[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/10/question_mark.jpg” thumb_width=”120″ /]Some clarity emerges from the controversy around Theranos
and last week’s Wall Street Journal
exposé [TTA 16 Oct
]. Last week’s rebuttal/denial released by the company said remarkably little, which disturbed Roger Parloff, the Fortune
writer who profiled the company in June 2014’s high-profile cover story. He failed to reach CEO Elizabeth Holmes, who on her break from an all-day with the Harvard Medical School Board of Fellows, taped a segment with CNBC stock tout Jim Cramer (a questionable priority indeed–Ed.
) Fortunately he received more specific answers via email from General Counsel Heather King. It clarifies among other things that venipuncture, not finger stick, is used in the majority of their tests in practice, and that dilution of samples is within industry practice for use in third-party analyzing machines. There also seem to be two sides to the proficiency-testing story. (Oddly, no mention of the sensational claims around British biochemist Ian Gibbons who was key to Theranos’ patent development and the alleged legal threats to his widow.)
For those who have difficulty getting through the WSJ paywall, Mr Parloff’s summary of the WSJ article’s main points is helpful. His conclusion: Theranos is wisely ‘dialing back’ its USP on drawing blood through finger stick to “Smaller samples. Smaller needles. Better experience.” (A neat pivot from what Theranos ‘made their bones’ on and still features–tiny finger-sticks.) His open-ended question (for, presumably, the next article): can it profitably run its low-cost testing business when it’s using the same analyzing machines as the big testing labs; and while cheaper, can doctors and patients trust the Theranos tests (which are a matter of health, and perhaps life and death) if they’ve flunked their first test at transparency?
Another view from Health 2.0 supremo Matthew Holt over at his Health Care Blog is that for Theranos, this blow is eminently recoverable if they play their cards right. Witness the recovery made by 23andMe, now in the good graces of FDA after having blown it badly to near-shutdown. (more…)
Three of the eleven companies through to the next stage of the NHS Small [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/10/SBRI-logo.jpg” thumb_width=”150″ /]Business Research Initiative (SBRI) are in the “Telehealth/Telecare for people with Learning Disabilities” category, according to the latest news release on the SBRI website. Each will receive a further £1 million to continue with prototype development and product testing.
The three companies are Red Embedded, Maldaba and Cupris Health. The other companies going through to the next stage are BioSensors, Digital Creativity in Disability, Bering, Docobo, ADI, Folium Optics, Armourgel and MIRA Rehab.
SBRI Healthcare is an initiative from NHS England supporting a programme of competitions inviting companies to come forward with their ideas and new technologies for known NHS challenges. In the last year, SBRI Healthcare has launched 10 new clinically-led competitions and awarded £22.4 million to 60 companies to develop products focused on specific NHS unmet need.
Read the full news release at SBRI Healthcare Funds Companies to Develop Game Changing Technologies.
Breaking News. According to an exposé published yesterday in The Wall Street Journal*, low-cost and fast growing small sample blood testing company Theranos [TTA 28 Aug] is not ‘doing what it says it does’. Four former employees allege that Theranos’ testing system, dubbed the Edison, which processes small finger-pricked blood samples collected in ‘nanotainers’, only handles a fraction of the tests claimed–19 out of 205. In a complaint to regulators, one Theranos employee accused the company of failing to report test results that raised questions about the precision of their proprietary Edison system–and that most of the tests were being run on traditional testing machines which required dilution of the tiny samples. The article reports on serious questions which have been raised on the accuracy of the Edison testing versus conventional testing, including the integrity of finger-pricked blood and sample dilution. Gaps in results were seen last year on tests for vitamin D, two thyroid hormones and prostate cancer, though Theranos has been reporting its tests to CMS in a process that all labs go through called proficiency testing, and has one test for herpes that has been FDA cleared.
In a follow up article, Theranos reportedly is no longer collecting nanotainers except for the FDA cleared herpes test.
Theranos is currently valued at $9 billion and has raised over $400 million in VC funding.
According to the first article, British biochemist Ian Gibbons, (more…)
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/10/Philips_AWS-IoT-infographic.jpg” thumb_width=”200″ /]The once-quiet Philips
is expanding its connectivity for HealthSuite through a partnership with Amazon
‘s recently announced collaboration with Amazon Web Services
(AWS). The objective in connecting through AWS is to expand to hundreds of million devices through a secure, stable IoT ‘device cloud’ that securely collects and analyzes data from apps (like the diabetes app in test with Radboud University, TTA 18 Sept
), medical devices and EMRs/PHRs. The Philips HealthSuite Digital Platform is a product of Philips’ collaboration with Salesforce, and is also (for now) targeted to senior care for adults. Philips’ release
and case studies are, unfortunately, buried in this very busy page. It’s another move for Philips that confirms their ‘Hospital to Home’ repositioning.
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/10/MyCareTrack.png” thumb_width=”150″ /]Tunstall Healthcare
has released a smartphone app for the safety of ‘lone workers’ including community health nurses who, in Australia, may be traveling and working in isolation or at night. MyCareTrack is accessed by a lone worker with an individual ID, and provides check-in, check-out capability, activity reporting, GPS tracking and SOS emergency alerts. It leverages Tunstall’s existing 24-hour response centers for automatic check-up calls and SOS. We wonder if this will be marketed in other countries as, for instance, the US has many areas which are as isolated as Australia for health workers. Pulse + IT (Australia)
It is rare to hear about telehealth from the Middle East, so it is refreshing to see a report dedicated to this subject. [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/10/Enabling-Telehealth.jpg” thumb_width=”150″ /]”Enabling Telehealth: Lessons for the Gulf” is a new report from the Intelligence Unit of The Economist which identifies principles and practices relevant to the Gulf Cooperation
Council (GCC) region. GCC is a regional intergovernmental political and economic union consisting of all Arab states in the Persian Gulf except for Iraq – i.e. Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and UAE.
The report has been commissioned by Philips and studies the environment in which telehealth operates – the policies, infrastructure, associated skills and institutional users. The Economist interviewed several experts for this report: the director of the Center for Connected Health Policy, associate Dean of the Mayo Clinic’s Center for Connected Care, chief medical officer of the European Health Telematics Association, a senior lecturer in professional healthcare education at the Open University and CEO of the International Alliance of Patients’ Organisations.
As the report points out in its summary, “… access to telehealth depends not only on telehealth technology. Policy frameworks must be modernised, communications infrastructures such as broadband and mobile network coverage must be improved, and skillsets – both of clinicians and patients – need to be strengthened.
Five key findings in the report are
- Ensuring access to telehealth depends not just on the technologies, but on the broader enabling environment, especially policy harmonisation, communications infrastructure, and skills.
- Governments should consider more efficient licensing if telehealth is to enable patients to access medical expertise outside of their state, province or country. Here it cites the examples of USA and Europe. The state by state licensing in the US is a barrier to telehealth and the cross-state harmonisation in the EU helps telehealth.
- Telehealth provision must go hand-in-hand with Internet infrastructure rollout, since vulnerable populations are the lowest users of the Internet.
- Focus on systems integration: “… build usable systems with the requisite security and privacy” which “work seamlessly with those already in place”.
- Health providers may need support in working with new technologiesThe full report is available to download here.
These days it seems you cannot get away from talk of innovation in the NHS – even the London Business School, this editor’s alma mater, is holding a conference on it, on 20th October. Then there’s the NHS Innovation Accelerator programme, the Accelerated Access Review (AAR), that this reviewer is involved with, the National Information Board (NIB), that this editor is also involved with, NHS Test Beds, the topic of a recent popular TTA blog, the NHS Vanguards, the NHS Pathfinders, the Integrated Care Pioneers and many others all seeking the holy grail of healthcare: improved patient outcomes, ideally at lower cost (or is that lower cost ideally with improved patient outcomes?).
If all this is too much and you have lost your way, the Royal Society of Medicine & NHS Innovations South West (NISW) have the solution: (more…)
Intel and GE’s joint venture, Care Innovations, is opening an IT and product development center in Louisville KY’s Norton Commons live/work community. According to reports, the 10-person office was opened to develop “software for medical monitoring systems that allow people to measure their vital signs in own homes and that will analyze the data for health care providers”, which sounds like a description of Health Harmony as mentioned further in the article. Also cited by CEO Sean Slovenski was the recent acquisition of several major clients in Mississippi, Louisiana, Kentucky and Tennessee. Headquarters will remain in Roseville, California, northeast of Sacramento and far east of Silicon Valley. Why Louisville? It’s the headquarters of Humana, currently in the early stages of a merger with Aetna. Mr Slovenski is an alumnus of Humana who undoubtedly recognizes that there’s always talent which shakes loose with any merger, often proactively. He has reorganized the company top to bottom since the days in the doldrums under Louis Burns, and added initiatives such as the Validation Institute plus academic relationships with the Jefferson School of Population Health, Xavier University and the University of Mississippi. Louisville is also a lot closer to Washington DC (1.5 hour flight time) and all those wonderful Federal programs with lots and lots of funding. Louisville Business First, release.
Speaking of the Aetna-Humana merger, it now has a strong boss man to make sure it works–Rick Jelinek, CEO for a year of OptumHealth, 19 years at predecessor now unit UnitedHealthcare including leading the Medicare Advantage and Medicaid businesses. The stakes are high in that the merger will create the second-largest managed care company in the US. Mr Jelinek also will lead Aetna’s enterprise strategy division, and will report directly to Aetna’s CEO. The timeline, unless the Feds put on the brakes, is to close in second half 2016. The combined operating revenue is projected at about $115 billion, with about 56 percent from government-sponsored programs, such as Medicare and Medicaid. The plan, according to Louisville Business First, is to headquarter the combined Medicare, Medicaid and Tricare businesses in Louisville. But, as they say, the meal is still being prepared, and assuredly not everyone at either company will find a seat at this table, or one they want to sit in.
TTA Situations Wanted poster succeeds! Back in August, Hannah Lowish, an experienced project manager formerly with one of the UK’s leading remote monitoring health providers, asked this Editor to run a listing posting her background in our ‘Who’s available?’ section (above). It was our pleasure to do so (and also revive this section under Jobs.)
Hannah has now written us advising that she has now started a new position with Tunstall Healthcare in their programme delivery team. Congratulations Hannah! And thank you for advising us.
And if you are seeking a new situation, or have a position to fill, we are listing–free as a service to our industry. Please write Editor Donna. We will post both confidential and identity revealed contacts.
Who’s hiring? mHabitat (UK) Who’s available? Industrial engineer with 20 years experience seeks Silver Economy company (Spain)
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/04/Thomas.jpg” thumb_width=”150″ /]Last week’s Health 2.0
conference was (of course) a three-ring circus of new technology and its corollary, a lot of hype. An astute writer new to this Editor, Michael Millenson, draws together the key points of two prominent, but not hyped speakers there: Robert Wachter, MD
and Michael Blum, MD
, both practicing in University of California San Francisco’s (UCSF) medical center. Dr Wachter, chief of the Division of Hospital Medicine, has been profiled in these pages earlier this year in a review of an excerpt
from his book, The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine’s Computer Age
. There he wrote about the example of Pablo Garcia, nearly dying from over-prescribed doses of an antibiotic that a chain of errors in their EHR started. Dr Blum is Director of UCSF’s Center for Digital Health Innovation. But their points are on the same track: “the danger of disruptive technology that disrupts the wrong things: upsets checks and balances that keep patients safe, makes working conditions more stressful and simply doesn’t play well with others.” His conclusions are on the money: #1, it’s not the technology but the adaptive change that front and back line clinicians will need to make; #2, entrepreneurs with whiz-bang tech that zips data to the clinician without fitting it into a care process are doomed to fail; #3 some kind of curation is needed. But whether that will be Care Innovations’ Validation Institute
or Social Wellth
(which purchased the late Happtique from GNYHA
) is another story. Key for Health IT Entrepreneurs: Don’t Disrupt the Wrong Thing (Forbes)
Currently in the US, the Department of Veteran Affairs may waive [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/10/Dept-of-VA-logo.jpg” thumb_width=”150″ /]the state license requirements for telemedicine services if both the healthcare professional and the patient are located at facilities owned by the Federal Government, according to Sen Joni Ernst from Iowa (see Ernst pushes for expansion of telehealth care for veterans). She is introducing the Veterans E-Health & Telemedicine Support Act in the Senate which, if enacted, would permit VA to allow the use of any location, such as a patient’s home. This, it is argued, will give better access to elderly, disabled and rural veterans. Ernst says that with 21 million veterans nationwide and 12% of veterans receiving some form of telehealth care in 2014 this could reduce costs for the VA. It is. however, not clear how many of the veterans receiving telemedicine care necessarily need out-of-state healthcare professionals to provide that care.
A similar Act is being introduced (or rather, re-introduced) in the House of Representatives by Rep Charles Rangel, a Democrat from New York with 18 co-sponsors (see E-Health Legislative Summary: The Veterans E-Health & Telemedicine Support Act of 2015). That act has previously been introduced in the House in 2012 and 2013 according Govtrack and its chances of being enacted this time round are considered very low (1%).
An antidote to Dan Munro’s top-down and pessimistic vision of healthcare transformation (having much in common with Ezekiel Emanuel’s, see below) are two parallel prescriptions on integrating digital health into our healthcare systems and maybe, just maybe, transforming it.
The first acknowledges basic reality: we have all the health tech and funding we need right now. We are way beyond the fictional one device, app or service that will deus ex machina and transform healthcare. What we in the field need to do is integrate them, measure (and integrate) the data, get these systems and services into the home and–interestingly–seek out atypical early adopters. Your users/patients may not be the sexiest market for cocktail party chatter–older adults, the developmentally or cognitively disabled–and you’ll have to think beyond smartphone apps, but here is an opportunity to make an impact on a real, large, high-need and open market which can improve care, outcomes and reduce/redistribute cost over time. How The Digital Health Revolution Will Become A Reality (TechCrunch) Hat tip to reader Paul Costello of Viterion Digital Health.
The second analyzes a key point often neglected in healthcare discussions but well-known to students of behavior, like marketers: the patient’s perception of value. (more…)
How to deliver medication reliably, well into the colon, to treat gastrointestinal disease most effectively? Purdue University researchers have developed an electronic drug capsule that delivers medication far into the digestive system. When triggered by the magnetic switch or electronic implant, it ‘detonates’ the capsule, releasing the medication. This delivery mechanism was tested through the stomach and into 20 feet of the small intestine. The promise is that it can deliver targeted medications farther into the colon, cost-effectively, to better treat IBS, Crohn’s and bacterial infections. The Purdue team is currently partnering with a biomedical company to take this into clinical trials. This takes the idea of Proteus’ ingested sensor to track medication one step further. Smart capsule to target colon diseases (Reuters)
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]If you believe we are in the midst of a slow, tidal disruption of healthcare and the ascendancy of patient-centered care–to the point of Topolesque patient ownership–then you will be upset to tears by the contrarian assertions of Dan Munro in Forbes
. He maintains that disruption isn’t what we think it is, but (and we cut to the chase here) it’s more like ‘process improvement’ and that it has to be driven by ‘K Street’ (translation: the street in Washington DC where Lobbyists Rule). Technology–patches on the flawed system. Doctors–desperately seeking to pay back their educational loans by picking the most lucrative specialties. (If they survive the internship and residency system without killing a patient or themselves; see The Misery of a Doctor’s First Days
But..there’s more. (more…)
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/10/darpa-electrx-electric-prescriptions-2.jpg” thumb_width=”200″ /]I sing the self-healing Body Electric!
With apologies to Ray Bradbury, in this Editor’s view, DARPA’s ElectRX
research is almost revolutionary, yet logical. Like a pacemaker, it monitors a condition (like heartbeat) and if ‘off’ stimulates the organ through an electric shock. Scale it to a nano-sized neuromodulator and you have ElectRX. In broad terms, a tiny device, perhaps delivered by a needle, analyzes an anomaly and delivers an electrical signal to nerve pathways to correct it. For diabetics, it could stimulate insulin production; to treat depression, control inflammation in the brain; for PTSD patients, stimulate the vagus nerve for neural plasticity. Controlling inflammation has other benefits, such as in spinal injury and in TBI. While the Gizmag article
spends time musing on ‘super-soldiers’ and the negative aspect, this Editor sees this research on the relationship between neural circuits and health as a significant development for both medicine and for Version 3.0 of digital health. DARPA web page on ElectRX.
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/10/Doctor-Big-Brother.jpg” thumb_width=”150″ /]“They’re watching me on my phone. They’re watching me on Facebook. They’re even watching me when I want to hide. Machines are a form of intelligence, and they’re being built into everything.”–Dr Zeynep Tufekci
The world of digital health is largely based on tracking–via smartphones, wearables, watches–and analytics taking and modeling All That Data we generate. Are we in compliance with our meds? Are we exercising enough? How’s our A1c trending? Drinking our water? All this monitoring–online and offline–is increasingly of concern to Deep Thinkers like Dr Tufekci, a reformed computer programmer, now University of North Carolina assistant professor and self-proclaimed “techno-sociologist.” At IdeaFestival 2015, she took particular aim at Facebook (surprisingly, not at Google) for knowing a tremendous amount about us by our behavior, of course using it to anticipate and sell us on what we might want. The ethics of machine learning are still hazy and machines are prone to error, different than human error, and we haven’t accounted for machine error in our systems yet. Like that big health data that mistakes a daughter for her mother and drops critical health information from a patient’s EHR [TTA 29 Sep]. A thought-provoker to kick off your week. TechRepublic
Related: The Gimlet Eye took a squint at Big Brother Gathering and Monetizing Your Big Blinking Data–data mining, privacy and employer wellness programs–back in 2013, which means the Eye and Dr Tufekci should get together for coffee, smartphones off of course. While Glass is gone, the revolt against relentless monitoring is well-dramatized in the well-watched video, ‘Uninvited Guests’. And we can get equally scared about AI–artificial intelligence–like Steve Wozniak.