Weekend ‘Must Read’: Are Big Tech/Big Pharma’s health tech promises nothing but a dangerous fraud?

If it sounds too good to be true, it isn’t. And watch your wallet. In 14 words, this summarizes Leeza Osipenko’s theme for this article. It may seem to our Readers that Editor Donna is out there for clicks in the headline, but not really. Dr. Osipenko’s term is ‘snake oil’. It’s a quaint, vintage term for deceptive marketing of completely ineffective remedies, redolent of 19th Century hucksters and ‘The Music Man’. Its real meaning is fraud.

The promise is that Big Data, using Big Analytics, Big Machine Learning, and Big AI, will be a panacea for All That Ails Healthcare. It will save the entire system and the patient money, revolutionize medical decision making, save doctors time, increase accuracy, and in general save us from ourselves. Oh yes, and we do need saving, because our Big Tech and Big Health betters tell us so!

Major points in Dr. Osipenko’s Project Syndicate article, which is not long but provocative. Bonus content is available with a link to a London School of Economics panel discussion podcast (39 min.):

  • Source data is flawed. It’s subject to error, subjective clinical decision-making, lack of structure, standardization, and general GIGO.
  • However, Big Data is sold to health care systems and the general public like none of these potentially dangerous limitations even exist
  • Where are the long-range studies which can objectively compare and test the quality and outcomes of using this data? Nowhere to be found yet. It’s like we are in 1900 with no Pure Food Act, no FDA, or FTC to oversee.
  • It is sold into health systems as beneficial and completely harmless. Have we already forgotten the scandal of Ascension Health, the largest non-profit health system in the US, and Google Health simply proceeding off their BAA as if they had consent to identified data from practices and patients, and HIPAA didn’t exist? 10 million healthcare records were breached and HHS brought it to a screeching halt.
    • Our TTA article of 14 Nov 19 goes into why Google was so overeager to move this project forward, fast, and break a few things like rules.
  • We as individuals have no transparency into these systems. We don’t know what they know about us, or if it is correct. And if it isn’t, how can we correct it?
  • “Algorithmic diagnostic and decision models sometimes return results that doctors themselves do not understand”–great if you are being diagnosed.
  • Big Data demands a high level of math literacy.  Most decision makers are not data geeks. And those of us who work with numbers are often baffled by results and later find the calcs are el wrongo–this Editor speaks from personal experience on simple CMS data sets.
  • In order to be valuable, AI and machine learning demand access to potentially sensitive data. What’s the tradeoff? Where’s the consent?

Implicit in the article is cui bono?

  • Google and its social media rivals want data on us to monetize–in other words, sell stuff to us. Better health and outcomes are just a nice side benefit for them.
  • China. Our Readers may also recall from our April 2019 article that China is building the world’s largest medical database, free of those pesky Western democracy privacy restrictions, and using AI/machine learning to create a massive set of diagnostic tools. They aren’t going to stop at China, and in recent developments around intellectual property theft and programming back doors, will go to great lengths to secure Western data. Tencent and Fosun are playing by Chinese rules.

In conclusion:

At the end of the day, improving health care through big data and AI will likely take much more trial and error than techno-optimists realize. If conducted transparently and publicly, big-data projects can teach us how to create high-quality data sets prospectively, thereby increasing algorithmic solutions’ chances of success. By the same token, the algorithms themselves should be made available at least to regulators and the organizations subscribing to the service, if not to the public.

and

Having been massively overhyped, big-data health-care solutions are being rushed to market in without meaningful regulation, transparency, standardization, accountability, or robust validation practices. Patients deserve health systems and providers that will protect them, rather than using them as mere sources of data for profit-driven experiments.

Hat tip to Steve Hards.

Digital health on the front lines of coronavirus checking, treatment and prevention (updated 2 Mar)

Coronavirus (COVID-19), which originated in Wuhan, China and has spread to at least 40 countries and 80,000 victims, with 2,700 fatalities, has been roiling both financial and healthcare markets. The stock price of payers in the US have been hit hard due to an anticipated uptick in illness, but interestingly, Teladoc has been up quite smartly in the past few days. Teladoc reported that one of eight virtual visits in January was due to flu, which isn’t atypical–but half had not used Teladoc before. Analysts do expect that there’s an opportunity for telehealth and telemedicine providers to attract new users due to what this Editor has dubbed ‘conscious contact’–that if you even feel remotely sick, you’re going to turn to a virtual visit.

COVID-19 is not remotely near a pandemic outside of China. The three hallmarks of a pandemic are cross-seasonal outbreaks (so far only in China), cross-geography (done), and most importantly, attacking the well. The fatalities have been among those with compromised immune systems, not among the young and healthy who do get it. It’s alarming, like SARS, because of the origination in animals, and the ease of person-to-person transmission via travel, as the outbreaks in Iran, South Korea, Italy, and on cruise ships visiting Asia have confirmed. In the US, the CDC is reporting that it is not currently spreading in the community, but is preparing for that scenario including containment, and has been since January.

But beyond the virtual visit, there are other areas where digital health is part of dealing with COVID-19:

  • Preventing the spread to the patient’s family members. Avaya has been working in China since January to provide enterprise customers with home agents to prevent the spread of the virus. For hospitals, they have donated equipment to enable remote consultation services and remote visiting video at the hospitals, including observation of isolation wards. They have provided a case study of their work with the Tongxiang Hospital at the Tongxiang Branch of Zhejiang Province People’s Hospital. (Photo at left courtesy of Avaya.) 
  • Another is remote patient monitoring. Sheba Medical Center in Tel Hashomer, Israel, is using Tyto Care to monitor the 12 Israeli returnees from the Diamond Princess cruise ship, who continue to be in isolation. The patients will perform the tests on themselves, especially respiratory tests. Jerusalem Post 
    • Update 2 Mar: A representative from Sheba, the largest hospital system in the Middle East, was kind enough to contact me with additional information on their RPM program for COVID-19. For patients requiring isolation in that stage of treatment, Sheba has implemented a modular ‘field hospital’ setup, similar to what the Israeli (and US) military use, which can be set up in any open area. This isolation is to protect immunosuppressed patients from disease spread in the main hospitals. Telehealth being used in addition to Tyto are the Vici telemedicine robot and the Datos Health app for home treated patients. This Editor believes that both European and US public health systems are looking at the Sheba and Israeli approach.
  • Robots–actually a telehealth cart–are being tested for patient self-testing, much like Tyto Care’s use at Sheba. Robots could also deliver food (although they could also carry germs) and sweep streets.
  • Other monitoring can be done via symptom checkers (Babylon, K, and others). 98point6 released a coronavirus screening chatbot app as early as January, but what they’ve turned up so far is more cases of the flu. STAT
  • Data analytics can pinpoint outbreaks. The Epic, Athenahealth, and Meditech EHRs have released new guidance, testing orders and screening questions (e.g. around travel and contacts) that will help to identify outbreaks.

Update 28 Feb: This Editor would like to know more about UV disinfection being used versus coronavirus for large spaces such as in hospitals and aircraft. If you have information on technologies such as PurpleSun which have been tested against hospital pathogens also being used against coronavirus, please contact Editor Donna.

Healthcare technologies which weren’t around during the SARS and swine flu epidemics may make a big difference in the spread, treatment and mortality rate of COVID-19. Healthcare Dive, HealthTechMagazine

UPDATE 28 FEB

As a service to our Readers, we are providing the following health service update links:

The UK Department of Health and Social Care and Public Health England has provided the following links to coronavirus guidance (hat tip to DOHSC via LinkedIn):

👩‍⚕️ Health: http://bit.ly/37qkWaV
🚂 Transport: http://bit.ly/2HDOFBW
👩‍🎓 Education: http://bit.ly/38KT41O
👨‍💼 Employers: http://bit.ly/2TfwpUT
🏡 Social care: http://bit.ly/2VhBIG9

US Centers for Disease Control (CDC)

World Health Organization (WHO) main website on coronavirus:https://www.who.int/health-topics/coronavirus

Health Canada’s main page: http://ow.ly/bLtF50yfJb7

China’s Anthem hack: they just wanna understand US healthcare

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]Knock yersself out! The Gimlet Eye files via Bottle from A Dot On The Map off the New York coast. One of the stranger follow ups of the past week–one that is difficult to read with straight face–is the report in the Financial Times that the Chinese hacked into insurer Anthem’s 80-million strong beneficiary database in order to study up on the American healthcare system and benefit their aging population. Neil Versel with raised eyebrow in MedCityNews quoting the FT story: “The Chinese hackers had trained their sights on the U.S. health sector to help the country understand how other nations deal with medical care, people familiar with the Anthem investigation said.” You’d think it would be easier for the Chinese to go to a few conferences, meet a few executives and learn a few things first. Then maybe they could do a ‘deal deal’ with an insurer on their IP, or bring them into China on a JV. With so many services for sale from the thundering horde of data analytics companies and multiple middleware providers, write a check already. But that would destroy the Fun of Hacking!

How the FT could actually print without a hint of skepticism this ‘nothing to see here, move on’ story rolls the Eye. (more…)

Events dear boy, events: a roundup of UK digital health stuff this autumn

This editor accumulated vast piles of notifications when on a two week holiday recently – here is the cream of the events notified. More to follow on resources shortly.

Between 4-6th September, SECC Glasgow is holding what it claims is the first ever medical education hackathon.

On the 14th September the free-to-attend London Health Technology Forum, organised by this editor, has an evening devoted to Exits (of the financially very lucrative kind). Baker Botts’ experienced lawyers will describe with examples the different exits available to the successful entrepreneur, why it’s important to plan ahead, and what the plusses and minuses are of each type of exit. Essential knowledge if you hope to become rich from your hard work & dedication.

On 17th September, KPMG are holding a free all-day event entitled ‘Information Protection in Digital Health’ at (more…)

The NHS fail at encouraging digital health startups

While Minister of Life Sciences George Freeman MP speaks very highly of the need for innovation and digital health in an NHS integrated health system, the reality is less encouraging for UK startups and their growth. The story of Big Health’s Sleepio and its move from the UK, told by Bloomberg, illustrates the difficulty that new companies and technologies have in fitting into a national framework, then selling into the 209 NHS regions plus related healthcare spenders. The long cycle and the narrowness of the frameworks are disincentives for many digital health technologies and their funders. Even if you win clients as part of being on the framework, when it expires after a few years, the business can be lost.

It’s hard to crack the code, and small companies are dependent on partners. A personal anecdote from this Editor’s time at Living Independently: the company achieved getting on a national framework with the QuietCare telecare product (2007) through partnerships with several larger telecare providers. We relied on them to offer QuietCare to the regions and councils. This had limited success and the US business far outstripped that in the UK.

Ten years ago, the situation was reversed. NHS, Government and council funding helped the earliest development and acceptance of telehealth and telecare, much as the Veterans Health Administration (VA) did with home telehealth and telemedicine in the US.  Other European markets and Canada have established private spending in this area, but these smaller markets–and funders– don’t have the potential that is possible in the US private market, even without reimbursement. The trend is reflected in investment: $4 bn in the US, less than €100 million in Europe. US developers now have a bonus in the potential of Asia, with China having the greatest interest and now funding. [TTA 23 July].  How the NHS Is Locking Out Britain’s Digital-Health Startups

Can digital health solve China’s healthcare quality, distribution problems?

Earlier this year [TTA 21 May] we noted China’s interest, governmental moves and private investments in digital health as part of ‘Internet Plus’: Tencent Holdings and Fosun International led the $35 million Series B round for ‘healthcare tricorder’ Scanadu; ZTE Health; Alibaba‘s investment in data cruncher CITIC 21CN. Now McKinsey partner Florian Then analyzed for Yahoo! Finance the promise of telemedicine and telehealth in that country, and the great problems they must solve. The huge disparity of care between urban and rural hospitals drives patients to the former, regardless of long distances and inconvenience. In population health, the unhealthy habits of much of China’s population make US/UK/EU concerns look unimportant: one of every three of the world’s smokers and 300 million hypertensives live in China.

A possible telemedicine-driven solution would be for urban hospitals to support via doctor consults and email rural hospitals to get patients into the medical system locally and earlier. Education would be delivered online, probably through those 847 million mobile phones on which 83 percent of Chinese Internet users access the web (market intelligence firm IDC). China also appears to be liberalizing (more…)

Nurses, China, ageing, longevity, TV, mobile data, Magna Carta, even logarithms – something for everyone!

This editor has always felt that telehealth and allied technologies is a nurse’s friend, enabling them to treat more people, with less stress, in short delivering more care and driving less car. It’s therefore great to see the European Federation of Nurses so active in the mHealth event in Riga recently, and to see them making a strong case for nurse engagement in the mHealth care pathways.

However this editor could not restrain a small chuckle at presumably a wayward spellchecker resulting in the phrase “incorporating big data logarithms for clinical pathways” appearing in the Presidential Message in their June-July 2015 Update.

Staying, briefly, overseas – the UKTI and co want to take you to the Expo 2015 in Milan on 28 September to 1 October to find new export opportunities. Programme for the main day is here. Book for the whole event here. Looking further afield, there is more info about the China Healthcare & Life Sciences Roadshow 2015 taking place in London, Manchester, Belfast, Glasgow, Leeds, Cardiff between 29 June – 8 July here. For those interested in exporting to China, the roadshow will highlight the extensive work that has been done to identify and scope current opportunities in the healthcare sector there. Great stuff.

On a different tack, this editor has just been made aware that the University of Greenwich has established (more…)

‘Internet Plus’ nurturing China’s nascent digital health market

Back in April this Editor was surprised by the interest Chinese investment companies had in Scanadu–and vice versa. Two of the three, Tencent Holdings and Fosun International, led the $35 million Series B round. Scanadu in return reportedly is developing products primarily for the China market, such as a urine analyzer.

Somewhat surprising, but it should not be, is the extent that private money tacks to the winds of official Chinese government policy. Ecns.com, the online site of the state China News Service, reports that part of the government ‘Internet Plus’ initiative will be targeted to the health and social care needs of 212 million people over 60 in China–a surprising 15.5 percent of the population. The civil affairs vice-minister has publicly advocated the use of the Internet, cloud computing and big data to transform care for the aged. Oddly, this also includes the development of ‘e-commerce’ for seniors.The language is also interesting and very careful–“The country’s population also features a large number of elderly people who are disabled and who are faced with empty nests and poverty” and a similar to the West shortage of carers. (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…)

Microsoft Kinect now as sign language translator

The versatility of Microsoft Kinect continues to astound, with uses ranging from human rehab/physical therapy to equipping robots with anticipatory powers for your drink to Ellie the Virtual Analyst. Add sign language translation to this list. The latest is Chinese sign language simultaneous translation via Kinect that will permit deaf and hearing individuals to understand each other. Sign languages are their own entity with grammar and rules that make the spoken/written language nearly foreign to the user. The system developed by Chinese Academy of Sciences’ Institute of Computing Technology and Microsoft Research Asia joins the one developed for American Sign Language last year. Wired.co.uk  Hat tip to Toni Bunting, TTA and TANN Ireland.