Health data changes Down Under: My Health Record, Tim Kelsey and Telstra

Australia’s federal government is hoping for a boost to its national personal health records system, starting with a renaming of Personally Controlled Electronic Health Record (PCEHR) to My Health Record. Proposed in the government’s $485 million budget announcement on eHealth is a resolution of implementation issues and introducing trials of participation models including designing opt-out approaches. Currently enrollment stands at a paltry 10 percent of Australians. Computer World (Australia) Hat tip to Mike Clark via Twitter

Come December, also taking the long trip there will be NHS England national director for patients and information Tim Kelsey to join Telstra Health as commercial director. Telstra is Australia’s largest telecom developing a footprint in health, and earlier this year acquired Dr Foster LLP, the UK-based health informatics company. Coincidentally (?), Mr Kelsey co-founded Dr Foster prior to 2006, when he joined the NHS to start up the information site NHS Choices. During his NHS tenure, Mr Kelsey faced numerous controversies which are detailed in the Guardian and IT news/opinion site The Register reports, mainly concerning the Care.data database for all English medical records. Concerns were raised about inadequate privacy, transparency and confidentiality provision in its design, and after a halt it has still not restarted, although 1 million people have preemptively opted out–another issue in common with My Health Record. According to the Guardian, “The scheme was recently labelled “unachievable” by a Whitehall watchdog, the Major Projects Authority, which said the future of the programme should be reassessed.” A successor to Mr Kelsey has not yet been named.

Telemedicine: critical massing or déjà vu, dear Humans, too?

A veritable blitz of telemedicine advocacy articles have appeared in the past week in leading healthcare and business publications. All of them promote telemedicine as a mix of consumer friendly (rapid care from anywhere at relatively low cost), a solution to the paucity of primary and specialty care in rural America, and contributing to quality affordable care. They both point out the increasing acceptability of the online consult (75 percent of consumers favor in a recent Cisco survey) and by doctors (60 percent). The writers are former Senator, Majority Leader and practicing surgeon Dr Bill Frist, and Dr Boxer is the chief telehealth officer of Pager and chief medical officer of Well Via. Health Affairs (Frist) and Wall Street Journal (Boxer).

Of course, do you need a human doctor at the other end, or will Humans do? The University of Southern California has tested Ellie, a virtual human,who’s been successful at getting patients to report honestly to her–more honestly than to real people.  (more…)

Should patients manage their own care records? RSM 4th June

Like the banking industry 10-15 years ago, Healthcare providers are coming to realise that if they start to provide intuitive software that can be used on consumer devices, then people (patients) will start to do more of the work (for free) that the Healthcare Industry currently has to pay for. These unpaid workers will be motivated by a desire for greater transparency of their own health and care information, and the ability to manage that information in the most efficient and effective ways possible; with the ultimate aim of improving their care quality and overall wellness.

This means that they will need something other than an EHR to do this, something that is constructed with the service user in mind, not the clinician. Something that makes it easy for them to see the interactions that they have had, the resultant actions, and the future planned interactions that are to come. Something that when they enter the highly fragmented world of UK care provision, allows them to have immediate access to the core elements of information that any other care provider would need. (more…)

Epic Systems getting into the app store business (US)

Epic Systems, the #1 company in the hospital and large practice EHR business, is launching its own app store, reportedly within a few weeks. This opens up interesting possibilities not only for mHealth app developers–who need application standards and guidelines soon–but also for Epic’s reputation as a closed system that shies away from interoperability with other EHRs like Cerner, Meditech and McKesson–a serious wrinkle with their Department of Defense EHR joint bid with IBM to replace AHLTA. The HIT Consultant article quotes a leading Epic customer consultant on that the first apps will be clinical, then crossing over into consumer; the latter seems an obvious move with PHRs (personal health records) as part of Meaningful Use requirements.

TMD–too much data–going nowhere

Here is a tech-savvy person lamenting (ranting?) in Venture Beat that there’s no one place to put all of his health data that he needs–weight, PHR (personal health record), his spin class and aerobic training data. AppleHealth/Apple HealthKit? Only the weight via a Withings scale maps to it, and you have to scroll past oodles of data categories, such as your molybdenum levels, to get to more vital things like weight and heart rate. FitBit lasted three months in his life before being tossed in a drawer. What took center stage at International CES were more devices dumping more data that doesn’t map into a central database. He acidly notes that Apple HealthKit is free because it is is worthless. Is there something broken here that we in telehealth need to deal with, quickly? My health data is killing me (figuratively) Hat tip to Tom Greene posting in The King’s Fund LinkedIn group Digital Health and Care Congress, this year 16-17 June. A reminder–call for papers closes 13 Feb!

Health apps presently of little use, says Australian telehealth expert

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2014/10/Margelis.jpg” thumb_width=”120″ /]”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…)

Box.com’s odd swerve into healthcare cloud storage and PHRs

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /] Both The Gimlet Eye (filing from a remote island) and Editor Donna have been pleased users of the Box.com file storage site for storing all sorts of files in the ‘cloud’ (a/k/a Somewhere Out There On A Whole Bunch Of Internet Servers), sharing and collaboration. It’s simple to use, it works and, for our needs, actually free. However founders Aaron Levie and Dylan Smith, who look barely old enough to shave (but smartly have A Touch of Grey in their management team), have their eyes set on far bigger prizes than our mediocre needs. Now they have added ‘special advisers’ Aneesh Chopra, first US CTO, and Glen Tullman, former CEO of Allscripts. Mr. Tullman certainly does add major luster (and connections) and Mr. Chopra, despite the Eye’s consideration of him as hyperbolic and politically, not technically, qualified for his previous positions in the Government and the state of Virginia, adds the inevitable political ones. Having them on the roster also adds heft to their imminently rumored IPO (TechCrunch; update, filed 24 March) and ultimately acing out other file sharers Dropbox in the enterprise area. Expectations are high; Box has $414 million in funding from a roster of investors (including Telefónica and Australia’s Telstra) through a Series F (CrunchBase) with a valuation of $2 billion (TechCrunch) and undoubtedly they’d like some of it back. Soon. (The completely overheated Castlight Health IPO only whets the appetite.)

Healthcare one key to a rich IPO. Box’s healthcare moves point in the enterprise direction. (more…)

MMR Global vs. Nehta, Round 2 (US/AU)

[grow_thumb image=”http://telecareaware.com/wp-content/uploads/2013/03/saved-by-the-bell1.jpg” thumb_width=”125″ /]Ding! The Australian reported last week that Nehta (National E-Health Transition Authority) is defending itself against charges by PHR company MMRGlobal that it has not responded to information earlier requested from and supplied by its operating company MyMedicalRecords and its licensee in Australia. MMRG is claiming that Nehta’s planned national PHR system will infringe upon patents held in Australia. According to The Australian article, Nehta’s chief Peter Fleming said that they learned of the claims only on 7 February and that MMRG had “nothing solid” to back them up:  “MMRGlobal has never contacted us at all and indeed our understanding is that they’re investigating a potential claim but have nothing solid” and “we’ve obviously taken a look at their patents, both from an architectural and a legal perspective, and have obviously briefed our lawyers to investigate, but certainly this company has not contacted us at all … We undertook very detailed analysis through third parties who put the standards in place around the world.”  The Australian (access via MMRGlobal website) Robert Lorsch, MMRGlobal CEO, has of course put on a full court PR press to counter this involving Australian singer Guy Sebastian and what appears to be a global awareness program to underscore the importance of a PHR–and their patents/IP–with Australian revenues being directed to a charitable foundation including charities Mr. Sebastian already supports. Guy Sebastian Speaks Out About MMRGlobal Patent Investigation in Australia (MarketWire via NBCNews.com) TTA recent related on MMRG: pre-HIMSS (26 Feb) and lawsuit update (20 Feb).

PHRs, ‘meaningful use’ and patent infringement (US)

MMRGlobal CEO Robert Lorsch’s interview by HIStalk today is a fascinating follow-up to our recent stories in several areas. First is the story of how he came to found MMRGlobal, and how this personal health record (PHR) stores both electronic ‘hard copy’ and user-entered health history data which is generally accessible. It is a little different than Microsoft Health Vault or the late and unlamented Google Health, with access based on a 10-digit telephone number ‘lifeline’ and a subscription model. MMRG claims 750,000 members to date. While MMRG’s legal track record has raised quite a few health tech industry eyebrows almost to the hairline, your Editor has to admit their actions are quite different from your usual non-operating ‘patent troll’ which preys on vulnerable early-stage companies [TA 10 Feb].  MMRG’s big legal actions are to hook ‘big tunas’–Walgreens, WebMD–plus ‘investigations’ of the Australian and Singapore Governments, based on its seven US and international patents building up in their portfolio since 2005. They have also announced similar scrutiny of Microsoft and AARP for their projected joint PHR. [TA 10 Feb, 20 Feb]

But…there’s more. Mr. Lorsch proceeds to draw the proverbial line in the sand for hospitals and practices which intend to achieve Stage 2 Meaningful Use (MU) compliant EHRs this year into 2014. Stage 2 MU has at least five core measures that depend upon patient access, one of which requires a patient-facing portal that permits viewing, downloading and transmitting their own health information.  (Useful bite-sized explanation by Dr. Rowley at HITECH Answers.) MMRGlobal is taking the stance that they believe that any of these portals which store information, or are full PHRs, infringe on their patent portfolio:

If somebody complies with that Stage 2 Meaningful Use, we believe that they will infringe on one of seven patents that we have issued in the US Patent Office an additional patents that we have issued in 12 additional countries around the world. What we have done is we’ve gone to the hospitals, providers, vendors, laboratories, and we’ve said, “Look, if you’re going to comply with Stage 2 Meaningful Use or you’re going to offer products and services that enable healthcare professionals to meet Stage 2 Meaningful Use, they’re probably going to infringe on one of our patents.”

We’re suggesting that they license those patents at very reasonable license fees, such that whatever they decide to do to comply with Stage 2, Stage 3 Meaningful Use, they have a license – a safe harbor — that they’re grandfathered in, where they never have to be concerned about infringement on any of our patents or other intellectual property. If those same hospitals say, “Are there any other ways to address this?” they could also use our products — our MyMedicalRecords products, our professional products — which are embedded with licenses for the technology.

The interview then proceeds to the money points: how hospitals, especially non-profits, and associations can ‘reasonably’ (again) pay to MMRG (or negotiate on behalf of members) those licensing fees, or simply buy the MMRG PHR.

Which leaves this Editor with a question: these systems are supplied by major companies: Cerner, Epic, McKesson, GE. The hospitals and large practices are only system users, albeit with considerable user HIT customization. If the PHR is part of the Epic, Cerner (etc.) system, and the hospital buys the system, isn’t the true source of the patent infringement the supplier, not the end user? Or is this MMRGlobal’s strategy to avoid being a snack for some very large and aggressive sharks? It remains….fascinating. HIStalk Interviews Robert Lorsch, CEO, MMRGlobal  Hat tip to reader Vince Kuraitis via Twitter.  Also to be noted are the on-fire comments under the article which clarify many of the US patent issues, and possible defense strategies which hospitals and associations/groups may follow.

Update 28 Feb: The latest MMRGlobal pre-HIMSS press release announces ‘going mobile’ with their own wellness app, built with MyVitaLink (note that website indicates a restructuring) that ties into their PHR, and their collaboration with Alcatel-Lucent. Second graph puts mobile companies on infringement notice.

 

MMRGlobal IP infringement lawsuits, allegations continue

Personal Health Record (PHR) patent holder and penny-stock company MMRGlobal [TA 10 Feb] continues to keep law firms in the US, Australia and now Singapore very busy with various complaints of patent infringement, demanding monetary damages, a permanent injunction and presumably, a lucrative licensing deal. Last week, MMRG filed in US District Court, Central District of California against health giant WebMD for their online PHR, claiming that from meetings dating back to 2007, WebMD incorporated “features and functionality that are the subject of MMR’s patents”. Today’s MMRG press release now highlights the Singapore Ministry of Health (with associated health agencies)which MMRG alleges uses PHR vendors which violate various patents–which just happen to be owned by MMRG in Singapore.  (more…)