HIMSS17 dispatches: Mayo maps neonate telemedicine, Amwell-Samsung, Samsung-T-Mobile

Mayo maps out an enterprise telehealth (telemedicine) support structure. Here’s how the Mayo Clinic deployed neonatology remote telemedicine to their sites in Minnesota, Arizona, and Florida. There’s plenty of flow charts and summary points in this presentation deck around team building, staffing consistently and reporting that improves processes. Hat tip to our HIMSS correspondent on the scene, Bill Oravecz of Stone Health Innovations. Material is (c) HIMSS. Session handouts for most presentations are publicly available via the Schedule page; click on individual sessions for further information.

American Well and Samsung are partnering on integrating care delivery. Their joint release is low on details, but towards the end there’s an indication that American Well, its partners, and other providers and payers will be able to offer their services to Samsung customers. Other reports (Healthcare Dive) indicate the partnership is destined to enhance Amwell’s Exchange platform between payers and providers. Partners listed are Cleveland Clinic, New York-Presbyterian Medical Center and Anthem (undoubtedly resting after sparring with Cigna). Also Healthcare IT News.

Separately, Samsung also announced a partnership with T-Mobile for developing IoT in the senior care space. This would pair Samsung’s ARTIK Cloud with T-Mobile’s cellular network for Breezie, a social engagement for seniors interface built on a Samsung tablet which has apps and connects to various peripherals for post-acute care and daily living. It sounds interesting, but once again the release hampers the reporter by being as clear as mud in what it’s all about. See if you can decipher this: ARTIK Cloud permits “Amazon Alexa, Samsung SmartThings, iHealth Feel Wireless Blood Pressure Monitor and the Pulse Oximeter – to intelligently communicate with each other.” “Each Breezie interface has more than 40 preconfigured accessibility settings and sensor driven analytics to adjust for different levels of digital literacy, as well as physical and cognitive ability.” The Breezie website is far more revealing. Healthcare Dive also takes a whack at it towards the end of the above article.

HIMSS17 dispatch: developing a telehealth IT team in health system and multi-site networks

Reader Bill Oravecz of Stone Health Innovations is attending HIMSS17 in Orlando, and was kind enough to forward a ‘hot off the presses’ link to this presentation deck given by Jay Weems of Avera eCARE (downloadable as PDF). The subject is ‘Telehealth Workforce Offers Unique Competencies & Opportunities’ and covers how telehealth/telemedicine IT is developed in a health system, mentoring rural originating sites in building proficiencies, and Avera’s experience in supporting a 13-state, multi-system, multi-specialty network. This is more about telemedicine (virtual consults) but offers lessons in developing both in a B2B model.

Material is (c) HIMSS. Session handouts for most presentations are publicly available via the Schedule page; click on individual sessions for further information.

Tender up: NHS Hammersmith and Fulham CCG (UK) seeking telemedicine for care homes

Susanne Woodman, our Eye on Tenders, has located a London-based one on Ted.Europa.eu worth your notice.

Who: NHS Hammersmith and Fulham Clinical Commissioning Group (CCG), on behalf of the North West London Clinical Commissioning Groups comprising of NHS Central London CCG, NHS West London CCG, NHS Hounslow CCG, NHS Ealing CCG, NHS Brent CCG, NHS Harrow CCG and NHS Hillingdon CCG is seeking to appoint a provider to deliver a 24/7, 365 day per year Telemedicine-clinical support function to support care homes initially across Central London, West London, Hammersmith and Fulham, Hounslow and Ealing Clinical Commissioning Group (CWHHE CCGs) areas.

What for: A provider to deliver a 24/7, 365 day per year telemedicine-clinical support function to support care homes initially across Central London, West London, Hammersmith and Fulham, Hounslow and Ealing Clinical Commissioning Group (CWHHE CCGs) areas.

  • This facility will be introduced to 43 residential and nursing homes across the geography covered by the CWHHE CCGs, with a phased implementation over the 3 years of the programme.
  • If the service is successful, the CCGs reserve the right to extend the provision to include residential and nursing homes and patients and carers living outside care homes in the NHS Brent CCG, NHS Harrow CCG and NHS Hillingdon CCG areas.

Tender receipt date: March 8, 2017 at 12pm

Value excluding VAT: £7 900 000.00

The procurement documents are available for unrestricted and full direct access, free of charge, at http://nhssbs.eu-supply.com (log in required)

Tender/RFI up: two more from EU-Supply (UK, IRL)

Susanne Woodman, our Reader who is our Eye on Tenders, has located two new tenders available on the EU-Supply site:

(NHSSBS)Telemedicine Advice and Guidance Service Deadline is 8 March 2017. Documents are attached and available after registration and log in. Contact Greg Reide, phone: +44-161-2123701

(CTM) Pobal on behalf of the Department of the Housing, Planning, Community and Local Government invites responses from organisations for the purpose of market research. This is a Request for Information and not a tender process. This is a market sounding exercise to obtain market information in respect of Telecare Equipment in relation to the Seniors Alert Scheme. Please refer to the Request for Information document which is available via this notice. Submissions should be sent to procurement@pobal.ie on or before 3.00pm, on Thursday the 2nd March 2017. Registration and log in required for further information.

NY’s Northwell Health Home Care partners with HRS for telehealth tablets

click to enlargeNew York State’s largest health system, Northwell Health, is partnering with Hoboken, New Jersey-based (and Blueprint Health grad) telehealth provider Health Recovery Systems (HRS) on introducing their tablets into their Home Care Network. The picture at left is of Bernard Feinstein, a 100-year-old Queens-resident Northwell Health patient, who seems to be easily using and handling the touchscreen tablet. HRS tablets are video-enabled for consults and monitor vital signs, connecting via Bluetooth to devices: stethoscope (heart and lung), pulse oximeter , blood pressure, and weight scale. If one enjoys examples of pretzel logic, the release states that Northwell’s telehealth implementation is one of the first–of Bluetooth-enabled monitoring in NY State home care and the first on Long Island. (Cable-connected telehealth systems have been commonplace since 2003, including Northwell’s home care.) The HRS partnership follows on Northwell Ventures’ $1 million Series A investment in Virginia-based telemedicine provider Avizia. Innovate LI,

The growth of telehealth, and the confusion of terminology (US)

Becker’s Health IT and CIO Review has written up a US-centric review of recent advances in telehealth and telemedicine but kicks it off with the confusion level between the two terms. Internationally, and in these pages, they are separate terms; telehealth referring primarily to vital signs remote monitoring, and telemedicine the ‘virtual visit’ between doctor and patient, between two clinical sites, or ‘store and forward’ asynchronous exchange (e.g. teleradiology). Somehow, in US usage, they have been conflated or made interchangeable, with the American Telemedicine Association (ATA) admitting to same, and American Well simply ‘just doing it’ in relabeling what they provide. On top of it, the two are incorporating elements of each into the other. Examples: TytoCare vital signs measurement/recording into American Well’s video visit; Care Innovations Health Harmony also providing video capability.

Of particular interest to our international readers would be the high rate of US growth in telemedicine utilization from 7 to 22 percent (Rock Health survey). Teladoc, the largest and publicly traded provider, passed the milestone of 100,000 monthly visits in November and the ATA estimates 1.25 million from all providers for 2016 (Teladoc release). Other US competitors include the aforementioned American Well, MDLive, and Doctor on Demand, the latter two also selling direct to consumer. They also compete against doctor-on-house call services like Pager and Heal. Reimbursement remains an issue both privately and publicly (Medicare and Medicaid) on a state-by-state level, with telehealth experiencing significant difficulties, as well as internet access, speed, and usage by older adults.

NHS Scotland launches Attend Anywhere video consult trial

click to enlargeAnnounced earlier this month by Shona Robison, Cabinet Secretary for Health and Sport, Scottish Government at the Scottish Digital Health & Care Week and Conference is the pilot of the Attend Anywhere virtual doctor visits. The consults are through a patient’s computer, smartphone or tablet using a Google Chrome web browser. The patient logs in to the website, waits in a private video room, the provider is notified that the patient is in the queue, and when the doctor is available, the video visit will start. (See illustration at left)

Initially, the service will target video call access to up to 50 health care providers including primary care, specialist services, speech and language therapy as well as pharmacy prescription reviews. According to Attend Anywhere, the service is available now to Scots in both rural and metropolitan areas. The service was developed as part of a collaboration between NHS Scotland’s Technology Enabled Care (TEC) Programme, Melbourne Australia-based video consulting specialists Attend Anywhere, and Healthdirect Australia, supported by NHS 24 Scottish Centre for Telehealth and Telecare. The press release links to a video of the consults in use in western New South Wales, including a care home. Scottish Centre demonstration site, Scottish Digital Health Week page.  Hat tip to Chris Ryan of Attend Anywhere Australia for the original articles and corrections. His LinkedIn post here shows the Scottish Centre’s table at the conference.

‘Chief Health Officer’ moms want 24/7 connected health for the family: survey (US)

A just-released survey by Blue Cross Blue Shield of Georgia and telemedicine provider LiveHealth Online indicates a near-total desire for–and ability to access–on-demand, 24/7 healthcare and virtual visits. The key motivations are economic, convenience and educational: 71 percent cited the loss of at least two hours of time at work and school due to taking their child to the doctor’s office.

Given their age (starting at 18 and up to 59), the 500+ moms surveyed not surprisingly felt confident using health technology, with 82 percent believing themselves to be the most ‘health-tech savvy’ in the family.

  • 64 percent stated that having access to healthcare on-demand was more important than having streaming video or food delivery
  • 64 percent (64%) of women surveyed said they found it challenging to take their kids to the doctor during office hours during the school year
  • 79 percent said they would be interested in trying or learning more about telemedicine to help themselves and/or their family when faced with a non-emergency medical issue

Over half–54 percent–believed that online video doctor visits would improve their confidence in attending to family health, “like having a health security blanket”.

The survey apparently did not test for price sensitivity; for instance, per visit fees and amount subsidized by the payer.

It was conducted earlier this year by EmpowHER, an online health community for women. BCBSGa’s interest is that it offers coverage for online visits to many of its health plan members via LiveHealth Online, which uses the American Well network but is a separate company. BCBSGa release, EmpowHER/LiveHealth infographic, Internet Health Management

An interesting adjunct to this survey would have been to ask about ideal healthcare tools used in conjunction with that online doctor visit. This is anticipated to be a major market for advanced ‘all-in-one’ telehealth diagnostic units such as those developed by Tyto Care, Scanadu Scout or MedWand [TTA 2 Nov]. These are not only capable of taking standard vital signs, but also clinical quality digital pictures of those sore throats and inflamed ear canals.

Should Australia review restrictions on use of telemedicine?

Research carried out in Australia shows that a hospital with telemedicine facilities for outpatient consultations was using those facilities for only one in seven potential appointments. The retrospective study of outpatient appointments at Princess Alexandra Hospital in Brisbane showed that in a 12-month period 2.5% of outpatient consultations were carried out by telemedicine. Although 17.5% of the appointments were potentially viable via telemedicine, a policy of permitting telemedicine only for rural residents meant that, as the majority of the viable telemedicine consultations were with metropolitan residents they were carried out as hospital visits.

This raises the question whether expansion of the use of telemedicine for hospital consultations in Australia should now be reviewed. Currently there is a geographic requirement that the patient’s location must be outside of an Australian Standard Geographic Classification Remoteness Area 1 (a city) for a telemedicine consultation  to be eligible for Medicare Benefits.

The research has been published in the Royal Society of Medicine publication Journal of Telemedicine and Telecare. The author, Monica Taylor, also presented the findings at Successes and Failures in Telemedicine 2016 in New Zealand where she was awarded the best paper award.

Who’s raising what! Babies to pets!

Our takeoff on ace direct response guru Denny Hatch’s ‘Who’s Mailing What!’ has been slightly modified from ‘getting’ to ‘raising’–we do want to be proper ;-)

  • The first big raise happens to be an Editor favorite due to its high Cute Factor–the Owlet smart sock for monitoring your baby’s oxygen level and heart rate. This latest round is $15 million, bringing their funding to $25 million. Investors included Eclipse Ventures and Eniac Ventures, plus new investors Trilogy Equity Partners, the Amazon Alexa Fund, RTP-HC, Capital Integral and Broadway Angels. Owlet is now the commercialization partner on a $1.5 million grant from the NIH to further infant health research, in addition to an earlier equal grant. Plans include a connected care feature giving users access to their data and the ability to share that data with pediatricians, scheduled for a 2017 release; retail and international distribution; two new product lines and a large infant health study. Finsmes
  • Cohero Health closed a $9 million Series A financing for its BreatheSmart lung function platform, which actively engages respiratory patients by tracking medication adherence and measuring lung function. Funding was led by Three Leaf Ventures, an affiliate of the Broe Group, with participation from Zaffre Investments, the investment arm of Blue Cross Blue Shield of Massachusetts, BioAdvance, and new investors GIS Strategic Ventures, Heitkamp & Thumann Group, and P5 Health Ventures. A StartUp Health company, they develop care connected devices and mobile applications that measure lung function and tracking adherence through the BreatheSmart toolkit. Finsmes, Mobihealthnews
  • PlushCare, a California-based telemedicine (virtual visit) company, had an $8 million Series A raise funded through GGV Capital with participation from Lightspeed Venture Partners and Exponent. Finsmes
  • And even pet health is getting funded. PetCoach, a Pennsylvania-based digital pet healthcare platform, secured $2m in seed funding from Comcast Ventures, in addition to earlier funding from DreamItVentures and Maveron. PetCoach provides an online pet care service combining personal advice and 24/7 access to certified pet professionals. Users can leverage the PetCoach website and the app in order to interact with certified veterinarians. Finsmes

Avizia over-subscribes its Series A by $6 million

Telemedicine startup Avizia announced an unusual bonus on what was thought to be a closed Series A with a $6 million additional investment. There was also an unusual investor–the New York-Presbyterian health system. The add-on was led by HealthQuest Capital. Also reported was an extension of Silicon Valley Bank’s agreement for $3 million in debt financing and a $1.5 million line of credit. In July, the first part of the Series A had $11 million from Blue Heron Capital, HealthQuest Capital and five other investors. Total investment is over $22.7 million. From a start in telemedicine carts using Cisco Telepresence, Avizia developed software and apps for mobile devices, including secure messaging for doctors within hospitals. The new funds will be used to upgrade its engineering capabilities to build new capabilities into its telehealth platform, integration with electronic health records and the ability to monitor the battery life of remote diagnostic devices. Also unusual is that they market in the US, UK and Australia covering 400 health systems, including 1,000 hospitals. MedCityNews, Crunchbase

eTELEMED/MATH 2017: call for contributions deadline extended

19-23 March 2017,  Nice, France

eTELEMED, the Ninth International Conference on eHealth, Telemedicine, and Social Medicine, and the co-located MATH (Mobile and Assistive Technology for Healthcare), are both calling for submissions of original scientific results. These contributions and presentations can take any one of these forms:

Contributions:
– regular papers [in the proceedings, digital library] – short papers (work in progress) [in the proceedings, digital library] – ideas: two pages [in the proceedings, digital library] – extended abstracts: two pages [in the proceedings, digital library] – posters: two pages [in the proceedings, digital library] – posters: slide only [slide-deck posted at www.iaria.org] – presentations: slide only [slide-deck posted at www.iaria.org] – demos: two pages [posted at www.iaria.org] – doctoral forum submissions: [in the proceedings, digital library]

Proposals for:
– mini symposia: see http://www.iaria.org/symposium.html
– workshops: see http://www.iaria.org/workshop.html
– tutorials: [slide-deck posed on www.iaria.org] – panels: [slide-deck posed on www.iaria.org]

Submission deadline is 19 November. The general information pages have more information on the conference tracks and topics. Links:  eTELEMED: General information, submission page; MATH: General information, submission page

US: Telemedicine to be used during disasters

The American Red Cross has entered into a partnership to pilot the use of telemedicine during periods of disasters in the US. During the pilot a nationwide network of physicians will be available for consultation via video calls.

Through this pilot collaboration, physicians working with Red Cross partner Teladoc will be available to people helped by the Red Cross whose access to health care providers has been limited or is unavailable after large-scale disasters. Teladoc’s virtual physician visit services will be made available via web, Teladoc’s mobile app and phone to address the primary health care needs of individuals affected by disasters.

Teladoc is reported to have donated remote medical care during the recent Hurricane Matthew. This partnership is positioned as an expansion of such disaster relief efforts rather than an expansion of its commercial activities.

Use of telemedicine in disaster relief has been implemented previously in the US by the Department of Veterans Affairs (VA). In 2014 the Office of Emergency Management of the VA awarded a contract to use the JEMS Technology disaster relief telehealth system. Going back much earlier, following the December 1988 earthquake in Armenia and the June 1989 gas explosion near Ufa, a satellite based audio, video and fax link, known as the Telemedicine Spacebridge, between four US and two Armenian and Russian medical centres,  permitted remote American consultants to assist Armenian and Russian physicians in the management of medical problems. Last year NATO tested use of telemedicine in disaster situations in a simulated disaster scenario in Ukraine.

Another system, Emergency Telehealth and Navigation, is deployed in Houston for helping with 911 calls. The Houston Fire Department has agreements with doctors so they have access to a doctor at any time to take calls from crew at emergency sites. They find that this avoids having to take some people to hospital when a doctor is able to determine that a condition is non-emergency where a paramedic may well have taken the patient to an Emergency Department.

The cybersecurity black hole–and bad flashback–that is the Internet of Things

click to enlargeOne week after the Dyn DDoS attack, the post-mortems get more alarming. Our Readers knew they were coming in 2014-2015 (our ‘Is IoT really necessary–and dangerous?)

IoT devices, and a lot of older networked medical devices, have been proven to be easy to hack, as even this non-ITer, non-codegeek realized then. But those in tech have been to this movie before–with Bluetooth circa 2002! Now shouldn’t designers have learned? From ZDNet:

“It’s almost like we’ve learned nothing from Bluetooth” says Justin Dolly, CISO at cybersecurity firm Malwarebytes.

“Seeing what these IoT vendors are doing, it just blows me away because they haven’t learned from history,” says Steve Manzuik, director of security research at Duo Security’s Duo Labs. “They’ve completely ignored everything that’s ever had bad vulnerabilities”.

Many of these devices, according to these experts, have default log in credentials, if they have them at all. IoT devices are also allegedly findable on a snoop site called Shodan. Reason why: the financial and market need to get products out fast and cheaply.

Over at data security company Varonis’ blog, with the great title in part, “Revenge of the Internet of Things”, another succinct and telling quote:

Once upon a time in early 2016, we were talking with pen tester Ken Munro about the security of IoT gadgetry — everything from wireless doorbells to coffee makers and other household appliances. I remember his answer when I asked about basic security in these devices. His reply: “You’re making a big step there, which is assuming that the manufacturer gave any thought to an attack from a hacker at all.”

Privacy by Design is not part of the vocabulary of the makers of these IoT gadgets

Varonis also gives a how-to on changing settings in your router so you don’t become a victim, and how to secure your gadgets.

Bottom line: when Hackermania is Running Wild, do you, or anyone, really need to be an early adopter of an internet- connected coffee maker or fridge? And if you need internet-connected home security, telemedicine virtual consults, telehealth/remote patient monitoring or telecare….best heed Varonis and secure it!

Earlier in TTA: Friday’s cyberattack is a shot-over-bow for healthcare 

Zimmer Biomet acquires telehealth company RespondWell

Orthopedic device maker Zimmer Biomet today (27 Oct) announced the acquisition of St Louis-based telerehabilitation + telehealth company RespondWell. RespondWell provides several facets of post-surgical physical therapy: telerehabilitation with clinically prescribed exercise routines, virtual doctor-patient consults, tablet-based personalized care plan delivery and data collection/RPM, and ‘gamified’ patient engagement tools. Up to the acquisition, according to Xconomy, RespondWell had raised $2 million from investors and had been seeking another raise of $8 million. Zimmer’s purchase price was not disclosed, but the changeover was swift, with the RespondWell website already copyrighted and top-bar tagged with Zimmer’s information.

Based on the release, RespondWell will be integrated into Zimmer Biomet Signature Solutions, using the brands Therapy@Home and presumably their original Fitness@Home. RespondWell’s former CEO Ted Spooner has been named VP of Connected Health at Zimmer Biomet; in his interview with MedCityNews, he was pleased at the exit and the acquisition by a company which wants to scale his solution.

Signature Solutions was formed from related Zimmer programs a few months ago as essentially a specialized value-based care consultancy and service provider. The combination of the two–VBC consultancy integrating with a health tech service provider–appears to be a nascent trend–and perhaps finally a path for telehealth providers. Hat tip to reader David Lee Scher MD via Twitter

‘Deconstructing the telehealth industry’ (Ziegler report, US)

A recently published white paper from Ziegler, a specialty healthcare investment bank, that actually does what it says –deconstruct the US telehealth (and telemedicine) industry. It also constructs a framework of ‘who does what’. Good graphic and text (but not infographic, mercifully) detail on the shareholders, barriers, tailwinds and future state, plus financial/acquisition participants and a compact growth history. Article here on Benzinga, or go directly to Ziegler to download.