Ransom! (ware) strikes more hospitals and Apple (update)–Healthcare.gov’s plus trouble

click to enlargeGet out the Ransom! California hospitals appear to be Top of the Pops for ransomware attacks, which lock down and encrypt information after someone opens a malicious link in email, making it inaccessible. After the well-publicized attack on Hollywood Presbyterian in February, this week two hospitals in the Inland Empire, Chino Valley Medical Center in Chino and Desert Valley Hospital in Victorville, both owned by Prime Healthcare Management, received demands. While hacked, neither hospital paid the ransom and no patient data was compromised according to hospital spokesmen. Additional hospitals earlier this month: Methodist Hospital in Henderson, Kentucky and Ottawa Hospital in Ontario, Canada. In Ottawa, four computers were hacked but isolated and wiped. It is not known if ‘Locky’, the moniker for a new ransomware, was the Canadian culprit. FBI on the case in the US. HealthcareITNews, National Post

Update: Locky is the suspected culprit in the Prime, Hollywood Presbyterian and Kentucky ransomware attacks. On Monday, Maryland-based MedStar Health reported malware had caused a shutdown of some systems at its hospitals in Baltimore. Separately, Cisco Talos Research is claiming that a number of the attacks are exploiting a vulnerability in a network server called JBoss using a ransomware dubbed SamSam. Perhaps both are creating mischief? Ars Technica, Cisco Talos blog, BBC News, ThreatPost

More and worse attacks north of the 49th Parallel. Norfolk General Hospital in Simcoe, Ontario had a ransomware attack this week that spread to computers of staff, patients and families via the external website through the outdated content management system. According to MalwareBytes, “The particular strain of ransomware dropped here is TeslaCrypt which demands $500 to recover your personal files it has encrypted. That payment doubles after a week.”  So if you are running old Joomla! or even old WordPress, update now! Neil Versel in MedCityNews

If you’re thinking Mac Prevents Attacks, the first ransomware targeting Apple OS X hit earlier this month. Mac users who  downloaded version 2.90 of Transmission, a data transfer program using BitTorrent, were infected. KeRanger appears after three days to demand one bitcoin (about $400) to a specific address to retrieve their files. HealthcareITNews

Finally, there is the Hackermania gift that keeps on giving: Healthcare.gov. (more…)

A gallimaufry of short digital health items to start the day with

The WHO has produced an excellent report on the state of eHealth in the European region, including a review of telehealth readiness. Ericsson have produced a very interesting report confirming what I guess anyone will have realised if they’ve traveled by public transport or have children: young people downloading video content are driving a surge in data usage: there’s much detail here though. Both are well worth the read.

Mentioning Ericsson reminds that the Telegraph recently produced a summary of the 20 best-selling mobile phones of all time – takes you back, with the substantial number once produced by Nokia.

The Royal Society of Medicine has it’s fifth annual medical app conference on April 7th – numbers booked have already well exceeded last year’s sellout so they are expecting to fill this year’s much larger conference venue. The focus this year is on the many legislative, regulatory and voluntary measures being introduced that will impact medical apps – there’s still room for old favourites though, such as Richard Brady’s always-topical (more…)

Apps and wearables – developments over the summer

Trying at least temporarily to distract this editor’s attention from his recent unfortunate experience with Jawbone technology, here are some interesting app and wearables snippets received over the summer.

We begin with news of the first CE certified mole checking app, SkinVision which rates moles using a simple traffic light system (using a red, orange or green risk rating). The app lets users store photos in multiple folders so they can track different moles over time. It aims to detect changing moles (color, size, symmetry etc.) that are a clear sign that something is wrong and that the person should visit a doctor immediately.

This contrasts with the findings of a paper published in June examining 46 insulin calculator apps, 45 of which were found to contain material problems, resulting in the conclusion that :”The majority of insulin dose calculator apps provide no protection against, and may actively contribute to, incorrect or inappropriate dose recommendations that put current users at risk of both catastrophic overdose and more subtle harms resulting from suboptimal glucose control.”, which to say the least of matters is worrying. (more…)

First ResearchKit health app released in UK, Hong Kong

click to enlargeOn Thursday, Stamford University released MyHeartCounts, the first iPhone health app using the Apple ResearchKit platform. Initial launch is in the UK and Hong Kong. It is designed to study factors around heart health by collecting data about physical activity and cardiac risk factors. Every three months, participants monitor one week’s worth of physical activity and also complete a 6-minute walk fitness test. The latest version of the app also includes feedback on users’ behaviors and risks. While the initial phase of the MyHeart Counts study both collects heart health data and provides personalized information to participants, the next phase will be to study motivational tools for users. Currently 41,000 participants have registered for this study. Medaxs via eHealthSpace.org (both Australia)

Google X develops health tracker–for research and clinical trials only

And it’s not for sale. The life sciences group within Google X is testing on small groups a wrist-worn device which can sense with high accuracy pulse, heart rhythm, skin temperature and environmental information like light exposure and noise levels. Bloomberg News, which appears to have broken the story, quotes Andy Conrad, head of the life sciences team at Google: “Our intended use is for this to become a medical device that’s prescribed to patients or used for clinical trials.” Obviously it will be more accurate both in hardware and in back end algorithms than what’s currently marketed via Android Wear for smartwatches. Perhaps this is meant for the ‘superusers’ of healthcare services at the top 5 percent using 50 percent of spend, the new ‘It Girls’ of healthcare, TTA 28 May)? However, he’s also projecting out 20-30 years, so health systems and researchers, do not hold your breath waiting for this to become reality. (This is also a counter to Apple’s ResearchKit.) Also Yahoo Finance and The Verge, which has a gigantic photo of a smartwatch but no caption attribution. The Verge also mentions their research in MS. Gizmodo also adds that Mr Conrad is directing the Google X Baseline project, which is doing human testing and crunching data to develop a baseline of normal human health.

More about Google X in this video interview on Tested with Astro Teller (for real), ‘captain of moonshots’ for the company, on ‘thinking big and failing quickly’. (24 minutes)

IBM Watson Health adds 2 companies, three partners, moves to Boston and into the cloud

click to enlargeA Day with a Big Exclamation Point for Healthcare Data and Analytics. In a series of press releases late NY time on Monday and a spectacular announcement at HIMSS (photo hat tip to Sandeep Pulim via Twitter), the recently quiet-on-the-healthcare-front IBM Watson has announced multiple major moves that re-position it squarely into the healthcare arena as the 90,000 lb. Elephant.

  • IBM Watson Health is now a separate business unit headquartered in Boston. The Watson New York headquarters will be expanded, but that may be for their other businesses: travel, retail, veterinary care, cognitive computing, and IT security and support. IBM claims that Watson Health will be hiring up to 2,000 healthcare consultants, clinicians and researchers, folding in existing units such as Smarter Care and Social Programs.
  • The IBM Watson Health Cloud is now their secure, open and HIPAA compliant platform for health-related data: physicians, researchers, insurers and health and wellness companies.
  • Three new partnerships were announced, designed to bolster IBM in different aspects of what is to be done with All That Data being generated from health and fitness devices. IBM Watson Health Cloud will be the secure platform, storage and analytics for Apple’s HealthKit and ResearchKitJohnson & Johnson will be working with Watson on pre/post-operative coaching and education and Medtronic on diabetes management using data from Medtronic devices. (more…)

Something for (almost) everyone – a digital health gallymaufry

The Association of British Healthcare Industries (ABHI) is looking for companies to share the British Pavilion at the CMEF trade show from 15th – 18th May 2015 in Shanghai, China. It is apparently the the leading Healthcare trade show in China and is now the largest Medical Equipment exhibition in the Asia Pacific region attracting over 60,000 visitors. Details here.

Still need to see some more predictions for 2015? – try these 12 for telecoms, which does include the odd interesting nod towards subjects we cover, including interconnection of wearables and connected homes.

Prompted by our mention of V-Connect in our review of our 2014 predictions, MD Adam Hoare has pointed out that his company also won the Medilink ‘partnership with the NHS’ award for their renal project with The Lister Hospital in Stevenage. Congratulations!

Accenture has produced an interesting (more…)

2015: a few predictions (UK-biased)

As intimated in our review of last year’s predictions, we feel little need to change course significantly, however some are now done & dusted, whereas others have a way to go. The latter include a concern about doctors, especially those in hospitals, continuing to use high-risk uncertified apps where the chance of injury or death of a patient is high if there is an error in them. Uncertified dosage calculators are considered particularly concerning.

Of necessity this is an area where clinicians are unwilling to be quoted, and meetings impose Chatham House rules. Suffice to say therefore that the point has now been well taken, and the MHRA are well aware of general concerns. Our first prediction therefore is that:

One or more Royal College/College will advise or instruct its members only to use CE-certified or otherwise risk-assessed medical apps.

The challenge here of course is that a restriction to CE-certified apps-only would be a disaster as many, if not most, apps used by clinicians do not meet the definition of a Medical Device and so could not justifiably be CE-certified. And apps are now a major source of efficiencies in hospitals – (more…)

41 percent of healthcare employees don’t encrypt mobile devices: Forrester

Just after this Editor rhapsodized that one of the unrecognized (except here) wins for Apple’s new iPhone 6 in healthcare will be to give the docs what they want–larger screens–is this sobering stat from Forrester. Only 59 percent of healthcare employees use full-disk encryption or file-level encryption on mHealth computing devices used at work. Yes, here is another hole in the data security dike that needs plugging, because Forrester also cites that 80 percent of data breaches relate to lost or stolen devices. (What, not mulch?)  Author Chris Sherman also quoted street prices for health records to The Wall Street Journal’s CIO Journal blog  (more…)

Yesterday’s Apple intros and implications for health monitoring

A knockout or a catch up? Now that the Hype Dust is settling (along with Apple’s stock price), let’s take a look at what we know today about the new, larger iPhones and the Apple Watch regarding health monitoring.

Where it was a catch up:

  • Size and screen in phones. Apple got the message: squinting at tiny type and swiping to enlarge is rapidly becoming yesterday’s pain. As smartphones and larger screens knocked out the Blackberry, Samsung led the way in sizing up and higher resolution–and others followed suit. The awful fact is that the smartphone market is aging, both in users and who’s left in the market to grow it, and we want to see, not squint.
  • click to enlargeFinally (drum roll), a sleeker smartwatch with fitness tracking, out sometime next year–and not just a sports model. The basic model is a rubbery Sport watch, the mid-line has a sapphire crystal, stainless steel case and (proprietary) swappable bands. The beauty is the upmarket version in gold with a leather band (left, courtesy re/Code).
    • Here Apple is up against multiple in-market competition from Fitbit to Moto to Withings to Samsung Gear–whose pricing is well below the starter Apple Watch at $349 in the $200 and below range.
    • The Apple Watch looks seriously great, distinctively thinner and it’ll be a prestige item. But does it track more and better? No. According to reports (updated today) this is what it has: heart rate monitor, pulse, daily activity for which you need the phone. No sleep monitoring. It also has to be charged every night. There may be other features from developers, but they are under wraps for now and will likely require phone tethering. (re/Code) It’s not a comprehensive lifestyle watch–yet.

Where it could be a knockout in healthcare:

  • Finally, a compelling reason for health care providers to ditch the old iPhone and not go Android. Healthcare providers in the US are heavily wedded to iOS: (more…)

2015: mHealth’s breakout year–or more of the same sideways?

click to enlargeAdopting or Ditching It? We’re barely into September, yet the first 2015 prediction-of-a-sort is on the record from Center for Connected Health‘s Dr. Joseph Kvedar in The eHealth Blog. Does Apple HealthKit+Samsung‘s SHealth’s iterations+Google Fit+smartwatches everywhere (including LG’s G Watch R) equal $7.2 billion in wearables alone by 2018 as part of a mHealthy $49 billion by 2020? He’s optimistic, yet he hedges his bets with the caveat

“The challenge in health care is that, though we know what patients/consumers need to do to improve their health, most of them don’t want to hear about it.”

Which indicates that Dr. Kvedar has joined our small group of Thinkers puzzling out why health apps haven’t taken off beyond their Quantified Selfer early adopters and what Parks Associates termed ‘Healthy and Engaged’ [TTA 11 Aug]. With 1/3 of the purchasers of activity trackers putting them in the drawer after six months and the unstickiness of apps (80 percent are abandoned after a shocking two weeks), the winning combination isn’t obvious. But is it ‘focus on engagement’ and ‘personal, motivational and ubiquitous’? Certainly key factors, but how do we get the ‘Challenged but Mindful’ with a chronic condition–or two or three–to track and reward their real progress, even on a bad day–which an activity tracker which constantly presses you to exceed your performance has trouble gauging. (more…)

Samsung vs Apple: Go big or go home

click to enlargeImplications for mobile health abound in the fight for the innovation throne. Kicking off the autumn intro season was Samsung’s big reveal Wednesday at IFA Berlin and NYC of their new phablets (Note 4, the oddly curved/fallaway screen Note Edge), the big ‘n’ curvy almost-phone Gear S smartwatch and the virtual reality headset Gear VR for the Note 4. Clearly Samsung is pushing the boundaries on size and innovation leadership–as well as the sheer number of phones/phablets/wearables in market with something for everyone. Its health developer platform SAMI and the Simband hardware [TTA 30 May] plus joint research with UCSF on ‘novel vital signs’ [TTA 2 June] positions it in the health tech area as the alternative to Apple. ZDNet, Gizmag (Gear S), CNet (Gear VR) which may have some health uses.

Next Tuesday is Apple’s premiere of two new iPhone 6 models with 4.7 inch and 5.5 inch screens to go on sale this month, plus an announcement for a yet-unnamed Apple wearable, but a rumored price of $400 for on-sale next year. Their developments with (more…)

Forced to wear a fitness tracker for insurance? (US)

For those covered by corporate health policies, the day is not far away where employee health insurance programs will require wearing a fitness tracker and meeting certain metrics, such as walking a million steps or sleep quality. Already some programs have the employee log food, exercise, blood glucose, heart rate and other vital signs to qualify for a discount. The trajectory is much like BYOD–once unheard of, now it is expected to be the norm in 50 percent of US companies by 2017, with a concomitant loss of personal security and privacy. CVS Caremark and other companies have already made the stick, not the carrot, the norm of employee wellness programs [TTA 12 April 2013]. Writer Adrian Kingsley-Hughes asks: “How much access do we want our employers to have to our medical data? How much access to our daily activities do we want our employers and insurers having?” And what about spoofing those Fitbits and Jawbones? His ZDNet article notes the interest that Apple (plus Samsung and Google, despite Sergey’s and Larry’s vapors–Ed.) has in health, then takes it out a few more yards with Wearables and health insurance: A health bar over everyone’s head (and do check out the comments.)

The smartphone as great healthcare leveler: Eric Topol

Eric Topol MD, cardiologist, Chief Medical Advisor for the rebooted (but so far quiet) AT&T ForHealth and Chief Academic Officer at Scripps Health, is no stranger to the ‘big statement’ and is well known as an advocate for all things mHealthy. For at least two years, he has been promoting the smartphone’s ‘equalizer’ capabilities in health not only via apps and ‘add ons’ but also as a storehouse or central repository for individual health information, including genetic screening, which can be transmitted onward to a practitioner, lab or PHR. Dr Topol’s ‘big statements’ were fully on display in his keynote at HealthLeaders’ CFO Exchange conference. A promoter of the ‘creative destruction of medicine’ (the title of his most recent book, WSJ article), he believes that everything from the office visit (virtualized) (more…)

All that Quantified Self data? Drowning doctors don’t want to see it.

click to enlargeOur long-time readers will remember Questions # 3, 4 and 5 of The Five Big Questions (FBQ*). They have not lost their salience as doctors are rejecting the not-terribly-accurate ‘telehealth’ data [TTA 10 May] generated by popular fitness trackers such as Fitbit, Misfit Shine and Jawbone. We do note that Apple’s Health/HealthKit has trotted out alliances with Mayo Clinic and Epic Systems (EHR) on apps and integrating data into an PHR [TTA 3 June], as well as Samsung’s SAMI [2 June] funding a University of California (UCSF) research center and (of course) Google. But this article confirms (more…)

Tons of app health data, bound for…third parties?

click to enlarge The law of unintended consequences also applies to Quantified Selfers. Health apps seem to be reaching beyond the QS early adopters and becoming a commonplace, whether on your wrist or built into your smartphone. Apple, Google, IBM and Samsung are all in.The DH3 set (Digital Health Hypester Horde) could not be more pleased. But where is that data going? According to the US Federal Trade Commission (FTC), it’s ending up where your online data goes–profitably sold by developers large and small to your friendly data broker and onward to marketers. You may think it’s private, but it isn’t. There is the famous case of an Target (store) app used to determine whether female customers were pregnant (purchases such as pregnancy tests) and then market related and baby products to them. Commissioner Julie Brill doesn’t like the possibility that health data could be part of the Spooky Monster Mash that is Big Data. “We don’t know where that information ultimately goes,” Brill told a recent Association for Competitive Technology panel. “It makes consumers uncomfortable.” (Ahem!) From the consumer protection standpoint, the FTC would like to do something about it, and they happen to be very good at that type of regulation. Compliance will not only be an added cost of doing business, it will cut into that ol’ business plan. And you thought that the only problem around apps and the Feds was gauging risk to users. Do you have that creepy ‘Big Brother is Watching You’ feeling?  Health IT Outcomes, FierceMobileHealthcare, VentureBeat.