TTA’s Spring Fever Week: NHS App report, CVS-Aetna’s merger lingers in court, digital health events blossom in New York, New Orleans–and for two weeks in Leeds

 

 

With a touch of spring fever, we round up events from a two-week digital health festival in Leeds to ATA in New Orleans. CVS-Aetna’s merger continues to linger in a Federal court. And the NHS App report is overall positive for its rollout later this year–but Microsoft’s HealthVault is rolling into history.

And scroll below for news of The King’s Fund’s Digital Health and Care Congress, including Matt Hancock as keynote speaker on day 2. Plus 10% off registration for our Readers!

NHS App’s pilot results: renewing prescriptions good, making appointments…not so much (Plus the demise of Microsoft HealthVault)
Leeds Digital Festival 2019: a two-week showcase of digital health and care (Quite an annual show across town!)
Spring is here, so are some events to enjoy–and broaden your horizons (From New York to New Orleans) 
Drawn-out decision on the CVS-Aetna merger held up again in Federal court (Examined up, down, and sideways in a Federal court–since October)

Fortune and Kaiser Health News take down EHRs and the havoc the wreak on doctors and patients. Our weekly news roundup looks at diabetic VR training in Wessex, telemental health in Australia, GreatCall’s health ambitions–and prescribing apps is baaack!

EHRs: The Bridge to Nowhere–other than despair. An investigative Must Read on ‘an unholy mess’. (The reality settles in, and it’s worse than you thought, whether you’re a doctor or patient)
News roundup from all over: prescribing apps is back! Plus telemental health Down Under, GreatCall’s health tech strategy, Wessex’s diabetic sim, telehealth growth outpaces urgent care

It was a busy week for acquisitions and investments–perhaps the health tech bubble is staying at a reasonable size–for now. The post-Nokia Withings is definitely wide awake with sleep tracking.

News roundup: Teladoc acquires MédecinDirect, Blue Cedar closes $17M Series B, Hill-Rom buys Voalte, Withings bolsters sleep tracking (Real but not crazy money on the line here. And Withings isn’t snoozing.)

Telemedicine Has Two Faces: the good in expanding mental health and preventing rehospitalizations in long-term care–and the very bad in delivering end-of-life news to an elderly patient.

Suddenly hot, redux: mental health telemedicine in long term care, analytics to help predict rehospitalizations in skilled nursing facilities (A traditional provider adds telemedicine, three new SNF tech companies preventing rehospitalizations)
A telemedicine ‘robot’ delivers end of life news to patient: is there an ethical problem here, Kaiser Permanente? (An insensitive use of good technology gets bad press for both)

A government study on tech to enable aging independence that actually may be useful. Meanwhile, the FBI is warning that Hackermania is running wild over healthcare. AliveCor’s KardiaMobile succeeds in UK’s EDs. And that music you have on to concentrate may be doing exactly the opposite.

A useful White House study released: ‘Emerging Technologies to Support an Aging Population’ (Big topics and tech approaches without the fluff)
Hackermania ‘bigger than government itself’–and 25% of healthcare organizations report mobile breaches (We ought to be doing better by now)
Smartphone-based ECG urged for EDs to screen for heart rhythm problems: UK study (Give the patients mobile ECG monitors to take home)
Listening to music impairs verbal creativity: UK/Sweden university study (Those headphones are not helpful if you’re trying to think)

Chronic condition telehealth monitoring is suddenly hot–again. When will digital health ethics be more than talk-talk? No more faxes, no more pagers in the NHS. Surprise! Consumer behavior should drive health tech. Plus late spring events + Connected Health Summit speaking opportunities.

Suddenly hot: chronic condition management in telehealth initiatives at University of Virginia and Doctor on Demand (We’ve been here before)
Events, dear friends: MedTech London, Aging 2.0 Philadelphia, speakers wanted for Connected Health Summit (More for your calendar from late winter into late summer)
First they came for the fax machines….now NHS is coming for the pagers (Pretty soon it will be the stethoscopes, the furniture…)
The King’s Fund Digital Health and Care Conference announces Matt Hancock as Day 2 keynoter (He’s everywhere!)
About time: digital health grows a set of ethical guidelines (But how to put it into action beyond the nice meetings and draft principles?)
A short but canny look at consumer behavior as a driver of health technology (Design that fits into life–what a notion!)

Rounding up HIMSS and the millennial/Gen Z healthcare mindset. It’s wall-to-wall Theranos for the next few weeks. And we bid farewell to a fine (if over-parodied) actor with our video advert.

News roundup: of logos and HIMSS roundups, Rock Health’s Digital Health Consumer Adoption survey, and the millennial/Gen Z walkaway from primary care (Increasingly not trad, dad)
The Theranos Story, ch. 58: with HBO and ABC, let the mythmaking and psychiatric profiling begin! (updated) (A deluge of Theranos Analysis)
From our archives: a long buried advert (RIP Bruno Ganz) (Editors Steve and Donna salute a fine actor and fine movie–remembered, humorously)

 


The King’s Fund’s annual Digital Health and Care Congress is back on 22-23 May. Just announced–Secretary Matt Hancock keynoting Day 2. Meet leading NHS and social care professionals and learn how data and technology can improve the health and well-being of patients plus the quality and effectiveness of the services that they use. Our Readers are eligible for a 10% discount using the link in the advert or here, plus the code Telehealth_10.


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, Health 2.0 NYC, MedStartr, Parks Associates, and HealthIMPACT.

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

Thanks for asking for update emails. Please tell your colleagues about this news service and, if you have relevant information to share with the rest of the world, please let me know.

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

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

TTA’s Week: the sheer, screaming misery of EHRs, for doctor and patient–and news from Australia, Wessex, and GreatCall

 

Fortune and Kaiser Health News take down EHRs and the havoc the wreak on doctors and patients. Our weekly news roundup looks at diabetic VR training in Wessex, telemental health in Australia, GreatCall’s health ambitions–and prescribing apps is baaack!

And scroll below for news of The King’s Fund’s Digital Health and Care Congress, including Matt Hancock as keynote speaker on day 2. Plus 10% off registration for our Readers!

EHRs: The Bridge to Nowhere–other than despair. An investigative Must Read on ‘an unholy mess’. (The reality settles in, and it’s worse than you thought, whether you’re a doctor or patient)
News roundup from all over: prescribing apps is back! Plus telemental health Down Under, GreatCall’s health tech strategy, Wessex’s diabetic sim, telehealth growth outpaces urgent care

It was a busy week for acquisitions and investments–perhaps the health tech bubble is staying at a reasonable size–for now. The post-Nokia Withings is definitely wide awake with sleep tracking.

News roundup: Teladoc acquires MédecinDirect, Blue Cedar closes $17M Series B, Hill-Rom buys Voalte, Withings bolsters sleep tracking (Real but not crazy money on the line here. And Withings isn’t snoozing.)

Telemedicine Has Two Faces: the good in expanding mental health and preventing rehospitalizations in long-term care–and the very bad in delivering end-of-life news to an elderly patient.

Suddenly hot, redux: mental health telemedicine in long term care, analytics to help predict rehospitalizations in skilled nursing facilities (A traditional provider adds telemedicine, three new SNF tech companies preventing rehospitalizations)
A telemedicine ‘robot’ delivers end of life news to patient: is there an ethical problem here, Kaiser Permanente? (An insensitive use of good technology gets bad press for both)

A government study on tech to enable aging independence that actually may be useful. Meanwhile, the FBI is warning that Hackermania is running wild over healthcare. AliveCor’s KardiaMobile succeeds in UK’s EDs. And that music you have on to concentrate may be doing exactly the opposite.

A useful White House study released: ‘Emerging Technologies to Support an Aging Population’ (Big topics and tech approaches without the fluff)
Hackermania ‘bigger than government itself’–and 25% of healthcare organizations report mobile breaches (We ought to be doing better by now)
Smartphone-based ECG urged for EDs to screen for heart rhythm problems: UK study (Give the patients mobile ECG monitors to take home)
Listening to music impairs verbal creativity: UK/Sweden university study (Those headphones are not helpful if you’re trying to think)

Chronic condition telehealth monitoring is suddenly hot–again. When will digital health ethics be more than talk-talk? No more faxes, no more pagers in the NHS. Surprise! Consumer behavior should drive health tech. Plus late spring events + Connected Health Summit speaking opportunities.

Suddenly hot: chronic condition management in telehealth initiatives at University of Virginia and Doctor on Demand (We’ve been here before)
Events, dear friends: MedTech London, Aging 2.0 Philadelphia, speakers wanted for Connected Health Summit (More for your calendar from late winter into late summer)
First they came for the fax machines….now NHS is coming for the pagers (Pretty soon it will be the stethoscopes, the furniture…)
The King’s Fund Digital Health and Care Conference announces Matt Hancock as Day 2 keynoter (He’s everywhere!)
About time: digital health grows a set of ethical guidelines (But how to put it into action beyond the nice meetings and draft principles?)
A short but canny look at consumer behavior as a driver of health technology (Design that fits into life–what a notion!)

Rounding up HIMSS and the millennial/Gen Z healthcare mindset. It’s wall-to-wall Theranos for the next few weeks. And we bid farewell to a fine (if over-parodied) actor with our video advert.

News roundup: of logos and HIMSS roundups, Rock Health’s Digital Health Consumer Adoption survey, and the millennial/Gen Z walkaway from primary care (Increasingly not trad, dad)
The Theranos Story, ch. 58: with HBO and ABC, let the mythmaking and psychiatric profiling begin! (updated) (A deluge of Theranos Analysis)
From our archives: a long buried advert (RIP Bruno Ganz) (Editors Steve and Donna salute a fine actor and fine movie–remembered, humorously)

The Topol Review’s relationship to reality explored by Roy Lilley. Robotics effects in therapy for children with autism and CP. The wind’s even more at the back of telehealth–but there are caveats. Plus Editor Charles is back with a UK digital health roundup.

Roy Lilley’s tart-to-the-max view of The Topol Review on the digital future of the NHS (This week’s Must Read)
Robots’ largely positive, somewhat equivocal role in therapy for children with autism and cerebral palsy (HIMSS)
The wind may be even stronger at the back of telehealth this year–but not without a bit of chill (VA, Virginia as indicators–and the hurdles when you get there )
A selection of short digital health items of potential interest (Editor Charles is back with views on AI and events)

The telehealth entrepreneur and the $5 million fraud = 15 years in prison. Scotland’s Current Health wins FDA clearance, Latin America telemedicine’s uncertain state, women in eHealth, and studies on digital health in health systems.

News roundup: Current Health’s Class II, Healthware Italy’s €10 million boost, the low state of Latin America telemedicine, weekend reading on digital health in health systems
Digital health versus eHealth: ‘here we go again’ with the confusion and the differences. Plus Women in eHealth (JISfTeH) (Reviving the terminology discussion)
The telehealth ‘entrepreneur’ whose $5 million funding bought stays at the Ritz and portfolios at Bottega Veneta (And 15 years in the Federal pen. Tell your mum or uncle to be wary of good stories)

 


The King’s Fund’s annual Digital Health and Care Congress is back on 22-23 May. Just announced–Secretary Matt Hancock keynoting Day 2. Meet leading NHS and social care professionals and learn how data and technology can improve the health and well-being of patients plus the quality and effectiveness of the services that they use. Our Readers are eligible for a 10% discount using the link in the advert or here, plus the code Telehealth_10.


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, Health 2.0 NYC, MedStartr, Parks Associates, and HealthIMPACT.

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

Thanks for asking for update emails. Please tell your colleagues about this news service and, if you have relevant information to share with the rest of the world, please let me know.

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

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

EHRs: The Bridge to Nowhere–other than despair. An investigative Must Read on ‘an unholy mess’.

If you hate your EHR, think it’s swallowing your information, adding hours to your day, and if you don’t watch it, you’ll make an error, you’re not a Luddite. You’re right. An exhaustive investigation by Fortune and Kaiser Health News (KHN) concludes that it’s ‘an unholy mess’. In fact, even if you are not a physician or clinical staff, it will make you wonder what was going on the collective brains of the digerati, Newt Gingrich, Barack Obama–and the US government–in thinking that EHRs would actually “cut red tape, prevent medical mistakes, and help save billions of dollars each year,” committing $36 billion to pursuing the ‘shovel-ready’ HITECH stimulus in the depths of the 2008-9 recession. Perhaps the shovel should have been used on a body part. Now if only those billions went towards an interoperable, useful, and national system rather than a money giveaway–which even Farzad Mostashari, then ONC deputy director and later director, now admits was “utterly infeasible to get to in a short time frame.” (Mr. Mostashari is now head of Aledade, counseling those mostly independent practices which lined up–hungry or terrified–for meaningful use EHR subsidies on how they can continue to survive.) Even the vendors were a bit queasy, but nothing was stopping HITECH. (Your Editor was an observer of the struggle.)

Now that we have been living with them for over a decade, EHRs have been found culpable of:

  • Soaring error rates, especially in medication and lab results
  • Increasing patient safety risks in lack of pass-through of critical information
  • Corporate secrecy, enforced by system non-disclosures, around failures
  • Lack of real interoperability–even with regional HIEs, which only exchange parts of records
  • Incomplete information
  • A very real cognitive burden on doctors–an Annals of Family Medicine study calculated that an average of 5.9 hours of a primary care doctor’s 11.4 hour working day was spent on the EHR
  • Alert fatigue
  • Note bloat
  • Plain old difficulty or unsuitability (ask any psychiatrist or neurologist)
  • A main cause of doctor burnout, depression, and fatigue–right up to high suicide rates, estimated at one US physician per day
  • Lack of patient contact (why the scribes are making a good living)
  • All those dropdowns and windows? Great until you click on the wrong one and find yourself making a mistake or in the wrong record.

Not even the head of the Centers for Medicare and Medicaid Services is immune. Seema Verma’s husband, a physician, collapsed in the Indianapolis airport. She couldn’t collect his records without great difficulty and piecing together. When he was discharged, he received a few papers and a CD-ROM containing some medical images, but without key medical records.

A long read for lunch or the weekend. Death by a Thousand Clicks: Where Electronic Health Records Went Wrong. Also the accompanying essay by Clifton Leaf

AI as patient safety assistant that reduces, prevents adverse events

The 30 year old SXSW conference and cultural event has been rising as a healthcare venue for the past few years. One talk this Editor would like to have attended this past weekend was presented by Eric Horvitz, Microsoft Research Laboratory Technical Fellow and managing director, who is both a Stanford PhD in computing and an MD. This combination makes him a unique warrior against medical errors, which annually kill over 250,000 patients. His point was that artificial intelligence is increasingly used in tools that are ‘safety nets’ for medical staff in situations such as failure to rescue–the inability to treat complications that rapidly escalate–readmissions, and analyzing medical images.

A readmissions clinical support tool, RAM (Readmissions Management), he worked on eight years agon, produced now by Caradigm, predicts which patients have a high probability of readmission and those who will need additional care. Failure to rescue often results from a concatenation of complications happening quickly and with a lack of knowledge that resemble the prelude to an aircraft crash. “We’re considering [data from] thousands of patients, including many who died in the hospital after coming in for an elective procedure. So when a patient’s condition deteriorates, they might lose an organ system. It might be kidney failure, for example, so renal people come in. Then cardiac failure kicks in so cardiologists come in and they don’t know what the story is. The actual idea is to understand the pipeline down to the event so doctors can intervene earlier.” and to understand the patterns that led up to it. Another is to address potential problems that may be outside the doctor’s direct knowledge field or experiences, including the Bayesian Theory of Surprise affecting the thought process. Dr Horvitz discussed how machine learning can assist medical imaging and interpretation. His points were that AI and machine learning, applied to thousands of patient cases and images, are there to assist physicians, not replace them, and not to replace the human touch. MedCityNews

Weekend Must Read: How an EHR in a teaching hospital gave a patient a 39X overdose

Weekend reading and a banquet for your consideration.

Though computers can and do improve patient safety in many ways, the case of Pablo Garcia vividly illustrates that, even in one of the world’s best hospitals, filled with well-trained, careful and caring doctors, nurses and pharmacists, technology can cause breathtaking errors.

This one began when a young physician went to an electronic health record and set a process in motion that never could have happened in the age of paper.

From The Overdose: Harm in a Wired Hospital by Robert Wachter, MD (Medium.com Backchannel), Part 1 of 4

The situation is a pediatric patient with a severe chronic illness, with multiple symptoms requiring multiple medications to control, admitted to University of California San Francisco (UCSF). The article is a case history of the chain of events, both technological and human, that led to an severe overdose of a routine antibiotic medication, which the patient had already been maintained on for years, nearly killing the child. You will see, with horror, how every check-and-balance failed in the prescribing and dispensing procedure, and why.

Dr Wachter is not only chief of the medical service and chief (more…)