International news roundup: ATA dispatches, compete for funding in Helsinki, Spry FDA-cleared for COPD, Merck acquires ConnectMed Kenya

There’s not much news so far from the just-wrapped ATA 2019 conference in New Orleans, but POLITICO Morning eHealth highlighted a drop-by by Sen. Bill Cassidy from Louisiana, urging attendees to demonstrate to their local politicos that telemedicine is safe and effective–and be ready to answer questions about fraud or misuse. Louisiana’s Ochsner Health System is branching into retail with the O Bar, cleverly designed to look like an Apple Store to merchandise wearables and other health tech devices. For Ochsner patients, they can enroll into RPM programs and have their data directly input into their Epic EHR. American Well released a survey of 800 doctors, with the unsurprising finding that 22 percent have used telehealth to treat patients, but this is up 340 percent since 2015; also that the doctors finding telehealth most attractive to practice are also reporting high levels of burnout. Looking for more substantiative news from NOLA.

It’s Helsinki for pitching your digital health idea in June. The 11th edition of the interestingly named EC2VC Investors Forum and Pitch Competition is now part of HIMSS/ Health 2.0 Europe 2019. Healthcare startups and SMEs looking for funding can apply, with 12 companies to be selected to present before a jury panel of digital health investors. The format is a four-minute pitch, followed by six minutes of Q&A. More information and to apply by 6 May, with finalists selected by 13 May. The event is 11 June from 13:00 to 16:00 at Messukeskus Helsinki Expo & Convention Centre. 

Spry Health’s Loop wearable device gained FDA clearance. Spry is a RPM device company with a wrist-wearable device that measures pulse oximetry, respiration, heart rate, and blood pressure (research only) through optical sensors. While users can receive reports on the display and alerts, it is primarily meant for clinical monitoring by physicians in healthcare systems. The RPM is meant to detect signs of patient deterioration and exacerbations early so that actions can be taken. For the present time, the company is focusing on the device’s use in COPD patients. Certainly there is a large market in the US–there are 12 million diagnosed patients, with COPD the third leading cause of death with over 120,000 deaths per year. Mobihealthnews, BusinessWire, MDDIOnline

Merck acquires Kenyan digital health startup ConnectMed. The pharma company is purchasing ConnectMed’s telehealth applications in Kenya serving about 8,000 consumers, as well as related management systems. Merck will use the platform in conjunction with its Curafa point of care clinical and pharmaceutical services. Started in September of last year, these are run by local independent pharmaceutical technologists, clinical officers and nurses for underserved populations in Kenya. ConnectMed will cease operations. During its lifetime, it developed three DTC digital health services in Kenya and South Africa. WT/Startup Africa

Telehealth and COPD: meta-study shows little QoL improvement

A review of studies on the use of telehealth interventions (generally remote patient monitoring but also education and pulmonary rehabilitation) with COPD patients is equivocal to somewhat negative on the effectiveness of telehealth on quality of life (QoL) improvement and positive impact on disease progression. Only three of the 18 studies surveyed showed statistically significant improvements, with the others showing no significant improvement. However, the researchers noted the low number of studies and that large-scale controlled trials would be called for; also at the end, they note that what might be more valid is the “comparison to absence of deterioration, relative to control groups, as a perhaps more realistically acceptable success criterion.” Stasis might be a better thing to evaluate given that COPD patients can deteriorate quickly without the right care. Published by a Danish research team at the International Journal of Chronic Obstructive Pulmonary Disease.  Dove Press open access. Also FierceHealthIT

Exploring how best to use telehealth to manage COPD – can you help?

Anyone working in telehealth knows that, of the principal long term conditions to which it is applied, COPD is the most problematic, with many telehealth trials showing no significant benefit. However in various meetings, Dr Julia Bott has tantalised me by suggesting that she and Dr Hilary Pinnock may know how to use telehealth more effectively.

Therefore, on 3rd March, we are holding a small, free, meeting at the Royal Society of Medicine in London from 3pm-5pm to examine how telehealth can be used to manage people with COPD better. Present will be both Dr Hilary Pinnock (University of Edinburgh) and Dr Julia Bott (University of Surrey).

So far we have senior representatives from two major telehealth organisations attending and probably need at least three more. If you are interested, please do email this editor, charles.lowe@btinternet.com, explaining why you’d like to join us for what I suspect may prove to be a groundbreaking event.

Ten years on from the WSD: is the future brighter for telehealth? Can wind farms help?

As Prof Mike Short pointed out recently, 2016 is the tenth anniversary of the start of the Whole System Demonstrator (WSD) programme that in retrospect, because of poor trial design, probably slowed the uptake of digital health in the UK more than any other single action. It seems appropriate therefore to look at how telehealth* has fared over that period, and perhaps even more importantly, is poised for the next ten years.

The mistakes of the WSD are well documented (eg here, here & here) – suffice it to say that it proved beyond all reasonable doubt, at least to this editor, that unlike medicine-based interventions, which seem less sensitive to their care pathway, digital health delivers most of its benefit through enabling a different, patient-centred care delivery, so every digital health intervention needs to be evaluated holistically, and in its own care pathway. Sadly over the ten years, much of the academic work looking at the benefits of telehealth has continued to evaluate the technology in the time-honoured way that medicines have been evaluated, with predictably largely equivocal results.

Those of us who have delivered telehealth projects though have a sense of disconnect as, time and again, a focused implementation – not a pilot – in which the staff delivering the service understand that it will be a permanent change for which they need radically to change the way they deliver care, yields huge returns on investments through savings typically in the 50-90% region. (more…)

Wing: a device that warns prior to asthma attacks

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2015/11/wing-device-964×644.jpg” thumb_width=”150″ /]A St Louis, Missouri startup, Sparo Labs, has developed what they term an ‘early warning device’ for asthma attacks. The Wing pocket-size sensor which connects to a smartphone app (iPhone 5 and later, Android soon) measure both peak flow (how fast you can blow out air) and FEV1 (how much air you blow out in 1 second). The app measures it against personal levels (80-100 percent of best is fine, 50-80 percent is caution and below 50 percent is red zone) so that a person (or caregiver) receives an accurate reading of their breathing level; if something is wrong, the person can take their medication and/or seek assistance. For the 10 percent of Americans who have difficulty breathing, not just from asthma but living with COPD, cystic and pulmonary fibrosis, bronchitis and other respiratory conditions, the Wing’s compact design and under-$200 price point won’t leave them breathless. Wing is financing/testing on Indiegogo with a 20 Nov goal of $50,000 ($32,000 to date), awaiting 510(k) FDA clearance with an in-market date of August 2016. PSFK blog, Gizmag,Hat tip to Toni Bunting, our former N. Ireland Editor. 

COPD Navigator app in pilot with Mount Sinai Hospital (NYC)

An app to help make life easier for a reported 24 million COPD patients in the US has been developed jointly by Mount Sinai Hospital, the affiliated National Jewish Health Respiratory Institute in New York and LifeMap Solutions. The COPD Navigator app encourages patient self-management through visualizing patient data and patterns, including symptoms, medication, treatment adherence, and quality of life, coupled with alerts about local air quality and weather which can dramatically influence risk. Patient data is transmitted to their physician, with an emphasis on fitting into office workflows. LifeMap is also tracking when the patient uses an inhaler through their self-designed Bluetooth LE device, though it uses any Apple HealthKit enabled inhaler. (more…)

An encouraging Australian RCT combining self-care and telemonitoring

A paper just published in the Journal of Telemedicine & eHealth (Volume: 19 Issue 9) entitled “Telehealth Remote Monitoring for Community-Dwelling Older Adults with Chronic Obstructive Pulmonary Disease” makes refreshing reading for those of us who still believe that a well-designed implementation of telehealth brings immense health benefit to those with chronic long-term conditions.

The authors, Kristen De San Miguel, Joanna Smith, and Gill Lewin, all from Western Australia describe a small RCT using Docobo kit that involved (more…)

So many apps, so little time

Over the past few days there seems to have been a particularly rich set of alerts related to mHealth apps (there’s even been an update to the mHealth Grand Tour website with a nice video to promote the tour that starts on 5th September). Adding to them a couple that others have kindly alerted me to, here are a few that might interest:

Let’s begin with an infographic on the rising popularity of mHealth apps that puts it all into context. However, in some countries mHealth is being held back by outdated privacy laws, and in the US lack of final FDA guidance is considered a check on progress.  If you ever wondered how much data your DNA, or your most recent scan contained, (more…)