TTA’s week: pop health en español, ATA’s choice, VA’s Cerner, de-retailing healthcare, more

Will the doctor’s office go the way of the retail store, even in NJ? Can we improve population health through telephone call centers? Will the UK get its mojo back in digital health innovation? Can the VA implement Cerner by 2019? And will ATA appoint a new CEO before then?

Only two weeks to go to Connected Health Summit 2017 in San Diego–save 20%. See below.

Beyond crowdfunding–startup funding through blockchain cryptocurrency, smart contracts (The Next Big Funding Thing?)
Commonwealth Fund case study on Spanish-speaking telemedicine services (MX, PH, US) (Population health south–and north–of the border)
Tender Alert: Torbay and South Devon NHS Foundation Trust for TECS (Looking for innovative telehealth)
VA’s Shulkin: Cerner rollout start by mid-2019? (The decision was a relief)
Innovate UK’s £35m Digital Health Technology Catalyst competition opens–apply now! (Another opportunity in UK healthcare)
Weekend Big Read: will telemedicine do to retail healthcare what Amazon did to retail? (Except there’s regulation…)
Tender Alerts: NHS Wales, Southend-on-Sea (More for innovative companies in UK)
Analyses of New Jersey’s new telemedicine regulations (Not quite parity, but a forward leap)
Some reflections on ATA and a future CEO–your ‘nominations’ wanted! (Name that CEO!)

Winners and losers…VA implements more telehealth, Israel gets its first aging services venture fund. Charterhouse loses equity in Tunstall, ATA’s Linkous leaves, Siemens delays the Healthineers and Theranos plays for time.

VA unveils several ‘anywhere’ new telehealth services for veterans (VA tech moves fast under Dr. Shulkin)
First aging services tech investment fund debuts in Israel (3rd Age tech)
Change at the top at ATA: CEO Jon Linkous departs after 24 years (Didn’t give notice either)
Charterhouse lost half its equity in Tunstall debt refinancing–Sunday Times report (updated) (Not unexpected)
Siemens plans IPO of Healthineers during 2018, possibly in US: reports (Expectations delayed)
The Theranos Story, ch. 44: Walgreens settles lawsuit, cash box empties further (The spiral to Flat Brokedom continues)

It’s an IoT Black Hat hackfest, Facebook bots learn argot, AI is debated after a fashion by ‘giants’, and Tunstall gets a partner that opens doors.

It’s all hackable by Black Hats: pacemakers, Amazon Echo, trains, heart monitors, prison cells! (Increasingly easy pickings)
AI good, AI bad (part 2): the Facebook bot dialect scare (Not all that…)
AI good, AI bad. Perhaps a little of both? (Top six effects) 
Tunstall pairing with Inhealthcare digital health for NHS remote monitoring (A shot of digital high-octane for the Big T?)


Connected Health Summit: Engaging Consumers analyzes the roles of connected health technologies and innovations in driving changes in consumer behaviors and business models. Now in its fourth year in beautiful San Diego, this event is focused on data-driven, human-centric patient experience and engagement. Keynoters include executives from Aetna, UnitedHealth, ShareCare and Geisinger. Readers save 20 percent! For more information, click on the advert or here.


Confirming football CTE, thinking ‘digital therapeutics’. Glass reboots, Fitbit and social robotics back up, TSA changes guard. Mindful (or mind your?) drinking, and catch up with The King’s Fund.

CTE found in 99% of former, deceased NFL players’ brains: JAMA study (News in both health and sports sections)
Shouldn’t we be concentrating on digital therapeutics rather than ‘health apps’? (A different look at the future of digital health)
The King’s Fund 2017 Digital Health Congress: videos, presentations now posted (Catch up!)
Fitbit’s smartwatch on track; Intel exits the game (Were they ever in?)
Can Google Glass’ enterprise iteration solve the patient documentation crisis? (Hands off help for hands-on workers)
Toyota’s $14 million bet on Intuition Robotics’ social companion robot (JP/IL/US) (ElliQ’s growing up)
Come along to London’s first mindful drinking festival! (Hic!)
TSA appoints new chair (Paul Shead takes the helm)

Recent articles of continued interest….

Creepy data mining on medical conditions run wild: where’s the privacy? (Ethically dubious practices)
UDG Healthcare buys American, adds Vynamic, Cambridge BioMarketing for up to $67 million (Acquisition trend for healthcare consultancies and marketing)
“Crazy”: StartUp Health’s 2nd Q digital health funding breaks record (Another round of champs and roses! Can it last?)

‘Record-shattering’ Q2 for digital health deals: Rock Health’s volte-face (Suddenly it’s wine and roses!)
Conference & Tender Alert: Perth & Kinross TEC event, Flintshire (Wales) tender (UK) (TEC event Sept 26, tender Aug 4)
‘Let me die at home’. The human and financial cost of ending telehealth (Cornwall UK) (A familiar, no less wrenching story to those who’ve worked in telehealth–the books don’t balance)

The Nightingale-H2020 project for wireless acute care (UK/EU) (Major initiative, get on it before tender)


Have a job to fill? Seeking a position? Free listings available to match our Readers with the right opportunities. Email Editor Donna.


Read Telehealth and Telecare Aware: http://telecareaware.com/  @telecareaware

Follow our pages on LinkedIn and on Facebook

We thank our present and past advertisers and supporters: Tynetec, Eldercare, UK Telehealthcare, NYeC, PCHAlliance, ATA, The King’s Fund, HIMSS, MedStartr, HealthIMPACT, and Parks Associates.

Reach international leaders in health tech by advertising your company or event/conference in TTA–contact Donna for more information on how we help and who we reach. See our advert information here. 


Telehealth & Telecare Aware: covering the news on latest developments in telecare, telehealth, telemedicine and health tech, worldwide–thoughtfully and from the view of fellow professionals

Subscribe here to receive this Alert as an email on Wednesdays with occasional Weekend Updates. It’s free–and we don’t lend out or sell our list–no spam here!

Donna Cusano, Editor In Chief, donna.cusano@telecareaware.com, @deetelecare

– – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – – –

Tunstall pairing with Inhealthcare digital health for NHS remote monitoring

click to enlargeA digital link of hope for Tunstall’s future? Announced at The King’s Fund Digital Health & Care Conference but oddly not receiving much notice was the UK collaboration of Tunstall Healthcare and Inhealthcare. Inhealthcare builds infrastructure for digital health services, and currently works extensively with multiple NHS regions and programs, such as the North of England Regional Back Pain Programme, NHS England’s Sheffield City Region Test Bed and the Darlington Healthy New Town project. Their services include telehealth monitoring for INR, COPD, medication reminders, a smartphone app platform, chronic pain management, and a surprising one that addresses undernutrition in older adults. The Tunstall-Inhealthcare objective is to integrate health and social care with clinical care systems in six areas: LTC home monitoring, identifying vulnerable patients, involving family members, 24/7 clinical care coordination centers, post-discharge management, and digital health at home innovation. Also noted is that Inhealthcare has programming technology that can reduce the time to build out services and apps.

Inhealthcare Ltd is part of Intechnology plc, owned by Peter Wilkinson, who has developed several UK internet and technology companies at scale–Planet Online, Freeserve, and Sports Internet (now Sky Betting and Gaming). Tunstall release

Q1 digital health investment: two perspectives from StartUp Health and Rock Health

StartUp Health’s and Rock Health’s investment/M&A roundups from Q1 2017 have just hit the deck. Before we dig into them, let’s start with the differences in methodology:

  • Rock Health tracks deals only over $2 million in value; StartUp Health seems to have no minimum or maximum; the latter includes early stage deals at a lower value.
  • StartUp Health gathers in international deals at all levels, whereas Rock Health includes only US-funded ventures.
  • Rock Health omits healthcare services companies (citing Forward, Oscar), biotech/diagnostic companies (GRAIL, Theranos), and software companies not solely focused on healthcare (Zenefits)
  • StartUp Health defines ‘digital health’ differently than Rock Health, with categories of ‘patient/consumer experience’, ‘wellness’, ‘personalized health/quantified self’, and ‘research’

StartUp Health is ‘over the moon’, breathlessly (appropriately as the home of the 25-year Health Moonshot) with Q1 trending, seeing the biggest investment quarter since 2010 at $2.5 bn. Topping up this number was GRAIL, which is developing a blood test for early cancer detection, with a massive Series B at $914 million. Far behind it in the $85-110 million range were (in descending order) Alignment Healthcare (population health), PatientsLikeMe (patient/consumer experience), Nuna (big data/analytics), and PointClickCare (EHR). Population health, patient/consumer experience, and research top their investment activity. Most deals are still seed and Series A (59 percent), but that is down five points from full year 2016; Series B’s share is up three points to 25 percent. But it remains a difficult bridge to cross to C+ rounds.

Rock Health splits the difference and calls it ‘business as usual’, surprised that there hasn’t been a tailspin. Its Q1 sandwiches between 2016 and 2015, well above 2015 but trending 23 percent below Q1 2016. Their biggest deals include the aforementioned Alignment, PatientsLikeMe and Nuna, omitting GRAIL and PointClickCare. Their top three investment categories are analytics/big data, care coordination, and telemedicine (over $50 million). Rock Health tracked almost 20 M&A, noting that many transactions are now ex-California. They also uniquely track public company performance. Here in 2016 is where Readers first noted weakness in NantHealth, but Fitbit and Castlight Health also had miserable quarters. Teladoc, Evolent Health (consulting), and Care.com had a good winter as well. Let’s see what Q2 brings.

HealthIMPACT’s upcoming events for 2017 (US)

The HealthIMPACT series of mainly single-day events on health tech/HIT’s effect on healthcare now covers several major cities in the US. What this Editor likes about them is that they compress a great deal of information in a single day, with well-presented, relaxed panel discussions with top executives and figures in the industry. They are also held in interesting venues like the Union League Club in NYC. Panels are being hosted this year by former colleagues from Health 2.0 NYC Megan Antonelli of Purpose Events and “The Healthcare IT Guy” Shahid Shah, with new vice chair Mandi Bishop, a HIT entrepreneur who was a Challenge Competitor at #MedMo16. Here’s the HealthIMPACT schedule with links to the individual events:

HealthIMPACT Southwest
Texas Medical Innovation Center | TMCx
April 4th, 2017  Receive a 20% discount off registration–use HIEB2017

HealthIMPACT Southeast
Florida Hospital Innovation Lab, Werner Auditorium, Orlando, FL
May 4th, 2017

HealthIMPACT East
Union League Club, New York, NY
June 5th, 2017 (note that this is a new date, changed from the date on the website)

HealthIMPACT WISE/Women in Information Science Retreat
Sundance Mountain Resort, Sundance, UT
June 23-25, 2017

HealthIMPACT Midwest
Matter Health, Chicago, IL
September 14, 2017

HealthIMPACT West
San Francisco, CA, October 7, 2017

TTA is a media partner of HealthIMPACT for 2017.

What is the future of digital technology in NHS England for the haves and have-nots?

This thoughtful essay published on The King’s Fund blog by David Maguire discusses the uncertain way forward for digitizing health within NHS England as part of the sustainability and transformation plan (STP). There’s a certain lack of vision and support from the top; there is £4.2 billion in funding over the next five years from the Department of Health, but priorities including ‘Paperless by 2020’ are unclear. There needs to be a ‘clear and definitive plan’, but at the same time, local innovation shouldn’t be stifled. Local areas vary widely in capability and resources. As Mr Maguire points out, some are still using Windows XP and others are well advanced in data analytics; some are more willing to take risks and have a “collective vision”. In a funding-constrained environment, local areas may find themselves scraping up, pooling resources to create the systems they need, and sharing that knowledge. Seizing opportunities for digital development in the NHS Hat tip to Susanne Woodman.

A reminder that the Digital Health and Care Congress is on 11-12 July. Preview video and the event page; the Digital Health Congress fact sheet includes information on sponsoring or exhibiting. To make the event more accessible, there are new reduced rates for groups and students, plus bursary spots available for patients and carers. TTA is again a media partner of the Digital Health Congress 2017. Updates on Twitter @kfdigital17

British Journal of Cardiology (BJC) Digital Healthcare Forum’s inaugural meeting

28 April, 9:30am-5pm, Royal College of Obstetricians and Gynaecologists, London 

Henry Purcell of the BJC was kind enough to post us with information on the first-ever BJC Digital Healthcare Forum. Organized by the BJC in association with the NHS, the Digital Health and Care Alliance (DHACA), and the Telehealth Quality Group, it is a novel ‘hands on’ meeting to assess if digital medicine can fill gaps in healthcare provision throughout the NHS. It is also in response to the massive pressures which winter has wrought on NHS health and social services. The Forum was designed by clinicians and leaders in healthcare informatics for UK commissioners, doctors and other HCPs involved in the management of long-term conditions (cardiovascular, obstructive pulmonary disease, diabetes etc.), as well as those engaged in health informatics, IT, and Trust CEOs. Speakers include Dr Malcolm Fisk of De Montfort University, our own Charles Lowe of DHACA, Professor Tony Young, National Clinical Director for Innovation (NHS England) and many more experts in digital health and care. For the latest information and to register, see the event website or the attached PDF.

What are the impacts of NHS CCGs forcing disabled and LTC patients into care homes? (UK)

click to enlargeCare for elderly and disabled goes off the tracks again. A report in the Health Service Journal (subscription required), covered in an opinion piece in the Guardian, indicates that thousands of patients who are disabled and also those who require long-term care may be forcibly put into care homes (US=nursing homes) rather than being treated and maintained in home care. According to the HSJ, “Freedom of Information (FOI) requests from campaign group Disability United found that 37 NHS clinical commissioning groups (CCGs) in England were introducing rules about ongoing care that could force up to 13,000 people with health conditions into care homes.” CCGs due to NHS cuts have been setting limits on financing home care, between 10 and 40 percent above the care home option. In other words, where a care home is cheaper, the CCG will withdraw payment for home care, and unless the individual can self-pay or has an advocate who can organize a care plan, that person may be involuntarily moved.

The word ‘institutionalization’ deservedly strikes fear on both sides of the Atlantic as a recipe for patient decline, physical and verbal abuse, theft and generally bad care. It’s a blunderbuss solution to ‘bed-blocking’ which we discussed here [TTA 7 Sep 16]–the care plan becomes ‘move ’em out’. By going this way in policy, NHS England is going counter-trend, against more personalized care delivered in home settings, and setting an unfortunate trend for other countries like the US.

Outside the scope of the article, but in this Editor’s thoughts, is the knock-on effect it will have on the UK’s developers and providers of telehealth and telecare services/TECS designed to support home care. Many of these technologies are in a transition period to the greater capabilities (and freedom from land line) of digital from analogue care, which was discussed in TTA here. Cutting domestic demand may not only be critical not only to companies’ survival, but also to their expansion in the (now far more open to the UK) US market. Readers’ thoughts?

CES 2017

The Consumer Electronics Show is half a century old this year and it click to enlargeis promising to be the biggest show yet. Here are some items that may be of interest to TTA readers.

The conference programme includes a Digital Health Summit and a Wearable Tech Summit (the organisers obviously haven’t been reading the TTA view on wearables so recently produced by Editor Donna). In the Digital Health Summit the top topics are going to be advances in genomics and precision medicine (not sure why this is digital health), Digital medicine and current trends such as “tele-everything”, wearables, aging, digital therapies (what’s that?) and VR. The wearable Summit top topics are the science of wearables, hottest wearable tech thus far and interactive jewelry.

There is a new “Sleep Tech Marketplace” presented by the National Sleep Foundation (no, really, I am not making this up) with 10 companies exhibiting everything from sleep tracking devices (Beddit), a system to mask noise during sleep (Cambridge Sound Systems), ultra thin earphones to wear in bed (Dubs Labs), a water mattress-topper to keep you cool while you sleep, an app to record your dream talking and snoring (Snail App) and a stress reducer.

If you are not attending between tomorrow and the 8th, then you could do worse than follow it on the official CES website or on engadget

NYeC Digital Health Conference (NYC)–next week

NYeC Digital Health Conference, 6-7 December 2016 | New World Stages, New York, NY
The New York eHealth Collaborative’s Digital Health Conference brings together 500 senior-level healthcare industry leaders to learn about new innovations and to foster dynamic conversation addressing how healthcare is being redefined through technology. It is well on track to fill completely, so if you’ve been delaying your booking, now is the time. And our readers enjoy a 10 percent discount.

Updated and expanded agenda here.

Keynote speakers:
• Robert Wachter, MD, Professor and Interim Chairman of the Department of Medicine, University of California, San Francisco, author of “The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine’s Computer Age” [TTA 16 Apr 15]. (To this Editor, this is a must-see keynote!)
• Steven Johnson, PBS Host and Bestselling Author, “How We Got To Now” and “Where Good Ideas Come From”

Some other speakers: Carol Raphael, the former CEO of Visiting Nurse Service of NY; Kristopher Smith of Northwell Health; James Mault of Qualcomm Life and Aron Gupta of Quartet Health. This year a who’s who of New York’s healthcare and health tech community will gather for two days of networking, lively intellectual exchange, and exploration to see what’s new, what’s cutting edge and what will shape the future of healthcare.

It’s worth taking the trip to NYC for this right before the holidays! For more information, click here for the website.

Telehealth & Telecare Aware Readers receive a 10% registration discount. Click on this link or the sidebar advert. Important–use code TTA when registering. For updates, @NYeHealth. TTA is a conference partner/media partner of the NYeC DHC.

Health tech’s disruptive power in pictures

click to enlarge

One of our Readers works for an agency that developed, under the direction of home care provider CEO Ryan McEniff, a digital health infographic which is packed with facts on how technology is changing healthcare processes, hopefully for the better. It’s a little lengthy but it covers how many tasks will be automated, workforce changes, global investment highlighting the US, Singapore, Canada and Australia, leading accelerators, startups and companies, how markets are accepting technology and the international challenges. What you need for your next meeting! Courtesy of Minute Women Home Care  (@MWhomecare) of Lexington, Massachusetts, Ryan and reader Veronika Gorina. Full infographic follows.

(more…)

Who’s hiring? 3rings (UK)

Steve Purdham, who is the Chairman of 3rings, is advising our readers of two new Business Development Manager opportunities with his company.

The ‘Internet of Things’ is going to change the future of care and 3rings is at the centre of this fantastic opportunity. Due to expansion in its operation, 3rings, is looking for two ambitious BDM’s to join our digital team. If you have passion to change things then contact Steve on steve@3rings.co.uk

Full details @ https://news.3rings.co.uk/?p=237

3rings has developed and markets an electrical plug that, when the appliances are used, tracks a person’s activities of daily living. The information is delivered to the 3rings app so that family, friends and neighbors not only know of normal behavior but also when something is ‘off’. (Our past two years of coverage is here.)

A couple more grant opportunities for SMEs

This editor was recently rendered temporarily speechless by an entrepreneur who complained that there was no money available any more to help him start his business. Upon recovering my power of speech I suggested he read Telehealth & Telecare Aware more avidly as we publicise many grants, awards, accelerators and other types of assistance. Here are two more:

mHabitat

mHabitat are launching a Digital Development Lab to accelerate the adoption of digital technologies in mental health.

They anticipate working with around six to eight Digital Development Lab participants over approximately seven months who will have access to a share of a £400k grant to accelerate their technology towards endorsement and adoption by NHS services and service users.

The Lab is open to applications from innovators (more…)

Mobile brain monitoring developments and impact (Israel)

Accelerator/healthcare innovator StartupHealth’s ongoing series Startup Health Now! (#94) interviews Israeli entrepreneur Nathan Intrator, founder of Neurosteer, on developing new applications for brain monitoring in TBI cases, the impact home monitoring will have on patients and Israel’s burgeoning digital health scene. Highlights from the 18 minute video from this past June at Wearable Tech + Digital Health Conference, New York, NY include applications to monitor those who are minimally conscious to assist doctors in treatment; how data from remote patient home monitoring can detect early stage problems so that doctors can take proactive care, reducing cost and disruption; and Israel’s digital health ‘corridors’. Video

Autumn/winter UK health tech events–Extra #1

SEHTA (South East Health Technologies Alliance), one of the largest healthcare networking organizations in the UK, has two upcoming digital health-related events of interest to those in London and the Southeast. Hat tip to Clare Ansett of SEHTA for the details.

London Innovation Surgeries 26 Sept at Queen Mary University, London. There are only two spots left so act quickly. More information here. SEHTA is in partnership with Kent Surrey Sussex Academic Health Science Network (KSS AHSN), GLA, MedCity, Digital Health.London and Enteric HTC.

How to Access Funding 12 October at City Hall, London. This is a ‘how to’ workshop on finding funding from crowdfunding to public/private sector. Partners are KSS AHSN, GLA, MedCity and Digital Health.London. More information here. Free but limited registration.

 

Add 3 years to ‘Paperless 2020’: Robert Wachter at The King’s Fund (UK)

The King’s Fund has helpfully published a report on the (duelling?) presentations at last week’s NHS Health and Care Innovation Expo by Robert Wachter, MD, the ‘digital doctor’ (our review of excerpts from his 2015 book here), and Secretary of State Jeremy Hunt on the feasibility of paperless health records. There is plenty of funding (£4.2 billion) for NHS.UK announced earlier this year, but plans are still sketchy. The adoption of the GOV.UK Verify service used in other parts of the UK government is intended to “standardise the process to activate patient accounts without the need for them to visit a GP surgery in person”. NHS is having another crack at an app library, and there was a bit of surprise, according to the writer, that Secretary Hunt said that fitness data will be integrated into NHS patient records. But Dr Wachter cautions that he’s walking back the 2020 date he advocated for full paperless records to 2023. He recognized that implementation in all but the most advanced hospitals (a handful) isn’t feasible. There are too many competing priorities and too little funding (and, this Editor would add, too many HIT threats like hacking and ransomware). Only the most “digitally-sophisticated hospitals” would be invited to be ‘global exemplars’ in exchange for matched funding, in his view. The King’s Fund will be publishing more about this later in September, presumably as a prelude to their upcoming Designing digital services around users’ needs on 6 Oct.  Wachter watch Hat tip to Reader Suzanne Woodman

Patient engagement: a digital divide in health technology accessibility

click to enlargeGuest editor Sarianne Gruber (@subtleimpact) scopes the ‘digital divide’ separating those who need health services the most from the patient engagement and other tools they need in this article. The studies are US, but the lessons apply anywhere in the world. This Editor notes that many patient engagement tools are over-designed and over-complicated for users, even if they are fairly competent and frequently use online and mobile. (I entered a ‘pilot’ of a stress reduction program which proved to be anything but–and quitting because it is invasive and the reporting is ludicrously burdensome.)

To developers: Imagine your patient engagement platform being used by a person on the less sophisticated, less educated and disconnected end of the spectrum–or by someone less able due to physical (vision, touch) or cognitive impairment. Put on bad glasses and gloves–and start. Better yet, find a few people and put it in front of them. If we can make the mental shift in developing mobile apps for Africa or India, certainly we can do so for Americans, Britons and Europeans.

What the Studies are Showing

Hallmarked as a solution to improve healthcare quality, cost and safety, studies are showing health technology is up against a “digital divide” when it comes to patient engagement. At the Internet Governance Forum, Pew Research Center’s Lee Rainie, Director of Internet, Science and Technology Research presented the Fact Tank Report discussing the “digital divide” that exists in 2016. The report documents that lower income, less educated, non-white, seniors and rural communities are the least likely to have home internet, home broadband, mobile connectors and smartphones. This summer’s medical publications, the Journal of the American Medical Association and the Journal of the American Board of Family Medicine, released studies where demographic and socioeconomic data marked the root causes to limited or no access to digital technology, thus hindering the benefits and improved outcomes it can bring to the neediest and most costly populations. Here are the highlights from each study.

Trends in Seniors’ Use of Digital Health Technology in the United States, 2011-2014, a research letter submitted from Harvard Medical School’s Brigham and Women’s Hospital, appeared in the August 2, 2016, JAMA. Authors, David M. Levine, MD, MA, Stuart Lipsitz, ScD, and Jeffrey A. Linder, MD, MPH,FACP made mention that this study, based on the National Health and Aging Trends survey (NHATS), was exempted from the Partners HealthCare Human Research/IRB Committee. The research team included participates to the longitudinal NHATS survey in 2011. The participants were re-surveyed annually on everyday (nonhealth) and digital health use until 2014. The research team acknowledged that this may be the first nationally representative study to examine trends in the adoption of digital health technology by seniors age 65 years and older who are community-dwelling Medicare beneficiaries.

Here are some the reported statistics from the study: (more…)