, Alexa! 3rings, the ‘smart plug’ that has been monitoring since 2015 a loved one’s or neighbor’s wellness through their daily use of a key home appliance like a kettle or TV, then reporting that activity via a mobile phone/smartphone app, has expanded to the Internet of Things (IoT) with the integration of the 3rings plug with Amazon Echo. 

The 3rings plug works with Echo and the Alexa avatar in two ways. The first is for family members, friends or neighbors to ‘ask Alexa’ (the Echo unit) if their loved one is safe, similar to the mobile phone reports and alerts. The second is to place an Echo unit in that person’s home so that the person can directly ask Alexa to tell 3rings they need help. This also sends an immediate alert to their friends/family network.

To this Editor, 3rings founder Steve Purdham noted that with Amazon Echo, the 3rings system is now expandable and agnostic, through the addition of proprietary sensors dubbed “Things that Care” and other makers’ devices to the 3rings smart plug so that families have a fuller picture of the monitored person’s pattern of activity. 3rings Things monitor temperature, activity, motion, open/close of doors and windows, and button, and are priced a la carte or in a package with the Echo. The system also integrates with Samsung SmartThings, purchased separately, for additional types of monitoring. “Through this platform we want to stay ahead of the Internet of Things curve and demonstrate how technology can care.” Steve confirmed that the system is available now via a new website from the original (and still available) 3rings, with a group of users already on board. Full rollout is expected in August. Another advantage of integrating with Echo, according to Steve, is that the system can be offered in any location where Echo is. Also release