The Theranos Story, ch. 21: the denouement of tears, fears and lawsuits

October 12, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/11/upside-down-duck.jpg” thumb_width=”150″ /]Finally, Theranos sinks its labs, Wellness Centers…and 340 employees. Since founder/CEO/controlling shareholder Elizabeth Holmes has been banned by CMS from running any labs for the next two years, shutting ’em down makes total sense in terms of saving her job. (Of course, if you are one of those fired employees in Arizona, California or Pennsylvania, it doesn’t. But hey, you may be worth more than Ms Holmes!) What she’s betting what is left of the company on is the miniLab, which hasn’t exactly come heartily out of the gate. It was Gimlet Eyed at the AACC annual meeting in Philadelphia, then shortly thereafter she withdrew from FDA review a Zika test using the miniLab due to lack of a patient-safety protocol approved by an institutional review board. (Tsk, tsk–Ed.)

Now the news of a lawsuit by a major investor will, in its process, reveal more of the Bubble That Was Theranos and possibly put the banana peel under the pivot. Investors sank over $800 million into the company, and one of them, Partner Fund Management, wants its $96 million back like Lee Marvin as Walker in Point Blank. According to the Wall Street Journal, which originally wielded the needle, the charges are that they and other funds were lured in by fraudulent claims and various misrepresentations of the Edison technology and its effectiveness–in other words, that they had labs and tests that actually worked. The SEC continues to investigate, including subpoenaing Partner and possibly other investors.  ABC News, Wall Street Journal (search on title ‘Major Investor Sues Theranos’ if you hit the paywall), Gizmodo 30 Aug, 11 Oct (a wonderfully Gimlety take by Eve Peyser), and a series of acid flashbacks in Forbes

See here for the 20 previous TTA chapters.

Artificial intelligence with IBM Watson, robotics pondered on 60 Minutes

October 12, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/06/robottoy-1.jpg” thumb_width=”150″ /]This Sunday, the long-running TV magazine show 60 Minutes (CBS) had a long Charlie Rose-led segment on artificial intelligence. It concentrated mainly on the good with a little bit of ugly thrown in. The longest part of it was on IBM Watson massively crunching and applying oncology and genomics to diagnosis. In a study of 1,000 cancer patients reviewed by the University of North Carolina at Chapel Hill’s molecular tumor board, while 99 percent of the doctor diagnoses were confirmed by Watson as accurate, Watson found ‘something new’ in 30 percent. As a tool, it is still considered to be in adolescence. Watson and data analytics technology has been a $15 billion investment for IBM, which can afford it, but by licensing it and through various partnerships, IBM has been starting to recoup it. The ‘children of Watson’ are also starting to grow. Over at Carnegie Mellon, robotics is king and Google Glass is reading visual data to give clues on speeding up reaction time. At Imperial College, Maja Pantic is taking the early steps into artificial emotional intelligence with a huge database of facial expressions and interpretations. In Hong Kong, Hanson Robotics is developing humanoid robots, and that may be part of the ‘ugly’ along with the fears that AI may outsmart humans in the not-so-distant future. 60 Minutes video and transcript

Speaking of recouping, IBM Watson Health‘s latest partnership is with Siemens Healthineers to develop population health technology and services to help providers operate in value-based care. Neil Versel at MedCityNews looks at that as well as 60 Minutes. Added bonus: a few chuckles about the rebranded Siemens Healthcare’s Disney-lite rebranding.

Telehealth in China: the largest market of them all?

October 12, 2016 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/10/HC_Bulletin_F14_bigdata_china_feature.jpg” thumb_width=”250″ /]Is China ready for telehealth, and the needed investment? It turns out that according to this article, the market does strongly resemble Western, Latin America and APAC countries in its needs and aging, dispersed population. The numbers (left) say yes. The market divides into three for the writer:

  1. A supplement to the public community care system, which has motivated most of the interest the Chinese government has in telehealth to care for millions (defined in the article as patient-doctor video consults, but doesn’t appear to exclude remote patient vital signs monitoring) as well as EHRs, scheduling, online access to diagnostic test results, and e-prescribing.
  2. Rural health care, not as unique as the writer seems to believe. Virtual consults and telehealth are used, and paid for, by CMS in US rural areas and on Native American reservations by the Indian Health Service. We also wrote about it in Brazil [TTA 27 Feb].
  3. Second opinions by Western physicians desired by high net worth individuals and upper middle class families. Again, not that unusual as this resembles the health tourism practiced by the affluent in Latin America and the adoption of video consults. This is denoted as the narrowest and chanciest of the three markets.

Chinese patients in (1) and (2), for the most part, would see any of these as an improvement. Their experience is that they get little time with a physician, don’t have a personal relationship with one or more doctors, and don’t expect much of a personal relationship with their doctor. So telehealth and RPM would be huge upgrades for China.  From Healthintelasia. Illustration from Analysis Group

Tunstall Americas adopts belle

October 12, 2016 | by

We haven’t heard much from Tunstall Healthcare in the past two months, but Tunstall Americas has announced that the belle PERS unit has been added to the US line of products which now . The belle is on the AT&T GSM cellular network for two-way voice communication with their 24/7 call center and GPS location technology. The pendant has a rechargeable battery that can last up to 30 days on a single charge, and can be either worn or carried in pocket or purse. Also new in the line is the Tunstall flood detector which signals the call center through the Vi+ and CEL.  Release, Tunstall Americas website.

Who’s hiring? 3rings (UK)

October 11, 2016 | by

Steve Purdham, who is the Chairman of 3rings, is advising our readers of two new Business Development Manager opportunities with his company.

The ‘Internet of Things’ is going to change the future of care and 3rings is at the centre of this fantastic opportunity. Due to expansion in its operation, 3rings, is looking for two ambitious BDM’s to join our digital team. If you have passion to change things then contact Steve on steve@3rings.co.uk

Full details @ https://news.3rings.co.uk/?p=237

3rings has developed and markets an electrical plug that, when the appliances are used, tracks a person’s activities of daily living. The information is delivered to the 3rings app so that family, friends and neighbors not only know of normal behavior but also when something is ‘off’. (Our past two years of coverage is here.)

GE Healthcare gets into accelerator biz with five.eight

October 5, 2016 | by

Having tip-toed around the accelerator action with StartUp Health Academy (GE Ventures), GE Healthcare (GEHC) is taking the full dive in with five.eight, named after the 5.8 billion people worldwide (citation not provided) who lack access to quality, affordable healthcare and need tailored approaches. Up to 10 startups in the initial program will be sourced from four social impact investors – Acumen, Aavishkaar-Intellecap Group, Unitus Seed Fund and Villgro. The five.eight funding will be up to $50 million, with each startup funded up to $5 million. The first startup in the program is Tricog, a Bangalore-based startup focused on improving survival rates in India by decreasing the average time between symptoms and treatment of heart attacks. Of course this ties into GEHC’s business in emerging markets, which is their Sustainable Healthcare Solutions, their “affordable care portfolio of high-value, low-cost technologies and healthcare delivery solutions for emerging markets.” HIT Consultant, HealthcareITNews

Ireland telecare monitoring a relative price bargain

October 5, 2016 | by

Our former Ireland editor Toni Bunting, in her business development capacity with TASK Community Care in County Meath and Belfast, notes that Irish pendant alarm (PERS) monitoring charges are on average considerably lower than charges in the UK and in Europe. At current advertised rates of approximately €65 – €80 annually, the rates are lower than the 2010 study of UK rates of £170-200 and £200 – £300 in Europe. (Of course with fluctuations in the pound, that may change!) Toni is asking if there are rates in Ireland which fall substantially outside this range, so please be in touch here or on Telecare.ie-Ireland’s Telecare Magazine, which provides information on emergency pendant alarms, telecare and 24/7 monitoring for Irish individuals, community workers and health professionals.

IBM Watson Health computes into diabetes management, UK care budgeting (US/UK)

October 5, 2016 | by | 1 Comment

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/10/SugarIQ2-712.jpg” thumb_width=”250″ /]IBM Watson Health, the advanced cognitive computing division of IBM, with Medtronic has developed an app that may, when marketed after FDA approval, help to ease for diabetes patients their daily ‘Battle of Stalingrad’. Sugar.IQ is an app that finds patterns in diabetes data through combining Watson’s cognitive computing capabilities with diabetes data from Medtronic and other sources. The app then uses continuous glucose monitoring data from Medtronic insulin pumps and glucose sensors to give specific, personalized information to the patient on their health trends and how to better manage their diabetes. The analytic features are impressive. Glycemic Assist lets the patient ask the app to follow specific food or therapy-related actions and events to see their exact impact. The Food Logging feature can track specific foods in a diary to determine the effects of specific foods. It is being tested presently on 100 MiniMed Connect users. Previewed at last week’s Health 2.0 conference. HealthcareITNews (photo), Medtronic blog post, Medtronic release (PDF) (This MiniMed Connect is not to be confused with the Medtronic MiniMed 670G artificial pancreas–hybrid closed-loop insulin delivery system for type 1 diabetes patients–just approved by FDA. MedCityNews)

In the UK, Harrow Council in northwest London is using IBM Watson Health’s Care Manager for social care service matching and budgeting. Using “cognitive technologies that provide personalised insight and evidence based guidelines”, Watson will match individuals’ needs and budgets to providers, and will be further able to manage costs over the ten-year agreement by “control(ling) the contract and payments between the individual commissioning for support, and social care providers competing to supply the service.” It’s not entirely clear to this Editor how the individual flexibility of care and services works with the recipient, however. The IBM Watson Health announcement follows on last May’s announcement with Alder Hey Children’s NHS Foundation Trust and the Hartee Centre to transform Alder Hey into the UK’s first “cognitive hospital”. DigitalHealth.net  Hat tip to reader Paul Costello of Viterion Digital Health

TSA’s 2016 International Technology Enabled Care Conference (UK)

September 30, 2016 | by | 1 Comment
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/09/TSA-logo-400×400.jpg” thumb_width=”100″ /]18-19 October, the ICC Birmingham

A reminder than in a few short weeks the annual International Technology Enabled Care Conference will take place at the International Convention Centre in Birmingham, hosting UK organizations across health, housing, home care, social care, industry and more.

The event will focus on TEC with the theme ‘Connected Care, Connected Homes and Connected Communities’, and feature a packed programme with, as they put it, “challenging debates, thought-provoking presentations, interactive workshops and brand new interactive zones to inspire, inform and drive forward sector collaboration.” The draft programme is here. Find out more at the conference’s home page and register at the full website here.  There are also a few exhibition booth stands and sponsorships left, looking at the interactive floor map, so your company may want to check here as well.

If you are a Reader and attending, please feel free to send Editor Donna your thoughts for publication on where the industry is going and what is it doing. (Please indicate if it is for attribution under your name or a nom de plume)

Mobile brain monitoring developments and impact (Israel)

September 28, 2016 | by

Accelerator/healthcare innovator StartupHealth’s ongoing series Startup Health Now! (#94) interviews Israeli entrepreneur Nathan Intrator, founder of Neurosteer, on developing new applications for brain monitoring in TBI cases, the impact home monitoring will have on patients and Israel’s burgeoning digital health scene. Highlights from the 18 minute video from this past June at Wearable Tech + Digital Health Conference, New York, NY include applications to monitor those who are minimally conscious to assist doctors in treatment; how data from remote patient home monitoring can detect early stage problems so that doctors can take proactive care, reducing cost and disruption; and Israel’s digital health ‘corridors’. Video

Wearables ‘shocker’: Website beats fitness tracker in weight loss program

September 28, 2016 | by

The shock waves are reverberating through the wearables industry, but it is likely less than it seems. The JAMA study being cited was testing the hypothesis that technology could assist a weight loss program, and also what type of technology did best. The subject group of 471 at the University of Pittsburgh was young–18-35, prime for a wearable–overweight to moderately obese, and tracked for 24 months between 2010 and 2012 (!) The participants were started on a group weight loss program supported with calls and texts for the first six months, then randomized into two groups that monitored their diet and fitness either through a fitness tracker plus website (enhanced intervention group), or those using a website only (standard intervention). Both groups lost weight but the enhanced/fitness tracker group lost 5.29 pounds less than the website-only group.

The caveats: According to Mobihealthnews, the fitness band used was BodyMedia SenseWear, which was acquired by Jawbone and as they noted, put out of business. Fitness bands now also look and feel different than this early generation. Mobile tracking apps are now the standard versus going online which was necessary four years ago–a huge jump in convenience. But tracking itself may change behavior. The authors speculate that tracking data might actually demotivate people, or that activity ‘congratulations’ may lead to a bit of cheating. But they should try it with up to date trackers. Also Healthcare Dive and Reuters

More tattletale data gathering: EEGs and sub-cutaneous RFID chips

September 21, 2016 | by

There’s a new biometric marker in town being used for authentication: the EEG (electroencephalograph). Brain waves have a cacaphony of information about emotional state, learning ability and personality traits, now being collected in relaxation or gaming apps through inexpensive headsets as simple as earbuds. So instead of iris scans and fingerprints, now it’s EEGs. However, it’s yet another privacy invading and eminently hackable source of data. Privacy: the collectors of information off that app may be matching your brain wave pattern to those on a data base–say, alcoholics. “In a blind trial, a machine learning classifier, trained to recognize brain patterns associated with alcoholism, used the brain wave data from the authentication systems to accurately identify 25 percent of the alcoholics in the sample.” You may not be a drinker, and the reading may be utterly ‘off’, but now it’s in the open, you have no idea of how it will be used. Similar patterns can be used to match from databases to identify learning disabilities, mental illnesses and more, which could make you tough to insure, for instance. IEEE Spectrum  Hat tip to former editor Toni Bunting.

The next generation of peripherals may not be external at all. Already around 50,000 early adopters or bodyhackers are implanting glass RFID chips in their hands or other parts of their bodies to let themselves into their homes and offices or to store emergency information. The head of a digital unit of Capgemini stored his Scandinavian Airlines boarding pass and travel information in a December test. This type of chip, about the size of a rice grain, uses no electricity but will activate when scanned by a reader. It’s easy to forecast medical uses such as records before surgery (operate on the right foot, not the left), an ID and information for someone post-stroke or with dementia, or as smart card loaded with funds. But this Editor can see it coupled with a nanosized battery as being tested now in external sensor patches or biostickers as John Rogers at University of Illinois, MC10 and others have been designing for several years–and the potential geometrically increases to send out other data such as vital signs. Perhaps EEGs one day? Wall Street Journal — plus a collection of our coverage of sensor patches

Fall/winter US events–Extra #1: TEDxNJIT, PCHA CHC and CHS

September 21, 2016 | by

“Shuttle Corridor” Conferences this fall! Coming up fast: New Jersey Institute of Technology is hosting a TEDxNJIT event on Innovation and Collaboration next Wednesday 28 Sept at the Jim Wise Theatre on their Newark campus. It’s not strictly healthcare–it includes everything from nanotech to the arts, students, entrepreneurs and local government. TEDx is the local, self-organized version of TED talks and “Ideas Worth Spreading”. See their flyer and website. Hat tip to Michael Ehrlich of NJIT’s Martin Tuchman School of Management. 

Partners HealthCare is hosting its 13th Annual Connected Health Symposium (CHS) 20-21 October, with an opening networking event on the 19th October evening, all at the Boston Seaport World Trade Center. The theme this year is “Digital Technology That Cares: Bringing the Human Element to Life”. Speakers are listed here. The CHS has traditionally been focused on care delivery and how it impacts the daily lives of patients, with a significant academic bent. More information, registration.

And put a few days aside before Christmas for the PCHA Connected Health Conference at the Gaylord National Harbor Resort near Washington DC, now back in December (11-14) when it belongs. It also includes the Global Digital Health Forum on the last two days, a separate conference co-presented by PCHA and the Global Digital Health Network, with the Canada-US Connected Health Workshop on the 14th and three pre-conference events on Sunday the 11th. More to come. TTA is a media partner of the PCHA CHC for the 8th year, starting in 2009 when it was the brand new mHealth Summit.

 

TTA’s Friday roundup of interesting articles, updates and weekend reads

September 16, 2016 | by

Fitbit may succeed in blocking Jawbone from selling in US? The Jawbone wins [TTA 27 July] in the US International Trade Commission court was apparently reversed due to a judge’s error for two Fitbit patents, and this may open the way for Fitbit to further block Jawbone. An additional California court action on infringement and misappropriation on trade secrets by Jawbone is headed for court in 2017. Mobihealthnews…..Maybe texting is enough? Dr Joseph Kvedar seems to think so for simple medication adherence and reminders, with reasons like the easy scaling of text messaging in EHRs, but prefers installing an app to deliver them due to the downsides of plain text messaging such as HIPAA and security. Thus we return to the logic of the desktop unit days (e.g. Health Buddy, Viterion) but delivered via smartphone. CHealthBlog….550 US primary care docs say no reimbursement, no telehealth (actually telemedicine). Usage in the past year was a scant 15 percent, with higher usage in Federally designated ‘safety net’ clinics (FQHCs) and HMOs versus PCMHs and ACOs where reimbursement by Medicare, Medicaid and private payers is far chancier. The survey was conducted by their association, the American Association of Family Physicians (AAFP). mHealthIntelligence….iHealth Andon Group buys France’s eDevice for $106 million. The aim seems to be integration of eDevice’s backend infrastructure to iHealth’s RPM devices. Mobihealthnews….A analysis of what went wrong at HealthSpot is in the new publication Telehealth & Medicine Today. A summary is that they had a business model that started out on point quite a while ago (2010) but then competitors and fresh technology ate their lunch (Editor’s term). They didn’t pivot to fit, moved too slowly and were overly wedded to their business model. A big problem was scaling costly kiosks and not finding the right places for them. While initially impressive, there was something all too elephantine about HealthSpot from the start. Our Readers interested in a Trip Down Memory Lane may read our collection of articles from 2013 here which pointed out most of the above….In the industry moves department, Peter Radsliff, whom this Editor worked with briefly on AgeTek-The Aging Technology Alliance (apparently defunct), has joined Arrayent, an IoT developer, as VP Marketing. Now that tells us something! Congrats to Peter!

And finally for a good long, but not light, read, this article in The Atlantic will give you a chilling glimpse of front-line medicine attempting to heal the carnage in Syria, using WhatsApp, texts and the simplest forms of telemedicine. A dedicated group of primarily Syrian-American doctors on a WhatsApp volunteer group called Madaya Medical Consultants uses it to perform consults with the minimal medical resources available in Syria. And yes, they know what Aleppo is.

Autumn/winter UK health tech events–Extra #1

September 16, 2016 | by

SEHTA (South East Health Technologies Alliance), one of the largest healthcare networking organizations in the UK, has two upcoming digital health-related events of interest to those in London and the Southeast. Hat tip to Clare Ansett of SEHTA for the details.

London Innovation Surgeries 26 Sept at Queen Mary University, London. There are only two spots left so act quickly. More information here. SEHTA is in partnership with Kent Surrey Sussex Academic Health Science Network (KSS AHSN), GLA, MedCity, Digital Health.London and Enteric HTC.

How to Access Funding 12 October at City Hall, London. This is a ‘how to’ workshop on finding funding from crowdfunding to public/private sector. Partners are KSS AHSN, GLA, MedCity and Digital Health.London. More information here. Free but limited registration.

 

Add 3 years to ‘Paperless 2020’: Robert Wachter at The King’s Fund (UK)

September 15, 2016 | by

The King’s Fund has helpfully published a report on the (duelling?) presentations at last week’s NHS Health and Care Innovation Expo by Robert Wachter, MD, the ‘digital doctor’ (our review of excerpts from his 2015 book here), and Secretary of State Jeremy Hunt on the feasibility of paperless health records. There is plenty of funding (£4.2 billion) for NHS.UK announced earlier this year, but plans are still sketchy. The adoption of the GOV.UK Verify service used in other parts of the UK government is intended to “standardise the process to activate patient accounts without the need for them to visit a GP surgery in person”. NHS is having another crack at an app library, and there was a bit of surprise, according to the writer, that Secretary Hunt said that fitness data will be integrated into NHS patient records. But Dr Wachter cautions that he’s walking back the 2020 date he advocated for full paperless records to 2023. He recognized that implementation in all but the most advanced hospitals (a handful) isn’t feasible. There are too many competing priorities and too little funding (and, this Editor would add, too many HIT threats like hacking and ransomware). Only the most “digitally-sophisticated hospitals” would be invited to be ‘global exemplars’ in exchange for matched funding, in his view. The King’s Fund will be publishing more about this later in September, presumably as a prelude to their upcoming Designing digital services around users’ needs on 6 Oct.  Wachter watch Hat tip to Reader Suzanne Woodman