46 percent of undiagnosed chronic disease discovered through corporate wellness program

A HealthMine survey of corporate wellness program participants found that 46 percent of respondents who were diagnosed with a previously unknown chronic disease discovered it as a result of their wellness program. Corporate wellness programs have been light on ROI metrics (many are at heart incentive programs). While the survey was conducted by a provider of these programs (HealthMine’s Automatic Health) and should be seen in that light, it also indirectly confirms the proactive value of health screenings. Employees want more as well. Participants in an earlier survey that they would like programs to offer vision (74 percent), genetic testing (75 percent), blood pressure (73 percent), cholesterol (69 percent), cancer (58 percent), and hearing (58 percent). The MedCityNews article also makes the excellent point that employers, through these wellness programs, are directly or indirectly accessing employee personal health information–a legally fraught area.

Medtronic favoring early-stage acquisitions, diabetes; American Well and Teva

Medtronic plc, now firmly planted in the Auld Sod of Ireland, reported a tidy $7.304 bn in its 4th quarter global revenue closing 24 April versus a prior year of $7.257 bn, with a net loss of $1 million. Their report yesterday (2 June) was primarily centered around the integration of Covidien and the foreign currency loss. Results were especially strong in the US with an 8 percent gain in fourth quarter. Earlier speculation that the major Covidien acquisition in addition to Corventis, Zephyr Technologies (through Covidien) and telehealth provider Cardiocom would slow future investments seems to be the direction CEO Omar Ishrak is taking, based on his comments during the analyst call. The Covidien strategy of making early-stage company acquisitions is to his liking and with new revenues from Covidien (and a more favorable tax domicile) certainly there is not a lack of funds despite a small loss in fourth quarter revenues. Another change from being a cardiac-centric device company is apparent in the growth area of global diabetes, shifting from pumps to diabetes management. They have a minority investment in diabetes manager Glooko, a partnership with IBM Watson Health for diabetes management, and acquired a Dutch clinic and research center, Diabeter. Jonah Comstock at Mobihealthnews has more on that call.

In a surprising move, Israel’s Teva Pharmaceuticals is putting a reported ‘tens of millions of dollars’ into American Well and their telemedicine (virtual consult) platform. The pharma interest at once may be narrow in utilizing these consults in clinical trials, but as we have seen with Merck’s telemedicine clinics in Kenya, there’s also a focus on monitoring critical medication at long distances. Late last year American Well completed an $81 million Series C, but it is not clear whether Teva is a part of this and the news is just now catching up. MedCityNews, Globes (Israeli business website)

Indian Health adopting telemedicine in Southern California for diabetes treatment

Tribal-owned Riverside-San Bernardino County Indian Health, which serves nine tribes through seven health centers in the ‘Inland Empire’ of California, is adopting telemedicine to reach Native American patients and reduce their rate of diabetes. According to an Indian Health spokesperson, Native Americans constitute the largest diabetic population in the world and are 177 percent more likely to die from the disease. In San Bernardino County alone, 13 percent of adults are diabetic, and nearly 80 percent are overweight or obese. The initial program brought endocrinologists serving other Western tribes in on video consults with doctors in Indian Health clinics. Later rollout of the program will include pulmonology, cardiology, gerontology and dermatology. The market potential for telehealth remote patient monitoring–better information and analytics for clinicians, self-monitoring training and education for patients–could be substantial here for companies willing to invest time, learning and to build relationships. California Healthline. FierceHealth IT

The hypealicious, hyperluxus Apple Watch debut–what the healtherati are interested in

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]L’œil de Gimlet eyes the Apple Watch. What’s down the road is more important than Monday’s unveil. Certainly The Eye, an adorer of all things over-the-top, would love to have the $10,000-and-up 18 karat, Daddy Warbucks, Solid Gold Cadillac edition of the Apple Watch. It is the sheer hyperluxus, Mercedes-Maybach S600-ness of it all that races my pulse. Stop at $4,000? Nein! $10,000 and up lends a golden glow to all those ordinary, plastic-banded, Mickey Mouse-faced $349 and up versions for the Applepolloi that take that pulse, burp your wrist when you’re not moving enough, open the garage door, play tunes and let you draw little thingies on the face that you can send to your friends. (Urp) What’s even better than a Merc-Maybach in Conspicuous Consumption-Ville? That it will be out of date in a year, unless Apple has a trade-in policy.

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/Tim-Cook-previews-the-App-008.jpg” thumb_width=”200″ /] Cue Tim Cook and the Happy Dance of the Watches. (Photo: Zuma/Rex via Guardian)

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/Apple-Goldfinger.jpg” thumb_width=”200″ /]Cue Shirley Bassey. (Gigaom via Twitter)

Ah, but let us get down to business and cut our swathe through the fog d’hype. (Editor Donna just walked in the door…)

As predicted and projected, the Apple Watch in stores 24 April in Australia, Canada, China, France, Germany, Hong Kong, Japan, UK and US goes light and standard on health measurement features: accelerometer, heart rate sensors, running and weekly activity reports. What’s different? Wrist burps you if you’re a lazy, sitting sod. (Not a great feature for deep meditators or napsters.) The leak from two weeks ago feinted health through downplaying the functionality of the Watch. Back in September, claims included blood pressure and stress monitoring. [TTA 18 Feb]

Now for the right cross. It’s not the Watch, it’s the ResearchKit. Apple gets serious in health apps beyond HealthKit, partnering with the stars in the medical research firmament. As reported: (more…)

Wearables blog – update

Since this editors’ piece on wearables four days ago there has been a stream of news about interoperability of various apps, resulting in frequent updates to the original blog, to the point where it was beginning no longer to resemble the original.

Chris Bergstrom of WellDoc has now kindly pointed me to the Mobihealthnews item on Samsung’s digital health partners announcement, and to his company’s specific interoperability announcement with Samsung, enabling activity and other data to be obtained from other Android apps to help those with diabetes to manage their condition better.

WellDoc of course developed the first prescription app – this item from mHealthWatch in turn based on a Telegraph article that suggests that GPs in the UK will shortly be prescribing apps for patients in large quantities. The source of the Telegraph’s intelligence is none other than Personalised Health and Care 2020, the recently published NHS document that we covered extensively yesterday, which was perhaps a tad less optimistic about medical app take-up.

Are wearables starting to deliver?

If you caught the recent Wired article entitled Wearables Are Totally Failing the People Who Need Them Most, you may have felt a sense of deep depression that a sector growing as strongly as it is is apparently delivering so little real health benefit (you may also be depressed to see the world of apps developers described as “From Silicon Valley and San Francisco to Austin and MIT…” although remember the North American-based Major League Baseball is called the World Series). The thrust of the article is that young people are developing wearables for people like them, who are then stopping using them within a few months, whereas those with long term conditions (LTCs) who are not the target customers are actually the ones using wearables consistently. As they say: (more…)

The sun is in his heaven and all’s well with the world?

It’s tempting to think that nothing much has changed in the world of telehealth & telecare recently. For example the quality of healthcare PR looks to be unchanged, if the recent announcement by Telehealth Sensors is anything to go by. They claim to have developed  an incontinence sensor that is “a revolutionary advancement in the home healthcare and post-acute care monitoring market.” Careful reading suggests this “revolutionary advancement” is based on the property of water, apparently only recently recognised by Telehealth Sensors,  that it conducts electricity (especially if its impure) – so advanced in fact that such sensors with a rather longer lifetime than the 30 days claimed by Telehealth Sensors, have (more…)

Unhappy endings: where even innovation cannot make a difference

This week’s sad news of the death of comedian/film star Robin Williams and his ongoing battles with addiction and depression are the center of this thoughtful article by EIC Veronica Combs in MedCityNews. Even with access to the best care and innovations such as virtual visits, Mr Williams committed suicide. The larger point made is that access and healthcare innovation don’t mean automatic adoption or a positive outcome. Some of those with chronic physical or mental illnesses choose not to change their behaviors, comply with a regimen or even to seek help, much less seek out technology or be a QSer. And some are simply beaten down and depressed by the perpetual Battle of Stalingrad that is chronic disease–ask any diabetic [TTA 5 Apr 2013]. Her conclusion is that though innovation may not help everyone, it doesn’t mean we should not pursue it. And, this Editor would add, for developers to realize that they must make technologies simple and affordable enough–‘tear down that wall’–so that those who won’t access help become fewer. (And, yes, there is a spiritual aspect of care that must be addressed–see VOX Telehealth’s work with HealthCare Chaplaincy Network TTA 25 July.)

Update:  Other factors may have tipped Mr Williams’ depression flare-up. The first (more…)

mHealth: too much to blog, too little time

As always the question is where to start? Perhaps with the FT headline ‘Powerhouse’ UK leads Europe app development, says research, a piece by Daniel Thomas on some research sponsored by Google & Tech City UK. A full version of the report is here. Key findings are that the UK:

  • Has become the largest tech hub in Europe for app development;
  • Received a third of revenues generated from mobile software in Europe last year;
  • Is the base for almost a fifth of European developers of smartphone applications;
  • is believed to be the world’s second most important tech hub after the US;
  • Has about 8,000 companies involved in app development, employing close to 400,000 people.

Apparently almost half of app developers and designers in the UK generate most of their income from apps, although a fifth generate no income from apps at all but rather see them as a hobby.

Staying with the FT, Prof Mike Short has kindly also pointed this editor to another article entitled (more…)

Another ‘bionic pancreas’ in test

Another possible weapon against the Continuing Battle of Stalingrad faced by diabetics is in test in the Boston area. A system developed by associate professor of biomedical engineering at Boston University Dr. Edward Damiano (whose son has Type 1 diabetes), and assistant professor at Harvard Medical School Dr. Steven Russell has a sensor inserted under the skin that relays hormone level data to a monitoring device which sends data to an app on the user’s smartphone every five minutes. The app calculates required dosages of insulin or glucagon to maintain optimal blood sugar levels, and communicates the information to two corresponding hormone infusion pumps worn by the patient. Their target for FDA approval and rollout is 2017. Gizmag. Previously Editor Charles and this Editor have written about Diabetes Assistant and two other systems in clinical trials, which also are bringing this to a closer reality [TTA 20 Aug, 5 Aug]

eHealth not rocket science: former rocket scientist (Australia)

Prof. Michael Georgeff is the aforementioned rocket scientist (actually the Program Director for the Space Shuttle’s control software) who is now CEO of Precedence Health Care. The company has developed what they claim is the first-ever chronic disease management network, cdmNet, accessible via broadband and mobile. Instead of controlling the shuttle, cdmNet controls the workflow end-to-end from care plans to follow up including all documentation. It is part of the Collaborative Care Cluster Australia initiative and is also the core technology infrastructure for Australia’s Diabetes Care Project. Post-discharge and chronic disease management integration into hospital/practice workflows is of course a huge issue elsewhere in the world, and perhaps the solution is found Down Under. eHealthSpace.org

Quick Tuesday takes on health tech

Long-term sensors, smart thermometers and the Scanadu Nirvana

The first study of long term use of carbon nanotubes as implanted sensors has been published in Nature Nanotechnology. The nanotubes were implanted for a year in animals to track nitrous oxide (NO), an indicator of inflammation which is important in and of itself, but the level of NO is also not understood long term in cancer. To detect NO, the tubes are wrapped in DNA with a particular sequence and wrapped in an alginate gel to stay in place for a recorded 400 days. The MIT team working on this is also working on nanotubes for real-time detection of glucose levels, towards an accurate insulin pump that would end the diabetic’s perpetual Battle of Stalingrad. MIT News and FierceHealthIT.

The Kinsa smart thermometer for iPhone and Android received a glowing article in Fast Company Design. (more…)

An infographic that tackles medication adherence well

This Vitaphone item does a most creditable job of getting behind the common misperception, covered in previous posts, that people don’t take medicines because they forget.

For me it doesn’t however address the issue of beliefs quite strongly enough though. To give an extreme example, when I worked in Newham there were people who believed that illnesses were supernaturally visited on them because of things their forefathers had done. To expiate those things, they had to suffer stoically.  The end result was that, even when diagnosed, medication prescribed and lifestyle advice given, some patients allowed eminently treatable conditions such as diabetes to deteriorate rapidly, unless those beliefs were addressed effectively.

A ‘mobilized’ artificial pancreas breakthrough?

Neil Versel (again) profiles a mobile platform that may be the start of the end of the Continuing Battle of Stalingrad for type 1 diabetes patients.  The prototype system, Diabetes Assistant (DiAs), is a closed-loop system which combines a modified Android phone with wirelessly connected wearables attached on the skin–Dexcom glucose monitors and Insulet OmniPod insulin pumps- to effectively act as an artificial pancreas. It was developed by University of Virginia’s Center for Diabetes Technology with funding via The Juvenile Diabetes Research Foundation and the National Institutes of Health’s National Institute of Diabetes and Digestive and Kidney Diseases. Findings of the 20 patients monitored were initially presented at June’s American Diabetes Association’s annual scientific meeting and published in the July edition of the journal Diabetes Care (PDF does not require subscription). The system was designed by an international team:  Sansum Diabetes Research Institute in Santa Barbara, Calif., University of Padova in Italy and the University of Montpellier in France.  Tests continued with summer campers and the integration of Bluetooth LE into the connectivity system.  Mobihealthnews article.

But can this small miracle of a system be hacked–and can providers be held accountable? This scary thought of ‘harm or death by hacking’, with the example given of an insulin pump gone awry–was tagged at the 2011 Hacker’s Ball, a/k/a Black Hat USA by Jerome Radcliffe [yes, in TTA back in August 2011]. The late Barnaby Jack was also on the medical device hack track. The danger is only now entering the consciousness of medical administrators and the industry press in mainstream venues such as Information WeekAre Providers Liable If Hacked Medical Device Harms A Patient? (Healthcare Technology Online). Also Kevin Coleman in Information Week tells more about the liability providers may find themselves in if they don’t update their systems.

Both the diabetes closed-loop systems under development (Diabetes Assistant is one of three) and the hacking threat were addressed by Contributing Editor Charles earlier this month [TTA 5 August] in his examination of how systems should move from decision support to decision taking in order to truly reduce patient or caregiver burden.

Gestational Diabetes Telehealth trial at John Radcliffe Hospital, Oxford (UK)

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/07/John-Radcliffe-Hospital.jpg” thumb_width=”150″ /]Diabetes in pregnant women, known as gestational diabetes, is said to have significantly increased over the past 20 years and affects 1 in 20 pregnant women in the UK. This  is probably caused by an excess intake of carbohydrates, says Dr Lucy Mackillop of John Radcliffe Hospital, in an interview in Inside Health on BBC Radio 4, broadcast on 23 July 2013.

A foetus growing in a high sugar environment can lead to an overweight baby resulting in birth difficulties. Such babies may also develop problems such as diabetes in later life. Gestational diabetes also carries all the usual dangers of diabetes for mother.

If a pregnant woman has one of 5 risk factors she will be fully tested for diabetes and if she is diabetic, she will be monitored during preganancy. Monitoring typically may be a fortnightly hospital visit, but at the John Radcliffe there is a trial of 50 mothers who have been given special blood sugar meters which connect to smart phones via Bluetooth.

A daily blood sugar test result is transmitted to the hospital where software picks out patients that may need attention by a midwife, and changes to the treatment regime can be implemented if necessary. This saves many unnecessary hospital visits while giving a much more frequent review of the state of the patients.

Download the full programme from the BBC Radio 4 podcast page.