Hip-protective airbags get another entrant from France. And fall prediction steps forward.

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2018/01/Studio-CAP-PHOTO-HELITE-1002-logo.png” thumb_width=”150″ /][grow_thumb image=”http://telecareaware.com/wp-content/uploads/2018/01/thumbs_Studio-CAP-PHOTO-HELITE-1010-logo.png” thumb_width=”150″ /]CES served as the US debut (the first was at November’s Medica fair in Dusseldorf) for Fontaine-lès-Dijon, France-based Hip’Air. Hip’Air by Helite is a soft belt with hip-positioned airbags that triggers upon fall detection but before ground impact. It is designed to be worn outside the body (unlike conventional pads), is reusable, claims a 90 percent reduction in fall impact, with a battery charge that lasts for over one week. According to their website, it will debut in Europe this spring after testing in nursing homes for €650 (US$800, UK£570). Video on their website above and on CNet.

Our Readers are well acquainted with the toxic statistics around falls and hip fractures. The US CDC found that 95 percent of hip fractures are caused by falls, usually sideways, they disproportionately affect women, and in the US they amount to about 300,000 per year. Hip’Air quotes their sources as 65,000 per year in France alone. NIH’s 2010 study found a 21 percent mortality rate after one year. Surgery/recuperation cost is around $30,000. Here is a largely avoidable cost.

In that context, it’s encouraging that Fort Washington, Pennsylvania-based ActiveProtective, which we profiled a year ago and received numerous Reader and company founder comments [TTA 10 Jan 17], is testing its belt-worn approach with Eskaton Village, an assisted living residence, in Carmichael near Sacramento California, and nearing a commercial debut. It is also based on sensors (3D) that sense a fall and deploy before impact in what they call ‘fall disambiguation’ and claims a comparable 90 percent impact reduction. It gained $4.7 million in Series A funding in December [TTA 19 Dec 17]. CBS 13 video. While Hip’Air is direct competition, albeit in Europe, more than one provider serves to convince funders and customer markets that the concept is valid.

Fall prediction is also stepping off the sidelines. Our earlier article covered four tech approaches that help to estimate and proactively act against falls [TTA 10 Jan]. Here’s another one from Spain, the FallSkip, which allows a physician or therapist to measure fall risk in under two minutes and in walking under 10 feet. Developed at Spain’s Universitat Politècnica de València, it consists of an Android-based mobile device Velcro-mounted on the back of a soft waistband for the patient which is worn during the walking test. The custom app provides and interprets motion readings to the doctor. New Atlas  YouTube videoHat tip to Toni Bunting 

To this Editor, advances in estimating fall risk are long overdue. Fall cushioning is too, and the less clunky but effective the better. But strength training is a needed adjunct, per the Dutch program. This physical training helps older adults and the disabled prevent falling and fall better, if they must. So what organizations in the US, UK, and EU are advocating this? There’s plenty of room for tech too. Not sexy or cocktail-party-buzzy at Silicon Valley parties, but a direct way to decrease cost and increase older/disabled quality of life.

Fall prevention: the technology–and Dutch–cures

The ‘Holy Grail’ of fall detection is, of course, fall prevention. The CDC statistics for the US are well known: One in four Americans aged 65+ falls each year. Every 19 minutes, an older adult dies from a fall. Falls are the leading cause of fatal injury and the most common cause of nonfatal trauma-related hospital admissions among older adults–2.8 million injuries treated in emergency departments annually, including over 800,000 hospitalizations and more than 27,000 deaths. In 2014, the total cost of fall injuries was $31 billion. In the UK, AgeUK‘s stats are that falls represent the most frequent and serious type of accident in people aged 65 and over, the main cause of disability and the leading cause of death from injury among those aged 75+. 

The technology ‘cures’ as noted in this NextAvenue/Forbes article centers around predicting if and when a person will fall.

  • The ‘overall’ approach, which is constant monitoring of ADLs through activity sensing and modeling/machine learning to detect early signs of decline or health change. Companies in this area are Care Innovations’ QuietCare (sensor arrays) and CarePredict (wrist worn).
  • Gait detection. Relatively small changes in gait and walking speed are an accurate, fast, and straightforward indicator of fall risk. Ten years of research performed at TigerPlace in Missouri showed that people whose gait slowed by 5 centimeters per second within a week had an 86% probability of falling during the next three weeks. Shortening of stride had a 50 percent probability of fall within three weeks.
  • Read the brain. Research at Albert Einstein School of Medicine in NYC indicates that in otherwise high-functioning older people, high levels of frontal brain activity while walking and talking can predict higher long term fall risk, up to 32 percent.
  • Balance impairment. Tests using VR to simulate falling in healthy subjects and tracking their muscular response also could be used to roadmap a person’s balance impairments and future fall risk–along with training and targeted physical rehabilitation.

The Netherlands has taken this last point and gone ‘low tech’ with physical training courses that teach older adults both not to fall and to fall correctly if they do. Students negotiate obstacle courses and uneven surfaces, then learn to fall properly on thick inflated mats. Many of those attending use walkers or canes, but complete the courses which reduce the fear of falling or getting up–and provide both fun and socialization. The courses have become popular enough that they are government rated with insurance often defraying the cost. New York Times

Add hospital-acquired infections to your list, Google Ventures!

Google Ventures’ Hot 7 [TTA 23 May] should be a Hot 8. Three recent articles have reminded this Editor that we are no further along in controlling nosocomial, or hospital-acquired, infections–and they are getting worse. They annually kill 75,000 US patients in hospitals and 375,000 patients in nursing homes. Those who get it and survive take months to fully recover, if they can.

  • They keep multiplying. The US’ Eye on Infection, Betsy McCaughey, former NY State lieutenant governor, brings to attention a new one called Candida aureus, a fungus which kills 60 percent of patients it infects. It’s been detected in New York (15 hospitals so far), New Jersey, Illinois, Massachusetts, and Illinois. It is carried on surfaces, sink drains, uniforms, clothing, skin, and devices, the last usually fatal to the patient. Patients can also be carriers.
  • The spread of CRE (carbapenem-resistant bacteria) could be the future of Candida aureus. In 1999, it was first detected at Downstate Medical Center in NYC. By 2008 it reached 22 states and is now a nationwide threat.
  • MRSA and MSSA are widespread, waxing and waning in outbreaks.

The problem has escalated to the point where Mark Sklansky, M.D., a professor of pediatrics at the David Geffen School of Medicine at UCLA, has launched a pilot to ban handshakes in two UCLA neonatal intensive care units–and it’s being debated on whether it’s effective or just consciousness raising.

Ms McCaughey attributes this to lack of action by CDC, despite Congress, in staying with outdated guidelines for how to clean patients’ rooms, ignoring the potential of automatic room disinfection to save lives. CDC underestimates the impact through bad sampling. Hospitals under-report deaths from infection. State authorities are no better in their inaction.

A solution far more aggressive than banning handshakes is screen-and-clean. Israel’s drastically reduced CRE by 70 percent in one year from its 2007 outbreak. Even babies are screened. Automatic room disinfection is not a panacea, but architects have been tackling this in designs for future hospital rooms for years. The most recent concept this Editor saw was at last November’s NYeC Digital Health Conference.

GV, where art thou? FierceHealthcare, Creators.com, NY Post

A ‘wearable airbag’ belt that prevents hip fractures due to falls (updated)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2016/11/belt.jpg” thumb_width=”150″ /]Editor’s Note: We are reprinting this article (originally from 23 November 2016) due to the comments by the CEO of ActiveProtective, Drew Lakatos, on 10 and 12 January, responding to the reasoned misgivings of one of our Readers. (Click ‘read more’ and scroll to comments at the end of the article.) This unusual step is being taken because this Editor believes that the problem is major–adults at high risk of falling and hip fractures. A technology solution such as this is worthy of examination by our Readers and further debate.

Do you believe older adults at high fall risk would voluntarily wear a belt that would deploy cushioning air bags around the hips in the event of a fall? This Editor was initially skeptical reading the MedCityNews article on ActiveProtective‘s $2.6 million Seed 3 round raise. The belt, looking at their photo and the one on the ActiveProtective website (left above), looks like a hard and uncomfortable ring, which didn’t make much sense as the ring in a fall impact could itself create injury. There was also a brief mention of fall detection but not how they worked together.

But before nominating this as a Thanksgiving Fowl, this Editor wanted to Dig Deeper. In their press, this TEDMED video with founder/presenter Drew Lakatos, while originally from 2014, explained its workings far better. (more…)

Virtual care stops germs dead in their tracks! (Who would have thought it?)

Here at TTA we do receive and read a lot of press releases, and most are pretty meh. (We work very hard to avoid subjecting our readers to meh, as we don’t much like it either.) Now this one takes a different tack. It backs up telemedicine and telehealth technology that enables the patient to avoid the germ-filled doctor’s office and ED. According to Zipnosis citing the Infection Control and Hospital Epidemiology journal, after the standard well-child visit, there is a 3.17 percent increase in influenza-like illnesses among children and their family members within two weeks. Extrapolated, this results in more than 766,000 additional office visits for flu-like symptoms each year and nearly $492 million in annual costs. Now here is a simple, proactive improvement in outcomes that achieves savings (hear that, HHS and NHS?) facilitated by healthcare technology. (See previous article on ‘A tricorder one step closer‘)

The remainder of the release concentrates on what a bad idea it is to subject the rest of the world to your germs when down with a cold or flu. Even the CDC wants patients to stay home from work, school and errands. (That is, if you can.) The point is made that virtual care can unjam doctor offices and EDs for those less dangerous who need hands on care. The light touch of the product message is that Zipnosis provides a white-labeled virtual care platform to health systems that first uses an online adaptive interview with a patient to document the condition, provides a diagnosis and treatment plan within an hour, directing the patient to an appropriate level of care. Release.

IMS Health report: mainstream health app adoption remains elusive

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/09/Key-findings2-thumb-IMS1.jpg” thumb_width=”200″ /]Despite 165,000 apps (and counting). A followup to IMS Health’s report of 2013, Patient Adoption of mHealth demonstrates how far mHealth has to go. Over 50 percent of apps have a single functionality, but connectivity to external sensors (e.g. wearables) has improved to 10%. 36 apps account for nearly 50 percent of downloads and 40 percent of all health apps have 5,000 downloads or less. Providers give limited if any guidance to consumers on app choice despite greater interest; ‘curation’ efforts, including IMS Health’s own [15 Dec 13], have largely failed. Other barriers to adoption are reimbursement (though many are free), limited healthcare system integration, regulator and privacy unknowns.

Where’s the progress? Chronic condition monitoring (left), with clinical trials more than doubling in the past two years, and focusing on treatment/prevention largely for older adults. These clinical trails are looking at mental health, diabetes, cardiovascular disease, weight management and oncology. IMS Health also recommends that users and stakeholders, including clinical organizations such as the CDC, ASCO and the Cancer Support Community tap into their clinical resources to develop and promote patient-centered apps. Download report (information required.)  A decidedly less cheerful take on the report is Stephanie Baum’s at MedCityNews.

Ebola and health tech: where it can help, where it failed (Updated)

 [grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/08/keep-calm-and-enter-at-own-risk-3.png” thumb_width=”150″ /]Ignore the sign…come on in, we can be quarantined together! Everyone is on Ebola-overload, so we will keep it short and sweet. The Gimlet Eye (recovering after an argument with a box, see below) advises a calm, adult-beveraged, low-media weekend with Mantovani, Bert Kaempfert or Percy Faith on the stereo.

  • Yes, digital health is addressing the needs that Ebola screening and care are generating. MedCityNews spotlights Medizone International’s AsepticSure peroxide/ozone aerial mist sterilizer which was originally developed to kill MERS and MRSA in field hospitals, to be tested by Doctors Without Borders in a 40-bed unit. Startup AgileMD launched a free mobile app for clinicians containing the Centers for Disease Control (CDC) Ebola prevention treatment guidelines (for what anything from CDC is worth….) Text message alerts used first in Sierra Leone are being expanded to seven West African nations for use by the Red Cross and Red Crescent (also BBC News). Sanomedics International has the TouchFree InfraRed Thermometer which is being used at US airports which are screening for passengers originating in West Africa, and Noninvasive Medical Technologies is promoting their ZOE fluid status monitor because it applies electrical currents externally to determine hydration levels.
  • Even crowdfunding’s getting into the act. Researcher Erica Ollmann Saphire and her colleagues at Scripps Research Institute  (more…)

Project ECHO using telemedicine to limit, treat hepatitis C virus

Two US government agencies plus the American Medical Association (AMA) are piloting a program to better diagnose and treat the hepatitis C virus (HCV). The Centers for Disease Control (CDC) is the lead in this Arizona and Utah-based project, with the Office of the National Coordinator for Health IT (ONCHIT) and the AMA creating new clinical quality measures and clinical support tools. The objective is to identify what works to treat HCV infections and then develop a scalable methodology. The program will integrate telemedicine (video consults), public health data analysis and outreach  to primary care physicians, academic centers and public health officials. CDC/ONC release/blog posting,  iHealthBeat, Health Data Management. Hat tip to Editor Toni Bunting.