Edinburgh Global Health MSc

A quick plug for the above which is a flexible part-time distance learning programme delivered entirely online using a combination of online tutorials, multimedia interactive learning materials, peer to-peer discussion and independent study. It looks very interesting. More details are here.

Claudia Pagliari tells me that the mHealth course will be available as a stand alone option or as part of a certificate of diploma track.

Post-market device surveillance – boring though very important

Thanks to Claudia Pagliari for passing me a news item from the Diabetes Technology Society, announcing that the Steering Committee has been assembled for its Surveillance Program for Cleared Blood Glucose Monitors. To quote:

“This program is intended to identify poorly performing blood glucose monitoring products on the market.   This surveillance program will provide an independent assessment of the performance of cleared blood glucose monitors following Food and Drug Administration (FDA) clearance.  The program will generate information that can assist patients, healthcare providers, and payers in making informed product selections.  The information will also be provided to FDA, which is the government agency that regulates these products.”

So why is this so important? Well one of the things this Editor discovered when doing research into how to encourage GPs to recommend medical apps is that none of the existing organisations that evaluate medical apps appear to recognise adequately that every change of operating system, every upgrade in functionality needs to be carefully checked to ensure the app is still as safe and effective as it was when the app was first evaluated. For example, some apps such as Mersey Burns check that the mobile is running the required operating system superbly; most don’t.

“After a product has been cleared for use by the FDA, there is currently no systematic post-market surveillance program that monitors for ongoing product quality post-clearance. Poorly performing BGM system can interfere with the ability of people with diabetes to reliably monitor their blood glucose levels, and make correct decision based upon the readings.  Inaccurate readings can lead to incorrect actions and therefore to adverse outcomes. Ongoing efforts by the FDA to improve accuracy standards for pre-market clearance would be undermined if performance was not maintained post-market.  Therefore, a post-market surveillance program is critically important to ensure the accuracy of cleared products for people with diabetes.”

So hats off to the Diabetic Technology Society – let’s hope others pick up this excellent initiative, particularly for medical apps. As David Klonoff, M.D., founder of Diabetes Technology Society and a Clinical Professor of Medicine at University of California, San Francisco said “This surveillance program will provide a significant benefit to both patients and manufacturers”.


Anyone doubting the benefits of clinical mobile access, read on…

Yes of course it is a survey produced by a supplier, so possibly a trifle biased, however EU News’s  item on the benefits of mobile access by community health people makes a very strong case for good access to clinical information when visiting patients that makes sense.

Notable quotes include:

Lack of access to patient information in real-time is affecting the ability of 88% of community health workers to perform their roles…

70% of participants said mobile working technology had resulted in greater patient involvement in care and the management of conditions, and had also improved the quality of visits, with more time focused on treatment.

Almost a fifth of respondents said they spent more than ten hours a week, the equivalent of more than two hours per day, on a combination of travelling back to base to file reports, and other administrative tasks – time that could be spent providing enhanced patient care or home visits.

mHealth: a salmagundi of items

Overloaded with Horizon2020 proposal adjudication and conference management (including the first DHACA members’ day on 11th July), this editor has been unable to do much Telehealth & Telecare Aware blogging. However the interesting items have continued to attract my attention and Prof Mike short (especially), Alex Wyke and Nicholas Robinson have continued to add further to the pile (huge thanks to all). So much seems worth highlighting: where to start? Perhaps with the 18 factors to make telemedicine a success, enumerated by the EU-funded Momentum project. Telecare Aware readers will be unsurprised by all 18, which look pretty basic. However many will notice obvious absences, such as the need to adduce evidence of the success of the intervention. Gluttons for punishment will find much more (more…)

Medvivo comes of age (UK)

A year after this editor began his three year stint with Telehealth Solutions, we had a corporate near-death experience, as money got very tight waiting for that first big telehealth order (thankfully it came, courtesy of NHS Norfolk). In those days of reduced salaries, and few employees, we could only dream of becoming a full service remote healthcare monitoring organisation.

This week’s announcement of the acquisition of Magna Careline shows how things have changed in just five years. After being acquired by Moonray Investors, (more…)

Enterprise wearables for clinical health–and more

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/06/Evena-veins-620×454.jpg” thumb_width=”150″ /]This ZDNet story technically has only one wearable in health–the Evena Medical Eyes-On Glasses which help medical staff find that vein (left) and is being trialled at Stanford University Medical Center. The other four profiled are being used in businesses as wide-ranging as engineering, restaurants, retail stores and manufacturing, but they are being used in the ‘here and now’: Abeseilon work-stream video; Google Glass for reviewing/recording work, training and coaching; the Theatro Wearable Computer ‘targeted’ messager; and, somewhat Big Brother-ish,  the Hitachi Business Microscope, an RFID-like device the size of an ID card that captures employee interactions and collaborations. A savvy HIT developer or implementer could, as has been done with Glass, find different uses for the other three in hospitals, home care or practices.

And you’ll be surprised what made TechRepublic’s list of wearables’ 10 biggest flops. (Already!)

Apple Health, minus the ‘book’, announced

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/06/healthkit-apple-wwdc-2014-87_verge_medium_landscape.jpg” thumb_width=”170″ /]Breaking and developing… Apple announced their long-rumored health tracking app [TTA 22 Mar] this morning at their WWDC (World Wide Developers Conference) in San Francisco. The consumer app is called Health (not Healthbook) and the developer platform HealthKit which are both part of iOS8 for iPhones and iPads in the fall. HealthKit facilitates pulling in of health data from third-party developers so that all health-related information for the consumer user is in one ‘hub’, similar to what Apple’s Passbook app does now as a ‘virtual pocket’ for airline boarding passes, movie tickets and coupons. Apple’s Craig Federighi, senior VP of software (pictured, courtesy of The Verge), made the announcement of the app and platform as part of the broader debut of iOS8 this morning.

Already on board is Mayo Clinic with an app that logs information like blood pressure, tracking normal range and it appears from reports that a severe enough deviation will initiate a contact with medical professionals. Nike was prominently featured as an app provider, further confirming that it’s leaving the hardware to their close corporate partner now that it’s out of the FuelBand business [TTA 22 April]. Epic Systems, a leading large system (hospitals/practices) EHR, appears to be integrating integrating its personal health record (PHR) with HealthKit, “suggesting a framework for getting information collected via HealthKit into patients’ MyChart (Epic PHR–Ed.) app.”

Editor Donna wonders if the still-in-early-days Better iPhone health personal assistant app (PHA), developed in conjunction with and backed by the aforementioned Mayo Clinic [TTA 23 Apr], will prominently integrate into Health. (We’ll cover when this develops, as we think it will–but mum’s their word for right now.)

In Mashable, the news was applauded by the CEO of leading app MyFitnessPal as a big validation. In his opinion, Apple would work with the existing field of apps and devices. Leading fitness bands Jawbone and Fitbit had no comment. Fitbit was shown during the presentation: CNET (one of six pictures here) and The Verge (article below). The latter makes the excellent point that Jawbone, Fitbit and the Nike FuelBand have all been sold in Apple’s stores.

The speculation is that Health will be a key part of the features of the iWatch to come, but Mashable in quoting Skip Snow of Forrester Research does bring up a significant wrinkle. Bluetooth LE as a network protocol chews up a lot of battery power, and bigger batteries make for clunky devices. Not exactly the Apple design ethic. Could it be that what’s delaying the iWatch is development of a new, more power-efficient network standard?

Update 3 June: With iOS8 having apps communicating with each other, have the Apple-oids opened the door for a Happy Hacking Holiday?  Stilgherrian in ZDNet points out that the ‘attack surface’ in info security-ese just got a whole lot larger. A future ‘oopsie’?

Hat tip to Editor Toni Bunting

More information: Mashable can’t stop mashing stories: Apple Reveals iOS 8: Interactive Notifications, Health App and MoreApple Gets Into Fitness Tracking With Health App and HealthKit for iOS 8Apple’s First Step Into Health Tracking Is Small But Powerful. Mobihealthnews gets into the act noting Epic’s involvement: Apple reveals tracking app HealthKit and partners with Mayo Clinic, Epic. The Verge positively is on said verge with Apple HealthKit announced: a hub for all your iOS fitness tracking needs.

Monday’s ‘in the news’ briefs

Proteus raises $120 million from “major new institutional investors based in the United States, Europe and Asia” for further development of its ‘smart pills’. Mobihealthnews. Previously in TTA here (starting in 2009!) It’s a long way from ‘tattletale pills’…..InTouch Health now has an FDA-cleared iPad app, CS for iPad, to support a digital stethoscope component on the mobile devices. The app is designed to assess heart and lung sounds in real time in acute-care settings particularly tele-ICU. MedCityNews…..In the mood to read your brainwaves? The Muse is here to help with neurofeedback. MedCityNews takes it on a test drive and if you don’t mind wiping your head down to get a good connection, it definitely points to the future of controlling computers with brain waves and in the meantime, pairing up health apps to get a correlation with those waves….And finally a ‘think piece’ in HeartSisters by Carolyn Thomas“To just be a person, and not a patient anymore” is largely an impossible dream for those with chronic disease. It’s part of the basis behind non-compliance and other patient behavior that doctors have difficulty understanding. The experience of the patient–the frustration (the ‘perpetual battle of Stalingrad’) and the burden that person carries is the argument behind ‘Minimally Disruptive Medicine’. Must reading as those same patients will be pressed now even more to Quantify Themselves and also to keep track of every fluctuation in vital signs on their iPhone.

More Samsung ‘we try harder’ telehealth moves

Is Samsung playing Avis “We try harder®” to Apple’s Hertz?

Samsung’s other, less noticed end-run in addition to the Simband reference hardware and SAMI ‘open ecosystem’  is an initiative creating a joint research center with the University of California, San Francisco (UCSF) called the Center for Digital Health Innovation (CDHI). It is being headed by Michael Blum, a medical doctor who is the UCSF assistant vice chancellor of informatics. From the statements made to The Atlantic, Dr Blum’s intent is to clinically validate the sensors and algorithms produced within the Samsung ecosystem. Already featured are four initial projects: CareWeb (a collaborative care platform built on Salesforce.com), Tidepool (infrastructure for diabetes apps), Health eHeart (clinical trial app on heart disease) and Trinity (‘precision team care’). On the frontier: ‘novel vital signs’ which he predicts will come out of the analysis of standard vital signs, “…new markers of health and wellness that come out of these large datasets.”  Is Samsung, rather than going head-to-head with Apple on Healthbook [TTA 22 Mar] is leapfrogging into something akin to Telehealth 2.0 or 3.0? Yet this Editor notes that we haven’t figured out, for the most part, the FBQs (Five Big Questions)* of 1.0….

* The Five Big Questions (FBQs)–who pays, how much, who’s looking at the data, who’s actioning it, how data is integrated into patient records.

Grant funds telemedicine for brain aneurysm

A grant of $150,000 has been awarded by a charitable foundation to fund a telemedicine [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/06/The-Missy-Project-logo.jpg” thumb_width=”150″ /]programme to help patients with brain aneurysms. The grant from The Missy Project, a Texas non-profit founded in 1999 after the sudden death of 12-year old Marisa (Missy) Magel due to a brain aneurysm, is being awarded to the Dartmouth-Hitchcock Hospital Center for Telehealth.

The funding will enable brain aneurysm patients in northern New England to have rapid access to neurovascular specialists, according to Dartmouth-Hitchcock. This will be achieved through telemedicine platforms to access the specialists at Dartmouth-Hitchcock from local facilities and community hospitals in what will be virtual aneurysm clinics. Once a patient has had a CT scan they will be able to proceed to a specialist consultation faster and more conveniently under this programme. In addition to virtual aneurysm clinics, the Dartmouth-Hitchcock project will include a 24/7 emergency department telemedicine acute consult service for pediatric and adult patients with suspected subarachnoid hemorrhage (which accounts for half of all hemorrhagic strokes), and customized educational video content, according to the Dartmouth-Hitchcock.

The number of deaths each year in the United States due to brain aneurysms  is estimated to be 32,000, more than either AIDS or prostate cancer, according to The Missy Project and an estimated 1 in 50 people, or 6 million people in the US have an unruptured brain aneurysm according to the Brain Aneurysm Foundation, so this project brings telemedicine to an important area.

Dartmouth-Hitchcock Center for Telehealth was awarded nearly a $1M from the USDA in February this year (see USDA invests $16M in distance learning and telemedicine) to deploy telemedicine equipment and services in New Hampshire and Vermont.

Suicide-alert sensor for prisons – no wearables needed!


GE Global Research has developed a non-contact monitoring system for prisons that aims to alert staff of a suicide attempt in progress. It works by tracking inmate’s movements and vital signs – but without the need for a wearable monitoring device! To achieve this the research team modified standard radar equipment to pick up the delicate movements of the chest caused by breathing and heartbeat.

The system which is designed to be mounted inside a prison cell could be an effective way to monitor at-risk individuals, without resorting to more expensive or more intrusive surveillance solutions. The US Department of Justice funded study proved to be 86 per cent accurate at determining whether someone required assistance.

The final technical report of the three part study is available in full at the National Criminal Justice Reference Service (NCJRS). GE is now exploring ways to commercialise the system in prisons and other settings. Read more: New ScientistNational Institute of Justice