What used to be the ‘third rail’ of caring may no longer be. The idea of cameras in the home to view activity of an older family member was so abhorrent to caregiving relatives that it was a key in selling purely sensor-based monitoring systems from the early 2000s on, such as QuietCare, GrandCare, Alarm.com Wellness, Healthsense, Lively, Tynetec/Legrand and many others. Today, in the age of selfies and video on social networks, video surveillance doesn’t seem so foreign. Age NI‘s study conducted through Ulster University had the surprising finding that over 90 percent of participants in several focus groups supported it, with two important caveats; that there was initial consent from the older person being monitored, and that only family members could view the video. With that, they found it ‘useful’, ‘ethical’ and ‘moral’. It would support the person’s safety in aging at home longer, and provide peace of mind for carers. Hat tip to Toni Bunting of TASK Ltd. PharmaTimes, Ulster University News
Intelesant’s latest project, Howz, has added electricity consumption to the monitoring set of Activities of Daily Living. The Howz set of multiple sensors generally monitors activity in the home, home temperature, lights on/off, and exterior door opening/closing, depending on their placement, but one sensor monitors electricity consumption by directly going into the meter to determine whether appliances are being used as an indicator of activity. These activities are reported over a smartphone app to those who have permission for reports. After a trending baseline over a few days is established via algorithms, the Howz system tracks departures from that norm and alerts via the smartphone app. This bears resemblances to this Editor’s former company which developed the behavioral telecare (first and still in market) QuietCare system, but the ‘meter reader’ is a new and smart twist.
Intelesant is testing Howz in 100 Manchester homes and is scheduled to be in a pilot with dementia patients at home in partnership with the Surrey and Borders Partnership NHS Foundation Trust. In December, they also announced that they are a finalist with the EDF Energy Blue Lab Acceleration Programme.
Howz is more comprehensive (and expensive) than 3rings‘ single appliance plug which keys into specific activities (tea kettle, TV on) [TTA articles here] but the objective for family peace of mind for older adults, especially those living alone, is the same. Available consumer direct from their website in the UK only (unfortunately) from £199 for the starter kit. New Scientist, Howz video on YouTube Hat tip to former Northern Ireland Editor Toni Bunting
Breaking News, Updated The Department of Veterans Affairs (VA) on 1 Feb issued over $1 billion in awards to four companies to provide Home Telehealth vital signs monitoring technologies to veterans in home care and monitoring. The four companies are Medtronic, Care Innovations, Iron Bow Technologies, and 1Vision LLC. The $1 billion is split evenly between the four ($258 million for each company over the five-year duration). The contracts are for an initial year (31 Jan 2018 end date listed on GovTribe.com), renewable annually for five years total. The bid process started in 2015 and the award had originally been scheduled for early-to-mid 2016.
On the suppliers:
- Medtronic is the incumbent as a supplier since 2011, dating back to Cardiocom’s 2011 award for its home monitoring units (Cardiocom was acquired in August 2013). Medtronic is a Dublin, Ireland HQ’d company with a US headquarters in Minnesota.
- Care Innovations is well known to our Readers as the developer of Health Harmony and the acquirer of the QuietCare telecare/behavioral monitoring used in senior housing. Their parent is Intel.
- Iron Bow Technologies is a supplier to VA in other healthcare areas (telemedicine and store-and-forward) and is a large, privately held IT company with multiple Federal contracts and deep Federal contractor roots. Their revenue has been reported at over $462 million (Washington Technology Top 100 2016).
- 1Vision LLC is a new company formed as a joint venture between HMS Technologies, Inc. and MBL Technologies, Inc. Neither are previously engaged as home telehealth providers, but both are Federal contractors. According to their individual websites, HMS is an IT systems integrator and MBL is engaged primarily in cybersecurity.
The question for this Editor is how Iron Bow and 1Vision, which are not telehealth (vital signs) monitoring companies but telemedicine and IT service providers respectively, will execute Home Telehealth with the VA. Have they partnered with yet-to-be disclosed providers in providing home telehealth services to the VA? (Watch this space)
While the award is the largest in US telehealth, the VA is, by this Editor’s experience in her last position with Viterion Corporation, extremely demanding on its service providers and will be even more so in the future. The future reasons are clear: 1) President Trump has put a Klieg light on the VA and 2) he’s named a new VA secretary, Dr David Shulkin, who is currently VA Undersecretary for Health (confirmation hearing notes courtesy of POLITICO, nomination approved by the Senate committee Tuesday, and easily confirmed Monday night 13 Feb), who has been highly engaged with HIT issues, including both the VistA EHR modernization/replacement and initiatives such as the recently unveiled Digital Health Platform [TTA 12 Jan]. (more…)
Updated. GreatCall, the older adult-targeted mobile phone/PERS company, on 20 December announced the acquisition of telecare/RPM developer Healthsense. Terms were not disclosed. Healthsense was one of the earliest developers (close after Living Independently Group’s, now Intel Care Innovations’, QuietCare) of a sensor-based residential system, eNeighbor, to monitor ADLs for activity and safety. It has been primarily marketed to senior living communities after an early start in home sales, and currently monitors 20,000 lives according to the press release. Healthsense acquired a similar system, WellAWARE, in 2013.
GreatCall is best known for its older adult-targeted mobile phone line, but in recent years they have expanded into mPERS services on phone and devices, including an emergency call center. The San Diego-based company acquired the remnants of the Lively in-home monitoring system a year ago and incorporated its watch-wearables into its medical alert product line.
This Editor speculates that one direction GreatCall may take is to expand into the senior community monitoring and home care business beyond mPERS. To date, GreatCall has been a highly successful, direct-to-consumer driven company which has popularized not only products to make technology simpler and more usable for older adults, but also led in a non-condescending approach to them. If the company decides to enter senior housing and home care, it presents a different and new marketing challenge, as both have been to date late technology adopters. Another concern is the cost/financial model, usability and reliability of Healthsense’s remote monitoring system.
The other direction is more conventional–GreatCall could incorporate the Healthsense technology and ADL algorithms into home monitoring, with a design resembling Lively’s original self-installed, attractively designed in-home telecare system.
Minnesota-based Healthsense in 15 years of operation raised what some would term a paltry $46 million of equity and debt financing in ten rounds (Crunchbase). Over this time, Healthsense’s investors were a small group, including New York-based Radius Ventures, Mansa Capital, West Health and Fallon Community Health Plan. After the $10 million venture round in 2014, the last investment was a small $2.6 million in February. Early investor Ziegler HealthVest Management, which purchased a significant interest in 2007, is not listed in Crunchbase’s roster, though one of their senior financial managers is on their board. This Editor senses (sic) that the investors were seeking to exit after a long time in.
The release has a summary of an earlier Healthsense study of interest to marketers of telehealth and telecare as a reference:
An independent 12-month study with Fallon Health (an investor–Ed.) found that using Healthsense remote monitoring in connection with Fallon’s model of care for seniors reduced total medical expenses by $687 per member per month — a nearly 16 percent reduction for pilot members as compared to a control group. The Fallon population using Healthsense demonstrated a 32.2 percent reduction in fees for inpatient hospital visits, a 39.4 percent reduction in emergency department costs and a 67.7 percent reduction in expenses for long term care vs. the control during the year-long study.
(Updated with further information on early investor Ziegler and the senior housing market; hat tip to reader Andrea Swayne)
An under-the-radar move by Intel-owned Care Innovations, which markets the Health Harmony telehealth and the QuietCare behavioral telemonitoring systems, is their entrance in the behavior change training business.
Care Innovations developed an accredited (CE eligible) training course for nurses to effect behavior change in patient beyond what may be a limited telehealth engagement. According to their release, the training will help them with coaching patients to increase their engagement with their health and identifying areas for improvement, along with the appropriate technology.
The three-hour course work, designed primarily for telehealth nurses but open to all, has three key learning sections:
- Six steps to take to achieve behavior change in healthcare
- Learning four coaching skills: crafting open-ended questions, sharing words of affirmation, demonstrating reflective listening and crafting summary statements
- Discussing the most common challenges associated with acting as the coach, which are avoidance, ambivalence, resistance and compliance.
There are three sessions before the end of the year, priced at a relatively modest below $300 rate, with group discounts. Information is on their website here.
It’s an interesting move in that the training seemingly is not exclusive to CI clients, although this Editor would expect that 1) it would fit best with CI’s system and 2) is a way of cultivating prospective clients in an academic, value-added way.
For CI, it is another association with the ‘intersection of behavior change and technology’ (more…)
Other than the press release, no information on Vi+ is on the Americas website yet, including pricing. (Vi without the sensor array has been sold for some time.) Vi+ is marketed in most Tunstall countries in Europe, Australia and New Zealand. The fact sheet from Ireland is representative of Vi+ in most markets.
It’s interesting that Tunstall Americas has chosen to enhance their PERS/call center services with sensors, versus entering the hotter telehealth area. Sensor-based activity/danger monitoring is hardly new. (more…)
- 81 percent are interested in sensor technology to prevent falls, particularly among their aging parents
- 54 percent worry about an elderly parent falling
- 70 percent of this group have this fear at least once a week, if not daily; regardless of whether the parent lives alone or not
Checking in with parents is a ‘top of mind’ anxiety for most of those surveyed, with most taking a team approach:
- 44 percent personally or have a sibling check in on their parent daily; 33 percent check in weekly; 12 percent stop by as needed
- 56 percent have neighbors or staff physically check on their parent daily
Not coincidentally, a team of engineers from Carnegie-Mellon are also researching active sensor technologies that gauge gait stability, dizziness and fatigue to predict and prevent falling–what at a former company we called the ‘Holy Grail’ of fall detection that can keep older adults active and well. No mention though of technology aids for ‘check in’ (see 3rings and also the original notion of QuietCare‘s behavioral telemonitoring.) MedCityNews, Carnegie-Mellon release
David Capper, their Commercial Director (picture right), acknowledged the attraction of technology in their first major external investment in this type of health tech. (more…)
Breaking News: Healthways, an online wellness program company based in Nashville, this morning announced that two executives well known to many of us in digital health have joined them. Sean Slovenski, CEO of Intel-GE Care Innovations, is now their President, Population Health Services. Steve Schwartz, their new SVP Strategy and Corporate Development, joins the company from VP Business Development and Strategy, 23andMe.
Mr Slovenski’s track record in 2.5 years at CI certainly impressed this Editor (formerly with the developer of their behavioral telemonitoring system bequeathed from GE Healthcare, QuietCare) with turning around the company from an outpost of Intel and GEHC having difficulty transitioning from ancient technology (remember the Intel Health Guide?) to a telehealth platform dubbed Health Harmony. He also put together a team that engineered multiple academic and health system alliances, along with an interesting turn into home digital health certification. While he came to CI from health insurance giant Humana in Louisville Kentucky running their behavioral health and wellness businesses, his prior experience includes both entrepreneurial turns at his own company and with smaller companies. He most recently engineered a Louisville outpost of CI [TTA 14 Oct 15]. Since Mr Slovenski is still listed on the CI website as CEO, this may have been a quickly executed move.
Mr Schwartz’s business development background includes long stints at two large healthcare companies, Allscripts (EHRs and practice management software) and LabCorp (lab testing). He weathered 23andMe’s FDA troubles and headed up their B2B sales area. Healthways release
Unusually, Healthways is a NASDAQ traded company that closed at $12.11 today in a down market. It’s old (in our terms) having been founded in 1981, becoming publicly traded ten years later. Its last round of venture financing was $20 million from CareFirst BlueCross Blue Shield in October 2013 (CrunchBase). Healthways has a fairly new CEO as well, who joined last August and obviously feels comfortable adding to his team.
One of the most logical places for telehealth, remote care management (RCM) and transitional/chronic condition management (TCM/CCM) is with home health providers and post-acute care, yet perennially it has been on the ‘maybe next year’ list for most telehealth providers. That ‘next year’ may be getting a little closer with the news that Intel-GE Care Innovations has inked a multi-year deal (no pilot-itis here) with major (~400 facilities) home health provider Amedisys using their PC/tablet-based Health Harmony platform.
The initial focus is an ambitious one: reducing hospitalizations and ER/ED visits among patients with congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), diabetes, depression as well as patients who have two or more of these conditions (co-morbidities). The most interesting to this Editor is the parenthetical mention of analyzing ADLs (activities of daily living) with clinical data. Does this imply the engagement of their venerable ADL monitor QuietCare? (It’s something the founding company worked on circa 2006 while this Editor was there; one would think the analytics have advanced since then.) Another aspect is that Care Innovations will manage Amedisys’ complete RCM program from recruiting to logistics, data analytics and application integration services. Business Wire
What this means: Telehealth (and telecare) companies are now increasingly obliged in these big wins to provide a plethora of additional related services. Health care providers demand services beyond the monitoring technology. They want the turnkey package, from nurse evaluations, care coordination/management, to analytics and logistics.This ‘service creep’ implies alliances and mergers to add on to technological monitoring capabilities–and beaucoup financing. (more…)
Sigh. Your Editor is in Error. The University of Missouri is still at it 12 years later with its sensor-based behavioral/activity/proactive care system in the Tiger Place assisted living community near Columbia. And it seems much the same: bed and residential motion sensors, fall detection tracked by a variety of sensors, gait analysis and analysis of activity changes (changes in behavior=changes in health, which still doesn’t excite those in senior care the way it should) . You have to admire the persistence of vision the founders/researchers have had (Marilyn Rantz, professor emeritus with the School of Nursing, and Marjorie Skubic, a professor with MU’s College of Engineering). Their research model has now spread to 13 communities and hospitals in Missouri, and they are commercializing it with a former student, George Chronis, with Foresite Healthcare to convert it into a reliable, robust assisted living/hospital monitoring/care transition system with a simpler, affordable ‘health at home’ version. Besides the nostalgia and supporting fellow ‘true believers’, what they have designed is still needed AND not achieved by RFID (a big fizzle) or ancient PERS. We can all wish them luck in a competitive and much changed market. MU researchers taking sensor system from lab to marketplace (Columbia Daily Tribune)
While Minister of Life Sciences George Freeman MP speaks very highly of the need for innovation and digital health in an NHS integrated health system, the reality is less encouraging for UK startups and their growth. The story of Big Health’s Sleepio and its move from the UK, told by Bloomberg, illustrates the difficulty that new companies and technologies have in fitting into a national framework, then selling into the 209 NHS regions plus related healthcare spenders. The long cycle and the narrowness of the frameworks are disincentives for many digital health technologies and their funders. Even if you win clients as part of being on the framework, when it expires after a few years, the business can be lost.
It’s hard to crack the code, and small companies are dependent on partners. A personal anecdote from this Editor’s time at Living Independently: the company achieved getting on a national framework with the QuietCare telecare product (2007) through partnerships with several larger telecare providers. We relied on them to offer QuietCare to the regions and councils. This had limited success and the US business far outstripped that in the UK.
Ten years ago, the situation was reversed. NHS, Government and council funding helped the earliest development and acceptance of telehealth and telecare, much as the Veterans Health Administration (VA) did with home telehealth and telemedicine in the US. Other European markets and Canada have established private spending in this area, but these smaller markets–and funders– don’t have the potential that is possible in the US private market, even without reimbursement. The trend is reflected in investment: $4 bn in the US, less than €100 million in Europe. US developers now have a bonus in the potential of Asia, with China having the greatest interest and now funding. [TTA 23 July]. How the NHS Is Locking Out Britain’s Digital-Health Startups
“It’s like déjà vu all over again” as Yogi Berra, the fast-with-a-quip Baseball Hall of Fame catcher-coach-manager once said. About 2006-7, telecare broke through as a real-world technology and the tone of the articles then was much like how this New York Times article starts. But the article, in the context of events in the past two years, indicate that finally, finally there is a turning point in care tech, and we are on the Road to Critical Mass, where the build, even with a few hitches, is unstoppable.
Have telehealth, telecare, digital health or TECS (whatever you’d like to call it) turned the corner of acceptability? More than that, has it arrived at what industrial designer Raymond Loewy dubbed MAYA (Most Advanced Yet Acceptable) in keeping older adults safer and healthier at home? The DIY-installed Lively! system keeps an eye on a hale 78 year old (more…)
This year, on the 10th Anniversary of Telehealth and Telecare Aware, we have invited industry leaders nominated by our readers to reflect on the past ten years and, if they wish, to speculate about the next ten. Here is the first article, with a UK focus, by Dr Kevin Doughty.
Many of us are frustrated at how little progress there has been in the deployment and acceptability of telecare during the past decade. Yet, despite warnings that an ageing population was about to bankrupt the NHS (and health insurance schemes elsewhere in the world), and that access to social care for older people was being withdrawn at such a rate that it could only be afforded by the wealthiest in society, our health and social care systems have just about survived.
But this can’t go on, and in England over the past 12 months: (more…)
Intel-GE Care Innovations, which markets both telehealth and telecare (QuietCare, one of the pioneers in behavioral telemonitoring) products, announced today a broadened relationship with the University of Mississippi Medical Center’s Center for Telehealth. CI will help them to establish the Innovation Living Lab which will create and evaluate new models of care via remote technology and techniques for behavioral change. The Lab will open at UMiss’ Venyu Technology Center sometime in 2016. UMMC and CI’s goal is to extend care models so that the home is a key location for care delivery. In the past year, both had partnered on the Diabetes Telehealth Network. CI since their change of management has made several interesting moves in the past year, including grouping telehealth systems under Health Harmony and creating a Validation Institute. Business Wire.