TTA’s Week: Best Buy’s GreatCall Big Buy, McAfee’s vital sign hack, more fall events, and a new ‘Who’s Available’

 

 

Best Buy’s $800M Big Bet on older adult health. Wearables that count particles, McAfee’s hacking vital signs counts. Our fall event update. And a new ‘Who’s Available’ for your telehealth company.  

Smart wristband wearable that counts blood cells, bacteria, and air particles (Soon everything on the wrist?)
What Best Buy’s $800 million cash purchase of GreatCall connected health/PERS really means (Staying ahead of Ravenous Amazon by recognizing the needs of millions of older adults)
OpenEMR’s security flaws threaten millions of patient records; McAfee successfully alters vital signs reporting into monitoring systems (Not your garden variety hacking)
Late summer and early autumn event updates: Save 20% on Connected Health Summit, SEHTA Health + Space, Lilley’s talk with Ali Parsa, PATH Summit, Connected Health Conference, HealthIMPACT (More events, plus for Readers 20% off Connected Health Summit)
Who’s available? A young graduate in telemedicine/eHealth studies seeks opportunity (From Africa, studing eHealth and telemedicine in Italy, certainly a unique perspective)

Telehealth, RPM get another Federal boost in 2019 through a new FCC program for rural US. IBM Watson Health fizzles, data breaches sizzle. 

More good news for telehealth, RPM in FCC approval of $100M Connected Care Pilot Program (Moving forward at last for those who can use it most in rural America)
Coffee break reading: a ‘thumbs down’ on IBM Watson Health from IEEE Spectrum and ‘Der Spiegel’ (Is Watson actually The Great Oz? Look behind the curtain!)
More and more into the (data) breach: 3X more patient records in Q2, UnityPoint’s breach balloons to 1.3M (And the next hack or WannaCry may not be noticed for 200 days)

Kicking off a new month with a look back at late July’s news plus an encouraging look at Telemedicine Texas-Style. Plus Theranos’ Tainted Love Drama.

The Theranos Story, ch. 54: cue up ‘Tainted Love’ in the courtroom (The subtext of Holmes and Balwani’s twisted governance)
Telemedicine changing Texas rural health and emergency medicine (Accept the Yellow Roses!)
Rounding up July: Teladoc’s new name and earnings, Hitching a Lyft, GlobalMed with FCC, Proteus and HIV sensing, Parks Associates, Welbeing

 

A 1.5 million patient breach in Singapore has worldwide repercussions. What if the next breach kills? The new Health Secretary may move NHS into the 21st Century–or not. Theranos=pocket lint. And meet a telecare training professional looking for opportunities.

Healthcare cybersecurity breaches multiply like measles as far away as Singapore. Is it a matter of time before hacking kills someone? (It’s spreading and treacherous)
Who’s available? A user training professional with experience in security, social alarm, and telecare control rooms (A possible hire for your company)
Will Matt Hancock be a refreshing change for NHS? Or another promise unfulfilled? (Is technology adoption enough?)
The Theranos Story, ch. 53: No more blood to squeeze out of this particular rock (Aggrieved investors out of time and out of the money)

Saving the NHS with digital change at The King’s Fund and in Yorkshire. Walmart teams with Microsoft for AI and gets a new head of health. Are derm apps good or bad, and a real blood ‘mini-draw’. Care Innovations sells off a significant health validation effort.

Can equipping care homes with telehealth save the NHS £1bn? (UK) (Extrapolating the NHS Calderdale results)
News roundup: Walmart and Microsoft AI, are derm apps endangering public with 88% skin cancer diagnosis? (Two more giants partner down the line, and derm apps have some risk)
Highlights of The King’s Fund Digital Health and Care Congress 2018 (Two days of longing for digital change)
Care Innovations sells off Validation Institute. But is there more to the story? And a side of Walmart Health action. (Whither Care Innovations’ future now partly owned by Roche? Its former president now heads up Walmart’s health area.)
A finger-prick, 10 minute CBC test which actually works from Sight Diagnostics (Israel) (Making the mini-draw idea work–for real, and not a bug-eye in sight)

CVS-Aetna looks likely, FCC likes telehealth, Cerner takes a bite of value-based health, and is telemedicine really a bust–or are we not thinking right? 

News roundup: FCC RPM/telehealth push, NHS EHR coding breach, unstructured data in geriatric diagnosis, Cerner-Lumeris, NHS funds social care, hospital RFID uses 
A mHealth refutation of ‘Why Telemedicine is a Bust’ (Mobiles will conquer all)
Department of Justice won’t challenge CVS-Aetna merger: report (Finally, a healthcare mega-merger that goes through)

The ‘record-breaking first half’ in funding that wasn’t. More ‘Bad Blood’. And GP at Hand’s disruption may be a good thing for UK’s GP practices, according to the RCGP chair.  More…

RCGP chair at The King’s Fund: destroy Babylon Health’s GP at Hand ‘amazing model’, the present financial model–or both (A whole lot of disrupting going on)
The Theranos Story, ch. 52: How Elizabeth Holmes became ‘healthcare’s most reviled’–HISTalk’s review of ‘Bad Blood’ (A Must Read)
Rock Health’s ‘Another record-breaking first half’ in digital health funding is actually–flat. (With a Soapbox Extra!) (Don’t believe the spin, dig in)

Some more views on (and by) Atul Gawande on the JP Morgan-Berkshire-Amazon health combine (Not what you think)


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

Subscribe here to receive this Alert as an email on Thursdays with occasional Weekend Updates. It’s free–and we don’t lend out or sell our list.

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

Who’s available? A young graduate in telemedicine/eHealth studies seeks opportunity

Maceline (Mimi) Kadurira is finishing up her MSc in eHealth & Tele-Medicine at Rome (Italy) Business School. She is seeking a position where she will gain additional exposure to various aspects of telemedicine, eHealth, and social sciences where she has an honors degree from Africa University in Harare, Zimbabwe.

Some points she would like to highlight re her suitability for a new opportunity:

  • Volunteer involvement. I have volunteered with Inspire Tutors as Communications and marketing Organiser helping with writing and maintaining company blog and spearheading campaigns and marketing awareness programmes and providing one-on-one coaching children and youths with developmental disabilities, including counseling. I also implemented individualized learning plans for students with intellectual disabilities. Shadowing case managers and attending mental health meetings was an incredibly beneficial experience during my volunteering time.
  • Professional experience. As a student (Intern) a full year as Human Resources Assistant, compiling time sheets, risk management, helping in the recruitment process, filing, data entry and general confidential information handling/maintenance.
  • E-Health and Telemedicine Management. Courses include Electronic Medical Records, Chronic Disease Management, Best Practice, Clinical Decision Support Systems, ESA activities in Telemedicine (space technology for downstream eHealth applications) Protection of personal data in eHealth, Standards and Interoperability.

Can your growing organization use Mimi? Contact Details: macelkaduri@yahoo.co.uk  Her CV is here

More good news for telehealth, RPM in FCC approval of $100M Connected Care Pilot Program

The Federal Communications Commission (FCC) moved relatively quickly to approve the Connected Care Pilot Program, approving broadband-enabled telehealth and remote patient monitoring services in underserved rural and remote areas. Funding for the program has been pegged at $100 million. The approval was unanimous on the program proposed by FCC commissioner Brendan Carr and Mississippi Sen. Roger Wicker.

CCPP will provide $100 million for subsidies to hospitals or wireless providers running post-discharge remote monitoring programs for low-income and rural Americans. An example is those run by the University of Mississippi Medical Center. The goal is to lower same-cause readmissions and improve patient outcomes. [TTA 13 July] Hearings late last month also were structured to support the program and start to fill out the details for a 2019 start [TTA 1 Aug].

Public comments are now open for a 2019 start to the program (see FCC website–look under Connect2Health which is the umbrella site for this and similar programs). Commissioner Carr had to look no further than the VA to see how Home Telehealth and other remote monitoring programs worked to drive down cost and improve patient outcomes. VA Health’s remote monitoring program cost $1,600 per patient compared to $13,000 for traditional care in one study. The trick is now translating this into an open system.

This is a nice boost to both real-time video and asynchronous remote patient monitoring in market development (and getting paid) in areas of great need. It’s also another Federal signal (so to speak) for 2019, following the proposed Medicare Physician Fee Schedule’s increased payments and broader applicability for both.  mHealthIntelligence, Mobihealthnews, FCC Release Hat tip to reader Paul Costello of Medopad.

TTA’s Week: Theranos’ Tainted Love drama, Telemedicine Texas-Style, Teladoc, Lyft, Welbeing, GlobalMed, fall events, more!

 

Kicking off a new month with a look back at late July’s news, looking ahead at autumn events, an encouraging look at Telemedicine Texas-Style. Plus Theranos’ Tainted Love Drama.

The Theranos Story, ch. 54: cue up ‘Tainted Love’ in the courtroom (The subtext of Holmes and Balwani’s twisted governance)
Telemedicine changing Texas rural health and emergency medicine (Accept the Yellow Roses!)
Rounding up July: Teladoc’s new name and earnings, Hitching a Lyft, GlobalMed with FCC, Proteus and HIV sensing, Parks Associates, Welbeing
Late summer and early autumn events for your calendar: Connected Health Summit, UKHealthGateway, PATH, Connected Health Conference, HealthIMPACT

A 1.5 million patient breach in Singapore has worldwide repercussions. What if the next breach kills? The new Health Secretary may move NHS into the 21st Century–or not. Theranos=pocket lint. And meet a telecare training professional looking for opportunities.

Healthcare cybersecurity breaches multiply like measles as far away as Singapore. Is it a matter of time before hacking kills someone? (It’s spreading and treacherous)
Who’s available? A user training professional with experience in security, social alarm, and telecare control rooms (A possible hire for your company)
Will Matt Hancock be a refreshing change for NHS? Or another promise unfulfilled? (Is technology adoption enough?)
The Theranos Story, ch. 53: No more blood to squeeze out of this particular rock (Aggrieved investors out of time and out of the money)

Saving the NHS with digital change at The King’s Fund and in Yorkshire. Walmart teams with Microsoft for AI and gets a new head of health. Are derm apps good or bad, and a real blood ‘mini-draw’. Care Innovations sells off a significant health validation effort.

Can equipping care homes with telehealth save the NHS £1bn? (UK) (Extrapolating the NHS Calderdale results)
News roundup: Walmart and Microsoft AI, are derm apps endangering public with 88% skin cancer diagnosis? (Two more giants partner down the line, and derm apps have some risk)
Highlights of The King’s Fund Digital Health and Care Congress 2018 (Two days of longing for digital change)
Care Innovations sells off Validation Institute. But is there more to the story? And a side of Walmart Health action. (Whither Care Innovations’ future now partly owned by Roche? Its former president now heads up Walmart’s health area.)
A finger-prick, 10 minute CBC test which actually works from Sight Diagnostics (Israel) (Making the mini-draw idea work–for real, and not a bug-eye in sight)

CVS-Aetna looks likely, FCC likes telehealth, Cerner takes a bite of value-based health, and is telemedicine really a bust–or are we not thinking right? 

News roundup: FCC RPM/telehealth push, NHS EHR coding breach, unstructured data in geriatric diagnosis, Cerner-Lumeris, NHS funds social care, hospital RFID uses 
A mHealth refutation of ‘Why Telemedicine is a Bust’ (Mobiles will conquer all)
Department of Justice won’t challenge CVS-Aetna merger: report (Finally, a healthcare mega-merger that goes through)

The ‘record-breaking first half’ in funding that wasn’t. More ‘Bad Blood’. And GP at Hand’s disruption may be a good thing for UK’s GP practices, according to the RCGP chair. 

RCGP chair at The King’s Fund: destroy Babylon Health’s GP at Hand ‘amazing model’, the present financial model–or both (A whole lot of disrupting going on)
The Theranos Story, ch. 52: How Elizabeth Holmes became ‘healthcare’s most reviled’–HISTalk’s review of ‘Bad Blood’ (A Must Read)
Rock Health’s ‘Another record-breaking first half’ in digital health funding is actually–flat. (With a Soapbox Extra!) (Don’t believe the spin, dig in)

Still wondering how Atul Gawande will continue medical practice and be a CEO? Will Google be the ‘Medical Brain’ powering hospitals and clinicians? News from early stage to mature companies. 

News roundup: Paradromics; Cerner’s trials with DOD, VA; Medtronic; Babylon Health; NHS’ private data
Google’s ‘Medical Brain’ tests clinical speech recognition, patient outcome prediction, death risk (Billions of data points to a lot of outcomes)
Some more views on (and by) Atul Gawande on the JP Morgan-Berkshire-Amazon health combine (Not what you think)

The pick of a noted healthcare innovator and theoretician to head the JP Morgan Chase-Berkshire Hathaway-Amazon health leviathan induces skepticism. Theranos is back–in the courts, and its principals who wouldn’t leave are facing prison time. 

The 50,000 foot pick as CEO of the JP Morgan Chase-Berkshire Hathaway-Amazon health joint venture (A great theoretician and gadfly, but not a herder of a million cats)
Instant GP, don’t even add water; Babylon Health taps into the corporate market via insurer Bupa (UK) (A budding revolution from the payer side?)
The Theranos Story, ch. 51: how Holmes wasn’t Steve Jobs despite the turtlenecks–a compare and contrast (Aping Steve Jobs won’t make you successful. But it will get you press!)
The Theranos Story, ch. 50: DOJ indicts Holmes, Balwani for fraud (updated) (What you need to know right here)
)
The Theranos Story, ch. 49: CEO Holmes reportedly raising funds for a new company–and feeling like Joan of Arc (John Carreyrou’s Theranos book is just out; Elizabeth Holmes isn’t Monty Woolley and not St. Joan either)
OnePerspective: Analogue telecare is a dead horse: stop flogging it (And go digital–the perspective from the CEO of Communicare247)


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

Subscribe here to receive this Alert as an email on Thursdays 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

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

Telemedicine changing Texas rural health and emergency medicine

The expanded use of telemedicine in Texas–controversial and delayed by the state medical society, despite its use in distance medicine and prisons–is slowly starting to change rural health in the state. SB1107 passed the Texas legislature in 2017, removing the previous requirement for an in-person medical consultation. Texas, like many Western states, has an acute shortage of primary care doctors in 184 of 254 counties, according to the state health service.

Where telemedicine fills that gap is in areas such as emergency rooms in rural hospitals. In Van Horn, population 2,000, with the next hospital 90 miles away, telemedicine enables the ER  to operate two trauma rooms and for the state, have a doctor there well within 30 minutes away which is the state requirement for a basic-level trauma facility. The ER connects with an office building in Sioux Falls, SD to a nurse and doctor on immediate call to help oversee care via the Avera eCare telemedicine system.

Universities have also worked to diversify telemedicine use in other settings. Texas Tech University Health Sciences Center has pioneered its use in ambulances and schools. The regional TexLa Telehealth Resource Center helps anyone looking to start a telemedicine project. By 2020, the University of Texas will have telemedicine fully implemented on campus. Houston Chronicle

News roundup: FCC RPM/telehealth push, NHS EHR coding breach, unstructured data in geriatric diagnosis, Cerner-Lumeris, NHS funds social care, hospital RFID uses

click to enlargeFCC backs post-discharge RPM plan. The “Connected Care Pilot Program” proposed by FCC commissioner Brendan Carr would provide $100 million for subsidies to hospitals or wireless providers running post-discharge remote monitoring programs for low-income and rural Americans such as those run by the University of Mississippi Medical Center. The goal is to lower readmissions and improve patient outcomes. The proposal still needs to be formalized so it would be 2019 at earliest. POLITICO Morning eHealth, Clarion-Ledger, Mobihealthnews

NHS Digital’s 150,000 patient data breach originated in a coding error in the SystmOne EHR used by GPs. Through the error by TPP, SystmOne did not recognize the “type 2 opt-out” for use of individual data in clinical research and planning purposes. This affected records after 31 March 2015. This breach also affects vendors which received the data, albeit unknowingly, but the duration of the breach makes it hard to put the genie back in the bottle, which NHS Digital would like to do. Inforisktoday, NHS Digital release

Unstructured data in EHRs more valuable than structured data in older adult patient health. A new study in the Journal of the American Geriatrics Society compared the number of geriatric syndrome cases identified using structured claims and structured and unstructured EHR data, finding that the unstructured data was needed to properly identify geriatric syndrome. Over 18,000 patients’ unstructured EHR notes were analyzed using a natural language processing (NLP) algorithm.

Cerner buying a share in population health/value-based care management company Lumeris through purchasing $266 million in stock in Lumeris parent Essence Group Holdings. The angle is data crunching to improve outcomes for patients in Medicare Advantage and other value-based plans. Lumeris also operates Essence Healthcare, a Medicare Advantage plan with 65,000 beneficiaries in Missouri. Fierce Healthcare

NHS Digital awarding £240,000 for investigating social care transformation through technology. The Social Care Digital Innovation Programme in 12 councils will be managed by both NHS and the Local Government Association (LGA). Projects to be funded span from assistive technologies to predictive analytics. Six winners from the original group of 12 after three months will be awarded up to a further £80,000 each to design and implement their solutions. New Statesman

Curious about RFID in use in healthcare, other than in asset management, access, and log in? Contactless payments is one area. As this is the first of four articles, you’ll have to follow up in Healthcare IT News

The King’s Fund Digital Health & Care Congress next week on 10-11 July

Time has flown by since this Editor first mentioned this event and now it’s next week. This year’s meeting features case studies in creating the right culture for large scale digital change, using digital technology to improve quality of care, prevention and changing behaviors, population health informatics, tools for self-management, reducing clinical variation, mobile working in community services, and much more. Featured speakers include Matthew Swindells of NHS England, the Rt Hon Paul Burstow of TSA, Ruth Rankine of the Care Quality Commission, and more. See the agenda here for Day 1 and Day 2. (TTA’s own Charles Lowe will be chairing Breakout T2B: Quality improvement 11:45am on Tuesday 10 July.) Two very full days 10-11 July, Tuesday and Wednesday, at The King’s Fund’s London location. For more information, click the advert in the right sidebar or here

CMS urged to further reimburse telehealth remote patient monitoring with three new CPT codes

The Centers for Medicare & Medicaid Services (CMS), which controls payments to doctors for the Medicare and state Medicaid programs, has been urged by 49 healthcare organizations and technology vendors to further unbundle the controlling CPT code for remote patient monitoring (RPM), 99091. The 2018 Physician Fee Schedule (PFS) Final Rule finally separated RPM from telemedicine remote visits by permitting separate payment for remote physiological data monitoring by unbundling CPT 99091 to reimburse for patient-generated health data (PGHD)–a new term. The letter to Administrator Seema Verma proposes 2019 adoption of three additional American Medical Association CPT Editorial Panel-developed codes which further break down various aspects of RPM, while maintaining 99091. 

CPT codes for Medicare and Medicaid are important because they also influence private insurers’ reimbursement policies. Practices which get paid for RPM are more likely to adopt enabling technologies if they are affordable within how they are paid. 

CMS started to include telehealth RPM in 2015 in a chronic care management code, 99490, but specifically prohibited the use of CPT 99091 in conjunction with CCM. This created a lot of confusion after some brief moments of hope by tying technology to a complex CCM model.

It’s possibly a ‘light at end of the tunnel’ development for hungry tech companies, but one which won’t be determined till end of year when PFS rules are released. Also Healthcare Dive.

International acquisition roundup: Doro and Welbeing; Teladoc and Advance Medical

Two international telecare/telehealth/telemedicine M&A deals made the news this last week.

Sweden’s Doro AB acquired Welbeing, headquartered in Eastbourne UK. Welbeing (formally Wealden and Eastbourne Lifeline) is a telecare provider of home-based personal alarms which supports about 75,000 residents in local systems. Their revenue in last fiscal year (ending 9/17) was £7.6 million (SEK 90m). Doro operates in the UK and about 40 countries, with a core business in mobile phones specially designed for older adults. Their Doro Care solutions provide digital telecare and social services for older adults and the disabled in the home. Doro is paying SEK 130 million (£11.1 million) for the acquisition of Welbeing, equal to eight times estimated EBITDA for the financial year 2017/2018, with 85 percent cash and 15 percent in Doro shares with a bonus based on financial performance. Release 

Making a few headlines in the US is telemedicine leader Teladoc’s purchase of Barcelona’s Advance Medical for a hefty $352 million, giving Teladoc a major international footprint especially valuable for its corporate clients and major payers. Advance Medical provides complete telemedicine services in 125 countries in over 20 languages. Even more valuable is their knowledge of local healthcare delivery systems, global expert medical opinion, and chronic care. The acquisition also gives Teladoc an international network of offices and a significant entreé with international health insurance companies. Mobihealthnews, Seeking Alpha (Teladoc investor slideshow)

VA’s ‘Anywhere to Anywhere’ telehealth initiative finalizes

VA Secretaries may come and go (or never get there), but their initiatives stay. With much fanfare last year, then-Secretary David Shulkin announced the ‘Anywhere to Anywhere’ telehealth and telemedicine program [TTA 3 Aug]. This program will use VA practitioners to provide virtual patient care across state lines when a veteran cannot make it to a VA hospital or clinic. The Department of Veterans Affairs published the proposed rule last October [TTA 3 Oct 17] with the Final Rule published in the Federal Register on 11 May.

Technically, it preempts state and local regulations around telehealth. “VA is exercising Federal preemption of conflicting State laws relating to the practice of healthcare providers; laws, rules, regulations, or other requirements are preempted to the extent such State laws conflict with the ability of VA health care providers to engage in the practice of telehealth while acting within the scope of their VA employment.”

It was widely supported by ATA, the American Association of Family Physicians, American Medical Informatics Association, Federal Trade Commission, the College of Healthcare Information Management Executives (CHIME), and many other industry organizations. It also enjoys wide Congressional support.

There is plenty of room for growth. Only 1 percent of VA’s veterans used Home Telehealth, while 12 percent used other forms of telehealth. They will be doing so with few suppliers: Medtronic, 1Vision/AMC Health, and Care Innovations. Iron Bow/Vivify Health was found to not have tablets which met the US production qualification. This Editor wonders how the current three suppliers will fare.

This telehealth program will be located in the apparently newly named Veterans Health Administration Office of Connected Care. mHealthIntelligence.com

‘Deconstructing the Telehealth Industry’ positively, focusing on ‘virtual care’ of older adults

A Big Study must-read. Just published is healthcare-specialized investment banking firm Ziegler’s 28-page update on their 2016 survey of the telehealth industry. Unlike some industry observers who believe that health tech has been ‘next year’s Big Thing’ far too long, with unproven effectiveness and savings, Ziegler believes it’s about to substantially ramp up in investment spending and tech integration.

The study looks forward and goes deeply into the markets. In their view, “We believe the next generation of successful virtual care companies will be those who understand the critical marriage between chronic care management, behavioral health, and social determinants.” Their focus is on the aging (50+) population and their higher risk for developing chronic conditions and the 50 percent/5 percent spread (50 percent of the spending is generated by 5 percent of the population). Their picture is that virtual care will ‘meet patients where they are’ in their daily lives.

The study sees trend confirmation in the adoption of virtual care by health systems (the widest–telestroke and tele-ICU), low-acuity care, and 2019 expansion of Federal reimbursement in Medicare Advantage Plan B with ACOs having more flexibility in telehealth-supported services. Ziegler promotes a change in terminology–‘virtual care’ as the ‘naturally integrated tool used to streamline the complex healthcare ecosystem.” Another difference: they place virtual care in the ‘smart aging continuum’ including its effect on decision makers, payers, care options, aging in place, and residential care.

A strong reference paper our Readers will be referring to for months to come. Deconstructing the Telehealth Industry, Part II (option for printable and viewable PDFs).

A tipping point in consumer acceptance of health apps, AI, and virtual care? Accenture thinks so.

Accenture’s 2018 Consumer Survey on Digital Health indicates that the tipping point may be here, sort of. Some key findings:

  • Consumers had high rates of favorable acceptance and likeliness to use AI-enabled clinical services: home-based diagnostics (66 percent of respondents), virtual health assistants (61 percent), and virtual nurses to monitor health conditions, medications and vital signs at home (55 percent), which may be good news for the future of telehealth services.
  • The 2,301 respondents already are using mobile and tablet health apps (48 percent). 44 percent are using patient portals for to fetch their health records, primarily to get information on lab and blood-test results (67 percent), to view physician notes regarding medical visits (55 percent), and their prescription history (41 percent).
  • Wearables are being used by 33 percent and favorably viewed by over 70 percent as beneficial in understanding their health condition (75 percent), engaging with their health (73 percent), and monitoring the health of a loved one (73 percent). 

Virtual care seems to be leading the way over wearables and remote patient monitoring–and after-hours care, patient follow-up, and patient education are leading virtual care.

  • 25 percent had received virtual care services in the previous year, up from 21 percent in last year’s survey. 16 percent are taking part in remote health consultations, compared with 12 percent in 2016. 14 percent are participating in remote monitoring, up from 9 percent in 2016.
  • 47 percent state that given a choice, they would prefer a more immediate virtual medical appointment over a delayed in-person appointment.
  • For after-hours care, 73 percent said they would use virtual care for after-hours (nights and weekend) appointments.
  • 71 percent said they would use virtual care for taking a class on a specific medical condition. 65 percent would use virtual care for a follow-up appointment after an in-person visit.
  • Most respondents said they would also use virtual care for a range of additional services, including discussing specific health concerns with medical professionals (73 percent), in-home follow-up after a hospital stay (62 percent), participating in a family member’s medical appointment (59 percent), and being examined for a non-emergency condition (57 percent).

Accenture release and report.

UK roundup: CCIO Simon Eccles warns against ‘shiny objects’, NHS Liverpool CCG award to Docobo, 87% concerned with NHS info security

click to enlargeNHS Digital CCIO doesn’t like ‘shiny objects’. Dr. Simon Eccles used his first NHS Digital board meeting as national CCIO to encourage delivering the current agenda first and not getting distracted by the ‘shiny objects’ of new innovations which also divert funding. “It is our collective challenge to make sure that doesn’t happen to things that are valued by the NHS – to do what we said we’d do and not be too distracted by new and shiny things.” This seems to be at odds with non-executive director Daniel Benton, who “suggested that NHS Digital needed to become more flexible as an organisation so that it was in a better position to roll with the punches in future.” Digital Health News

Docobo announced their win of the NHS Liverpool Clinical Commissioning Group‘s scale up of telehealth as part of the Healthy Liverpool program. The three to five-year contract has a maximum value of £11.5 million. The current Mi Programme (More Independent) partly funded by the Innovate UK dallas initiative and using Philips equipment is at 900 patients with 5,300 total patients since 2013. The plan is to scale up the program to 4-5,000 patients a year and support new clinical pathways and conditions including lung conditions, heart failure, and diabetes. Docobo’s platform is Doc@Home which uses patient information from the CarePortal device or their own digital devices. Docobo release. NHS Innovation Accelerator, Digital Health News

A survey of 500 British adults conducted by UK IT VAR Proband found that perceptions of public sector information security are poor. 87 percent were concerned about the security of their information with the NHS. Of that 87 percent, 34 percent were ‘very concerned’ about their cybersecurity. Taking this with a grain of salt, 80 percent distrusted security at the Driver and Vehicle Licensing Agency (DVLA) and 78 percent on data held by the police. The General Data Protection Regulation (GDPR) can’t come too soon [TTA 17 Feb] — but are you ready? More in Proband’s Online Security Audit (PDF).

Telehealth policy and reimbursement changes summarized by Center for Connected Health Policy (US)

A significant barrier to the adoption of telehealth (defined here as video consults, store and forward imaging, and remote patient monitoring) is the issue of reimbursement gaps. Basic Medicare (the Federal program for those over 65) pays for video and store and forward only under certain conditions (primarily under rural telehealth programs) but does pay for RPM as part of chronic care management (albeit under a maze of codes and procedures). Medicaid (the state low-income insurance program) is far more lenient, and private pay in states varies widely, with 36 states having some form of parity payment legislation. However, Medicare is planning expansion beyond what is covered in private plans (Medicare Advantage) by 2020. Some Federal programs such as the advanced Next Generation ACO program and the bundled payment Comprehensive Care for Joint Replacement model have telehealth waivers.

The always-helpful Center for Connected Health Policy (CCHP) has published a five-page guide to where these programs stand. Becker’s Hospital Review. CCHP PDF 

Telemedicine’s still-sluggish adoption in health systems revealed in survey of health system executives

Sage Growth Partners, a Baltimore Maryland-based healthcare research and strategy firm, released a study surveying US C-level executives and service line leaders at a variety of larger health systems (integrated delivery networks (IDNs), academic medical centers (AMCs), community hospitals, and specialty hospitals) on their telemedicine use. It combined initial/exploratory qualitative interviews (total N=65) with online quantitative surveys (completed N=98) taken 2nd Quarter 2017.

Have we reached a tipping point? The findings indicated that just over 50 percent (56 percent) had developed in-house telemedicine systems or were already working with vendor/s on implementing telemedicine in their organizations. The study’s definition of telemedicine was broad, inclusive of any technology and programs that connect providers and patients not physically at the same location when care is provided. 

But many of the findings are dismaying:

  • Budgets–limited at best. Most (66 percent) had budgets under $250,000 per year 34 percent committed over $250,000 with most under $100,000, but three-quarters believe those budgets will increase next year. 
  • What it’s used for: Emergency use (29 percent), remote patient home monitoring (21 percent, and non-emergency cases (20 percent). 
  • How many vendors do they want to deal with?: One is quite enough–54 percent prefer a single telemedicine solution across the continuum of care (however defined), with 31 percent accepting two solutions. 
  • Has it changed the ‘standard of care’?: Yes for stroke, according to 70 percent surveyed. 75 percent believe it will potentially change the standard of care for behavioral health/psychiatry, followed by neurology (53 percent), primary care (52 percent), and cardiology (48 percent).
  • What about direct-to-consumer telemedicine?: The top must-haves are EMR integration, appointment scheduling, and store-and-forward messaging (60+ percent). What’s surprisingly not so desired: store-and-forward of images (47.9 percent–so much for home wound management) and vitals capture (45.9 percent–so much for connecting devices to telemedicine).

Perhaps it’s this Editor looking at the ‘glass half-full’ with a ‘Gimlet Eye’, but here we are in February 2018 still having this discussion at the executive and service line levels. The progress has been glacial at best on starvation budgets, yet telemedicine vendors are multiplying. What is also not promising: these executives’ preference for enterprise solutions which preclude small, innovative companies from getting past the pilot or trial phase. Another barrier: the insistence upon EMR (EHR) integration, which sounds appropriate except that Cerner and EPIC are ‘walled gardens’. Defining Telemedicine’s Role: The View from the C-Suite (PDF, free download from Sage). Also Clinical Innovation + Technology and Global Healthcare 

Rounding up what’s news: LindaCare, TytoCare funding; Medicare telehealth parity, Norway’s big cyberhack, Virta reversing diabetes, DARPA’s 60th birthday

click to enlargeYour Editor’s been away and then largely out of pocket over the past two weeks. Here’s our roundup/catchup beyond the bombshells:

In remote patient monitoring for chronic disease, Philips, PMV, and other investors invested €7 million ($8.6 million) in Belgium’s/Hartford CT’s LindaCare. The Series B funding will accelerate its US expansion of OnePulse for remote monitoring of chronic heart failure and cardiac arrhythmia patients with Cardiac Implanted Electronic Devices (CIED). It is in use in major European hospitals and in US trials, though there is no mention in the release or on their website on CE Marking or FDA clearance/clinical trials. Previously from its 2013 founding, it had €1.6 million in funding. Also Mobihealthnews.

TytoCare, a remote monitoring telehealth/video consult platform which integrates peripherals for a virtual physical exam, raised $25 million in a Series C round led by large Chinese insurer Ping An via their Global Voyager Fund plus Walgreens, Fosun Group, OrbiMed, LionBird, and Cambia Health Solutions. Release. Their total raise is $45.6 million since 2012 (Crunchbase). Their most current partnership is with Long Island-based Allied Physicians Group which is featuring at-home telehealth visits at its pediatric practice in Plainview.

More favorable Medicare reimbursement for telehealth is the subject of four US Congressional bills. The one furthest along is the ‘Creating High-Quality Results and Outcomes Necessary to Improve Chronic Care Act of 2017’ (S.870), which aims to improve at-home care, increases Medicare Advantage flexibility, gives ACOs more options and expands telehealth capabilities for stroke and dialysis patients. It passed the Senate in September and now goes to the House Subcommittee on Health of the Committee on Energy and Commerce. The effect of all four is on Medicare payment parity with in-office visits, which does not currently exist and is not affected by the various state parity bills on insurance for those below 65. American Well touts a 10-fold growth in revenue, but the likelihood of any of these four bills being signed into law is small, particularly with a pending report from the Medicare Payment Advisory Commission. Becker’s Hospital Review

Norway released at end of January news on an “advanced and persistent” 8 January cyberattack on Health South East RHF. This has both a health breach and military twist.

(more…)