VA unveils several ‘anywhere’ new telehealth services for veterans

The new Veterans Affairs Secretary, David Shulkin, has wasted no time since his appointment in introducing several technology and mobile-based services at the VA, all of which are long overdue in this Editor’s estimation:

  • Anywhere to Anywhere VA Health Care will authorize telehealth consults and cross-state care for veterans no matter their location and regardless of local telehealth restrictions. VA is already the largest provider of telemedicine services (called VA Telehealth) in 50 specialties to 700,000 veterans annually. This new regulation will enable VA to hire primary care and specialist doctors in metro areas to cover veterans in rural or underserved areas. 
  • Rolling out nationally over the next year is the VA Video Connect app where veterans can use their smartphones or home computers with video connections to consult with VA providers. At present 300 VA providers at 67 hospitals are using it.
  • The Veteran Appointment Request (VAR) app will also roll out from its test. It will enable veterans to use their smartphone, tablet or computer to schedule or modify appointments at VA facilities nationwide.

Dr. Shulkin advocated these programs while undersecretary, especially ‘Anywhere to Anywhere’, which required advice from the Justice Department. VA’s technology is also being supported by the American Office of Innovation to improve care transitions between the Defense Department and VA. 

President Trump participated in the announcement with Dr. Shulkin and sat in on between Albert Amescua, a 26-year Coast Guard veteran at a VA clinic in Grants Pass, Ore., and Brook Woods, a VA internist in Cleveland. VA announcement with videos, POLITICO Morning eHealth, HealthcareITNews

Shouldn’t we be concentrating on digital therapeutics rather than ‘health apps’?

Where the money and attention are going. The first generation of Quantified Self apps was all about viewing your data and storing it online in a vault or graphs…somewhere, usually proprietary. Your Pebble, Fitbit, or Jawbone tracked, you crunched the numbers and found the meaning. At the same time, there are wellness companies like Welltok, ShapeUp, Keas, Virgin HealthMiles, and RedBrick Health, usually working with companies or insurers, that use various methods (money, gamification, other rewards) to influence lifestyle and improve a person’s health in a quantified, verifiable, but general way. What’s happened? There are now apps that combine both data and behavior change, focusing on a specific but important (again) condition, coach to change behavior and verify results rigorously through clinical trials. Some, like Omada Health, prove through those clinical trials that their program successfully changes pre-diabetic indicators, such as weight loss, decrease cholesterol and improved glucose control–without medication. This results in big savings for insurance companies, one reason why a $50 million Series C was led by Cigna. Another model is to work with pharmaceutical companies to better guide treatment. Propeller Health with its asthma/COPD inhaler tracker is partnering with pharma GlaxoSmithKline on a digital platform to better manage lung patient usage, and surely this will go through a clinical trial. We will be seeing more of this type of convergence in medical apps. (The rebooted Jawbone Health Hub is moving in this exact direction.) The Forbes article, while short, is written by someone who knows the business of apps– the co-founder of the AppNext distribution/monetization platform. He does achieve his aim in making us think differently about the potential of ‘health apps’. 

Blue Cedar releases new security for health apps, built into the app

click to enlargeFor healthcare organizations, device and app developers, one stumbling block for apps has been securing data. The endpoint for security has been to secure and manage the device, which constrains widespread BYOD use and convenient downloading. What if, instead, the apps and the data on them were secured without needing to further secure the device? This is what Blue Cedar, a mobile security developer, has done with what they call a mobile device management (MDM) alternative, with security ‘baked into the app”.

One of their first for the new platform is MedStar Health, the largest healthcare provider in the Maryland and Washington, DC region. Blue Cedar’s MDM enabled them to secure their mobile app for clinicians that contained protected patient information (PHI) yet run securely on personal mobile devices.

Blue Cedar’s Chief Product Officer, Chris Ford, spoke with this Editor and explained that their new platform (V3.14) works through injecting a security code in the mobile app, which enforces policy on encryption and use. Their Enterprise Mobility Management (EMM) can now incorporate support for secure apps on unmanaged devices, security and connectivity for VoIP-based apps, and enforcement of granular controls for HTTP-based apps. This and other features of the new platform will permit healthcare app developers to distribute apps through sites like the Apple Store or Google Play and “trust functionality” that allows control of data sharing between apps on the same device.

Blue Cedar spun off last year from IoT security company Mocana, founded in 2002, and now has over 150 customers in multiple verticals. They believe their MDM alternative is ideal for healthcare organizations and health app/wearable developers, recently adding representation in the UK and Europe. Release (PDF)

6th Global mHealth App Developer Economics Study–early results in

click to enlargeresearch2guidance has shared with the Editors some of the preliminary results of the 6th Global mHealth App Developer Economics Study. Currently at 2,000 participants and open till the end of May (click here to take the 15 minute survey), it has grown to be the largest global market study of the sector. (Last year’s study topped out at more than 5,000 industry respondents and is available as a free download here.) For their time, respondents can view initial results upon completion of the survey, after publication in 2nd Quarter receive a copy of the report and be automatically entered into their prize draw of an Apple Watch or Samsung Gear.

Many of the results to date are neatly summarized in the infographic at left and below:

  • 61 percent believe mHealth solutions can cut costs through therapy adherence
  • 65 percent believe mHealth adoption could save costs by shortening or avoiding hospital visits
  • Market potential as a distributor: app stores still lead (61 percent) but half believe health insurers are now second. Doctors and hospitals trail at 42 percent and 38 percent respectively.
  • Most positive impact: following up and monitoring of conditions; information provision; diagnosis and treatment
  • But goals are still distant: 53 percent of respondents revealed they had only “partly achieved their goals”. 4 percent claimed their mHealth “dreams came true”. (Perhaps those who had their companies acquired? — Ed.)

r2g release.

TTA and DHACA (Editor Charles, Managing Director) are media partners for this study. Hat tip to Sean Phillips of r2g. Previously in TTA, Charles’ original article.

A gallimaufry of short digital health items to start the day with

The WHO has produced an excellent report on the state of eHealth in the European region, including a review of telehealth readiness. Ericsson have produced a very interesting report confirming what I guess anyone will have realised if they’ve traveled by public transport or have children: young people downloading video content are driving a surge in data usage: there’s much detail here though. Both are well worth the read.

Mentioning Ericsson reminds that the Telegraph recently produced a summary of the 20 best-selling mobile phones of all time – takes you back, with the substantial number once produced by Nokia.

The Royal Society of Medicine has it’s fifth annual medical app conference on April 7th – numbers booked have already well exceeded last year’s sellout so they are expecting to fill this year’s much larger conference venue. The focus this year is on the many legislative, regulatory and voluntary measures being introduced that will impact medical apps – there’s still room for old favourites though, such as Richard Brady’s always-topical (more…)

Health tech innovations are doing little for baby boomers

click to enlargeWonder why the duck is upside down and sinking? Maybe it’s looking for all that transformative tech! Versus The King’s Fund sunny article above is Laurie Orlov in Boomer Health Tech Watch. Her POV is that as of right now, health tech innovations are not moving the needle for obese (39 percent) and chronically diseased US baby boomers. They aren’t downloading health apps and wearing wearables. Workplace wellness programs? Au contraire, they make us feel less well (Harvard Business Review) and anxious that we’re getting spied on by the company. Maybe we realize that All That Data isn’t secure (healthcare being a Hacker’s Holiday Camp), so we’re not playing the game. And the cost of care that the ACA was supposed to level off? Not if you’re a self-insured Boomer struggling to pay an ever-higher monthly premium, or even in a corporate high-deductible plan, paying increased deductibles, restricted networks, ever-higher treatment costs and fighting your insurer at nearly every turn. Add to that safety risks of procedures, mistakes compounded by EHRs [Dr Robert Wachter, TTA 16 April]  and (not mentioned) hospital-acquired infections. No wonder investment has cooled. Health and tech innovations do little for baby boomers

Does current digital health meet baby boomers needs and wants?

The answer, according to health tech industry analyst Laurie Orlov (Aging in Place Tech Watch, Boomer Health Tech Watch) is…not really. Despite its massive size (76 million in the US), spending power (by 2017, 70 percent of US disposable income), breadth (1946-64) and need (despite living longer, by 2030 37 million will be managing more than one chronic condition), most health apps, especially fitness apps, don’t resonate with boomers despite over 50 percent having smartphones. The reasons are many–they’re complicated, often hard to follow, view, and abandonment across all ages is still high. Even among Fitbit purchasers, abandonment is fully one-half. As income decreases, smartphone access also becomes a cuttable budget item. Much more in this paper published by the California Healthcare Foundation.

Better’s fast fail, ending health assistance service 30 Oct

click to enlargeBetter is sadly not. This two-year old service that provided personal health assistance, including a real, live health assistant, to guide members through health questions, the thickets of insurance claims, finding doctors and specialists, apps and more, announced earlier this week that it was ending operations as of 30 October. While it was announced via their Twitter feed on Tuesday, most of the industry learned of it through Stephanie Baum’s article in MedCityNews today. Better formally debuted only 16 months ago [TTA 23 Apr 14] and at the time this Editor felt that it was a service in the right direction, a kind of ‘concierge medicine for the masses’ needed when individuals have to direct more and more of their own care.

A solid start, as our Readers have seen, does not guarantee success, but this fast fail is still fairly shocking. A concern at the time was the pricing for the full service model at $49/month, which later became the family price (individuals were $19.99/month). CEO/co-founder Geoff Clapp was among the most Grizzled of Health Tech Pioneers; he had been a co-founder of Health Hero/Health Buddy from 1998 to its sale to Bosch Healthcare, a very long pull in telehealth, and he had spent much of his post-Health Hero time generously advising other startups. Yet despite the involvement of blue chip Mayo Clinic as a service provider, its financial backing from their investment arm and socially-oriented VC Social+Capital Partnership, it managed to raise only its initial seed funding of $5 million (CrunchBase).

So what happened? (more…)

IMS Health report: mainstream health app adoption remains elusive

click to enlargeDespite 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.

UK, Nordics lead best EU countries for mHealth business: survey

Respondents to research2guidance’s fifth annual mHealth Economics survey rated UK and the Nordic countries the best for mHealth market success, based on factors of market readiness and maturity including doctors and consumers. Other top countries were Sweden, the Netherlands, Denmark and Finland. Germany and France were significant because of market size and investment in healthcare. According to the survey where over 5,000 healthcare app publishers and health professionals ranked countries on multiple points, “In UK, Sweden, Denmark and Netherlands doctor’s acceptance of apps and high level of digitalization are seen as main drivers. Germany is attractive mainly because of its substantial market size and its big number of potential users.”click to enlarge

Findings were presented this week at the mHealth Summit in Riga, Latvia and is the first part of a larger study on developer economics and future healthcare delivery. As a media partner, TTA participated starting in March in inviting respondents to the survey. A free download of the report is available to our readers here (minimal registration required). Release

All about the fitness devices with Parks Associates, Juniper Research

Fitness trackers are hot, hot, hot.

So Parks Associates‘ latest study tells us, with 60 million US households expected to own at least one by 2019 (hey, only 4 years away!) with global revenues exceeding $5 billion. Of that, smartwatches will constitute 100 million units. Given that only 7 million Android-based watches have been sold to date, and that the Apple Watch is projected to be about 10 million (2.3 million sold to date, according to ZDNet which glows away), that may actually be–achievable. POLITICO Morning eHealth also reported from their interview that about one-fifth of smartphone and tablet owners use a health app on a monthly basis, and 19 percent of smartphone owners find a “master” health app that aggregates data from other health apps appealing. Parks release.

In the UK, of Juniper Research’s top five smart wireless devices, three have a relationship to health, with the Apple and Google-TAG Heuer smartwatches on the high end and GOQii Fitness using their or anyone’s watch or fitness band to keep you on track for the price of their subscription. Less karma than when we saw them last June at CEWeek, more coaching. The apps will be the primary generator of revenue in fitness-band land, with hardware margins declining in the next few years. (Speaking of revenue, Juniper’s full study will set you back a tidy £3970.)

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

click to enlargeL’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.

click to enlarge Cue Tim Cook and the Happy Dance of the Watches. (Photo: Zuma/Rex via Guardian)

click to enlargeCue 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…)

Participate in the 2015 Global mHealth App Developer Economics Study

click to enlargeTTA readers are invited to participate in the fifth annual mHealth App Economics survey, sponsored by research2guidance in collaboration with mHealth Summit Europe and HIMSS. The study will look at the mHealth app market, how apps generate revenue, how behavior could be changed by apps, the use of APIs and sensors as well as other related topics–and is the largest industry survey on mHealth app development.

Click here to go to our exclusive link and participate in the survey. The survey is available till 26 April. Share your opinions and experience on how mHealth apps impact healthcare delivery now and in the next five years. Plus, every participant will receive the chance to win one of five free entry tickets to the mHealth Summit Europe in Riga, Latvia 11-12 May, where the results will be presented; a free copy of the 2015 report as well as the possibility to see initial results after completing the survey. Download link for the 2014 study (PDF).

TTA is a media partner of the 2015 Global mHealth App Developer Economics Study, and was a media sponsor of this year’s US mHealth Summit.

UK’s Best SME Mobile Health APP Finals on Monday 2nd February

The shortlist judging for the above, entries for which we sought in December, will take place on the afternoon of Monday 2nd February from 2pm to 7pm in St Bride, St London. Attendance is free, and offers an unparalleled opportunity to listen to the pitches of what are considered the twelve best SME mobile health apps in the UK. Details are here – do be sure to scroll down to click the ‘book now’ button as places are limited.

The judges (disclosure: of whom this editor is one) will select those SMEs to go forward to the finals at the MWC in Barcelona in the first week in March.

The event is sponsored by UK Trade & Investment, techUK, and PatientView/myhealthapps

Health apps presently of little use, says Australian telehealth expert

click to enlarge“Immature” and “focused on low-lying fruit such as fitness tracking and not focused on the big issues of management of disease” are also two of the compliments that Dr George Margelis of the University of Western Sydney’s TeleHealth Research & Innovation Laboratory (THRIL) has bestowed on the current state of health apps. Until the collected data ‘plugs into other digital platforms’–he mentions the Australian government’s PHR, eHealth–apps will not help those who need it the most. “Unfortunately, managing these diseases, in particular the chronic diseases that are a major part of the current burden, requires more than just tracking a few physical parameters which is what the app world is up to.” Dr Margelis called for collaboration between app developers and healthcare professionals; while he scores Apple’s HealthKit, that may be the means to make his vision come true. It should be noted that Dr Margelis (more…)

Insomnia Apps: A replacement for sleeping pills?

sleepstation

For those of us suffering from insomnia there’s no denying it can be a real pain! For some it means wakening up a number of times throughout the night, while others are unable to get back to sleep after only a few hours rest. In my case it means drifting off into a peaceful slumber before inevitably waking just minutes later with a jolt, looking like Frankenstein’s monster and wondering if someone just hit me up the face with a bolt of lightning!

The latest NHS approved sleep app is Sleepstation. It’s one of three listed on the NHS Choices Health Apps website, the others are Sleepio and Sleep Diary. (more…)