State telemedicine legislation update (US)

Here’s some brief updates on US telemedicine legislation scene to hit the news recently.

Florida

Florida is progressing the telehealth bill we reported on 12 Feb 2015. The Florida Senate [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/Florida-House-of-Representattives.jpg” thumb_width=”150″ /]Telehealth Policy Committee revised the draft bill on 18 Feb 2015 so the need for Medicaid reimbursements to be the same for telemedicine and face-to-face consultations is removed.

Mississippi

We have reported many telehealth initiatives from Mississippi and the state is now considered to be “a leader in telemedicine” according to a recent report in Politico. “Mississippi’s telemedicine program, ranked among the seven best in the country, has inspired neighboring Arkansas to take bigger steps in some areas of the field, and the impact of its success is making waves in Washington as well” continues Politico.

Mississippi is also helping to move telehealth at a federal level. Rep. Gregg Harper (R-Miss.) and Rep. Mike Thompson (D-CA) introduced a bipartisan bill in July last year to expand telehealth services under Medicare. The bill called Medicare [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/mississippi-logo1.jpg” thumb_width=”150″ /]Telehealth Parity Act 2014 starts to move face to face and telehealth consultations to be on an equal footing.

(more…)

New alliance for m-health in Europe

Swedish telecommunications company Tele2, with operations in nine European countries, has announced that it is to partner with HCL Technologies to develop Machine to Machine (M2M) [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/Tele2.jpg” thumb_width=”150″ /]and Internet of Things (IoT) solutions, particularly those within the m-health [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/HCL.jpg” thumb_width=”150″ /]market. In an announcement on their website, HCL Technologies, which employs over 100,000 people worldwide, said “by focusing on the Healthcare segment in Europe, the two companies will jointly address one of the fastest growing areas of the M2M/IoT market. For example, in healthcare the two companies are planning to develop remote patient monitoring systems that are enabled through smartphones. HCL and Tele2 will work together in an effort to reduce transactional and operational costs for their partners, whilst tapping into the lucrative revenue opportunities that exist within the European IoT/M2M market.”

The news article continues “HCL will be responsible for the implementation, integration, roll-out and ongoing support of M2M/IoT solutions, in addition to device connectivity through its flagship Device Gateway product – Aegis. This becomes feasible through Tele2’s Control Center, which is the market leading M2M/IoT connectivity platform in the world.”

Telecare LIN Newsletter

The Telecare LIN Newsletter for this month is out now and contains 44 pages of news, views [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/02/ALIP.jpg” thumb_width=”150″ /]and updates on various projects related to care for the elderly and telecare, mainly from the UK.

A short article in the NHS England website announcing a meeting in London in March entitled “Older People’s Care Summit” is highlighted and some of the statistics there caught my eye. It says that there are 3 million people over the age of 80 in the UK and by 2030 the number is expected to double with the figure reaching 8 million by 2050. I’ve worked with the demographic change graphs for some time now but this is a particularly stark statistic to bring home the need for new approaches to care for the elderly. (The summit still had spaces available if anyone is interested and registration is at this page).

There is a link to Roy Lilley’s new website “The Academy of Fabulous NHS Stuff”  and pointers to some article on telemedicine in China.

On the technology side there is an item on mental health apps and a pointer to a good article on why Australia (could be any country really) isn’t further ahead than it is with Assistive Tech for the elderly living at home.

A good read to catch up on things you may have missed over the month.

AstraZeneca awards over $200k for heart failure telehealth

AstraZeneca Healthcare Foundation, the charitable arm of the UK based pharmaceutical company AstraZeneca, has awarded $205,564 to HSHS St. John’s Hospital in Illinois to support their Tele-Heart Pathway programme. [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/02/HSHS.jpg” thumb_width=”150″ /]The programme provides interventions to heart failure patients in their homes to support health management. With telemedicine and telehealth technology doctors monitor symptoms and help avoid complications at home after surgery, according to the hospital.

 “We have seen a rapid evolution in the last few years of new devices and new ways of communicating with our patients,” said Mark Stampehl, MD and Medical Director of the heart failure programme at Prairie Heart Institute (PHI) at St. John’s Hospital, in an article entitled Telemedicine elevates care for heart patients published in the fall 2014 issue of the hospital’s quarterly magazine Healthy You. “Today, we are using tools to remotely monitor a patient’s condition and increase communication with other physicians to give patients access to specialty care from home.” (more…)

Florida to try telehealth legislation – again

After repeatedly failing to pass a law to formalise payments for telehealth, Florida State [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/02/Florida-House-of-Representattives.jpg” thumb_width=”150″ /]legislature is to try again this year, according to Florida state senator Aaron Bean. Moderating the Telemedicine and Telehealth session at the Florida Health Care Affordability Summit on Monday, 8 February, Sen. Bean has suggested that the latest bill, highly focused on telehealth, will be only 3 pages long. Attempts to legislate in in the previous session of the Florida House of Representatives resulted in failed bills in both chambers due to the inclusion of many controversial items.

(more…)

State of telehealth in Australia – a GP’s view

As we have noted in the past, Australia has provided incentives for GPs to implement videoconference telehealth [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/02/AFP2.jpg” thumb_width=”150″ /]consultations in remote rural areas. Simple though it may be from a conceptual point of view, providing the ability for people in isolated communities to have access to specialists can make an enormous difference to the healthcare they receive.

Dr Ewen McPhee, a GP from rural Queensland, writing in the Australian Family Physician’s December issue (“Telehealth: the general practice perspective”) briefly looks at the state of videoconference telehealth in Australia 3 years after the current incentives were implemented. “Three years later, the implementation of telehealth videoconferencing has been inconsistent and patchy, yet to be normalised as part of primary care practice” says McPhee.

Living in cities like London or New York it can sometimes be hard to imagine (more…)

Telehealth for Motor Neurone Disease

In a recent article (Wearables and mHealth: a few observations, TTA July 13, 2014) editor Charles Lowe reported on the [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/10/sitranlogo.jpg” thumb_width=”150″ /]successful uses of telehealth to manage those with Motor Neurone Disease (MND) in Australia. Now we have a report from the Sheffield Institute for Translational Neuroscience (SITraN), part of the University of Sheffield, of a trial in the UK of a patient monitoring system to ensure that aids and assistance can get to patients at the right time.

According to the news release from SITraN the system consists of an App on a tablet and a website. The App provides weekly updates on mobility and general well-being to the patient’s specialist MND care team. The website provides guidance on the use of breathing support for people with MND.

SITraN has received funding from the National Institute for Health Research for a trial of 40 patients to assess how well the telehealth system works.

House Bill introduced to improve Accountable Care Orgs (US)

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/10/file0001205588090-doctor.jpg” thumb_width=”150″ /]A bill has been introduced in the US Congress with the aim of improving Accountable Care Organizations (ACOs). The cross-party bill HR 5558, to be known as the ACO improvement act of 2014, if passed, will amend the Medicare ACO Programs to permit the use of remote patient monitoring, deliver images to remote providers and improve the data sharing between ACOs and Medicare administration.

ACOs are groups of doctors, hospitals and other health care providers who come together voluntarily to give care to Medicare patients. The goal of the three ACO programs is to ensure patients, specially the chronically ill, get the right care at the right time avoiding duplication and waste. When an ACO succeeds in achieving savings for Medicare, that saving is shared with the (more…)

Smartphones, wearables are the future says NHS England

NHS England has sketched out the future of healthcare and it will be one using smartphones and wearable bio-sensors to monitor ourselves and alert clinicians. [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/09/NHS-England.jpg” thumb_width=”150″ /]NHS National Medical Director Sir Bruce Keogh has written to around 250 organisations across health, social care, industry and third sector asking them to support the Technology Enabled Care Services (TECS) programme which he says will take the NHS into this new technological era.

The TECS programme, born out of the Three Million Lives (3ML) initiative (which didn’t quite go anywhere after all the song and dance, including from Prime Minister David Cameron), was reviewed last year resulting in the change of focus to “address the demand for support and practical tools to commission, procure, implement and evaluate technology enabled care services” according to Sir Bruce’s letter as reported on the NHS England website.

The TECS Stakeholder Forum‘s views and proposals now form the TECS Improvement Plan for 2014-17. This is a broader group following the failure of the 3ML Stakeholder Forum, which consisted mainly big industry organisations, to achieve anything of substance.

According to the NHS England website posting, Sir Bruce explains: “To ensure continued progress, we have brought together a TECS Implementation Group consisting of experts and leaders from across these sectors whose remit is to support the strategic development and delivery of the proposals within the Improvement Plan. In addition, we have formed the TECS Executive Steering Group which meets regularly to provide clinical, technological and strategic leadership for the programme at a director level in NHS England.”

This all sounds like a lot of bureaucracy and a drawn out attempt to rescue what remains of the 3ML programme. I started thinking of the Titanic and deck chairs.

Assisted Vision: sight enhancement for the partially sighted

Dr Stephen Hicks is a Research Fellow in neuroscience and visual prosthetics at the University of Oxford. He and his team are working on a project to develop a pair of glasses to help partially [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Smart-Glasses.jpg” thumb_width=”150″ /]sighted people “see” what is in front of them.

BBC’s Johny Cassidy spoke to Hicks recently about the Oxford smart specs project for BBC’s In Touch programme. The project uses Augmented Reality (AR) to make objects in the field of vision sharper for partially sighted people. Hicks says the object is to “try to make a pair of glasses which look relatively normal to people in the environment and still provides a computer based object enhancement and object detection that would be able to be seen by people with very, very limited sight”.

The glasses use two cameras, a gyroscope, a compass and a GPS unit. The “lenses” are made of transparent OLED displays enabling the wearer to see through with any available sight and also allowing others to see the user’s eyes.

“The next step in terms of commercial development is to reduce the size of the glasses and the processing unit into something acceptable to people in day to day life”, says Hicks. The “take-home” versions are targeted to be built in autumn this year.

How much is it likely to cost? A stated goal of the project is to keep the costs down so that the maximum number of people as possible will have access to these glasses. So where possible off-the-shelf components are being used. Hicks says that a pair of glasses for less than £300 is possible compared to just under US$10,000 for the only other one that Johny Cassidy had been able to find. Google Glass, Epson Moverio and similar glasses are, of course, not functionally comparable.

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.

Health funding cuts in Australia

Health and science funding in Australia are facing huge cutbacks under the new Government [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/Australian-budget.jpg” thumb_width=”150″ /]of Prime Minister Tony Abbott leading to expectations that the existing telehealth programmes will be reduced or abandoned as a direct result. A raft of cuts include closure of health and science agencies, funding cuts to major research institutes and the introduction of co-payment for each GP visit.

The Guardian reported that a cut of $1.8 billion of planned health payments to the States will take place over the next four years and The Lancet reports that the government’s share of the health service funding will be cut by $15 billion per year by 2024. The treasurer for New South Wales has stated that NSW itself would need to find an extra $1.2 bn over the next four years. ABC reported yesterday that the South Australian Government is planning to shut hundreds of hospital beds in next month’s budget in what will be the largest cut in its history.

Where will this leave the Australian telehealth and telecare services which have been showing rapid take-up in the recent past, helped along by several far-sighted Government initiatives such as Medicare Locals and telehealth pilots? And what impact will there be on the recent One in Four Lives industry initiative?

 

UK Telehealthcare MarketPlace 2014 (UK)

UK Telehealthcare is again having a free-to-attend London Market Place in Kensington Town [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/UKTHC-logo-final1.jpg” thumb_width=”150″ /]Hall, on 2nd June 2014. In case you are wondering, UK Telehealthcare is the re-branded London Telecare. The change which took place in September last year is taking the London Telecare model nationwide.

These Market Place events provide the supplier members of UK Telehealthcare the opportunity to show their telehealth and telecare products and for visitors to try them out and discuss their requirements. The Market Place is open for five hours and there is a programme of talks running in parallel. See the flyer (pdf) for other details. As the flyer says, there is no need to book but please let Doug Miles know id you are planning to attend.

April Telecare LIN newsletter out (UK)

The Telecare Learning and Improvement Network (LIN) newsletter for April is out now to download and read at your leisure and as usual contains a host of items from the last month.

There is a good roundup of UK care news in the face of the creation of the Clinical Commissioning Groups as well as news from further afield.

The LIN comes from the Health Tech and Medicines Knowledge Transfer Network which was, until April, one of the many KTNs funded by the UK Technology Strategy Board (TSB). There has now been a major reorganisation of KTNs at the TSB and the various KTNs have been consolidated into one KTN with communities within this KTN specialising in different areas. There is no mention of what impact, if any, this will have on ALIP and the the Telecare LIN – perhaps something for next month?

More UK older adults are now going online

Telehealth and telecare applications can often depend on the willingness of the users to use the [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/Ofcom-logo.jpg” thumb_width=”150″ /]internet and that is not to be taken for granted with older users. On the other hand it is indeed the older people who can most benefit from these technologies. Recent research in the UK shows encouraging results in this respect.

Ofcom, the UK telecoms regulator, has a duty to promote media literacy and to carry out research to measure the usage of all forms media. The results of the most recent surveys commissioned by Ofcom were published on Tuesday. Adults’ Media Use and Attitudes Report 2014 is an encouraging report showing that the use of the internet by over-65s has increased by over a quarter over the past 12 months.

“The proportion of people aged over 65 that are accessing the web reached 42% in 2013, up nine percentage points from 33% in 2012. One reason found for this is an increase in the use of tablet computers by older people aged 65-74 to go online, up from 5% in 2012 to 17% in 2013. This has helped to drive overall internet use up from 79% of all adults in 2012 to 83% in 2013” say Ofcom.

“However, older people spend significantly less time surfing the web than younger people (16-24 year olds), who on average spend more than a whole day (24 hours 12 minutes) each week online. This compares to an average 9 hours 12 minutes online per week among adults over 65.”

Although these results are for the UK, they probably broadly represent the trends in most developed countries.

Welsh Government to develop new eHealth and Care Strategy

The Government of Wales has announced that it is to develop a new eHealth and care strategy in [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/04/Welsh-Goverment.jpg” thumb_width=”150″ /]conjunction with health boards, NHS trusts and local authorities in Wales. The strategy will focus on using technology such as video conferencing, remote monitoring and better use of health records.

In a written statement issued last week while the Welsh Assembly is on its break, the minister for health and social services states that consultation will take place with health and social care professionals and users and the strategy will be in place by the end of the year.

“This will help us achieve our aim of ensuring there are more services, care and support available for patients in their homes or in their local communities” says the statement from Mark Drakeford.

“Technology has a key role to play. This could include the use of video conferencing to allow patients and health professionals to talk to each other; to aid diagnosis and decision making and remote monitoring for people with particular health conditions. Technology can also help improve access to services by bringing them closer to people’s homes, for example by providing mobile services in rural areas.

“With an increasing ageing population it is essential we enable people to live independently for as long as possible. Without this, the health and well-being of individuals will be adversely affected.

“We will expect our information to be accessible to professionals where and when it is needed whether in health or in social care. We already have the Individual Health Record, with appropriate security and governance in place. Any potential wider access to people’s data would only be with their consent.”

The full statement is available on the Welsh Government website here.