Trusting a virtual diagnosis? 74 percent of adults wouldn’t (US)

July 17, 2015 | by | 1 Comment

It’s a matter of trust. While telemedicine is benefiting from liberalization of state regulations, proof of cost savings and consumer acceptance of mobile technologies (plus a surge in investor confidence!), there’s still the hurdle of patient confidence.

Just under 45 percent in this survey are very or somewhat comfortable with a virtual doctor’s appointment. Over 64 percent would not readily choose one over an in-person visit.

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When it comes to trusting the diagnosis, almost 75 percent of the 504 respondents either would not trust it at all (29.3 percent) or would trust it less (45 percent). But the ‘would not trust’ sentiment is heavily skewed to those 45+ (left).

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The good news here is that when it comes to follow up with a doctor via telemedicine, the tables turn almost exactly in its favor (left).

The hope is that the last will increase acceptance of the first–and the age trend is telemedicine’s friend. Both bode well for the growth of telemedicine in the near future.

Do Patients Trust Telemedicine? (PDF) (TechnologyAdvice Research/Google Consumer Insights) Also HIT Consultant plus their infographic (hat tip to AliveCor’s David Albert MD via Twitter @DrDave01)

Telemedicine’s 25 things to know better–and Better

July 17, 2015 | by

For those of us who have been Terminology Warriors going back to the oughts (see founder and EIC emeritus Steve Hards’ summary in ‘What is Telecare’), this is a useful summary of not only what is telemedicine and who is authorized to perform it, but also how it is developing (US focus) in state law and reimbursement (private and Medicare). Despite being published earlier this month, it is already dated as reimbursement parity laws have been passed in Connecticut and Delaware [TTA 10 July]. The richly IPO’d Teladoc is omitted on the provider list in point #21; Better is anomalous as it is less telemedicine than a personal health assistance service.  25 things to know about telemedicine (Becker’s Health IT and CIO Review)

About Better: they have joined with Johns Hopkins’ Sibley Memorial Hospital Innovation Hub to provide support for orthopedic episodes of care. These generally are for a 90 day period which extends from scheduling the procedure through post-discharge recovery, and are usually tied into a bundled payment from an insurer or Medicare. Johns Hopkins press release Hat tip to CEO Geoff Clapp.

Blueprint Health’s 8 for Class 8

July 17, 2015 | by

Blueprint Health announced its Summer 2015 class of 8 on Thursday. The NYC-based accelerator, since its early startup days in 2011, now focuses on companies further along in the development continuum. Telehealth companies would find Oculus Health most interesting as Medicare chronic care management and telehealth reimbursement present opportunities for remote patient monitoring expansion.

Bind (Bind-Health.com) Helps prospective parents to make informed decisions about genomic testing and provides genetic counseling services
Crediyo (Crediyo.com) Decreases patient payment write-offs and improves cash flow for medical practices with turn-key patient lending products
Ekovia (Ekovia.com) Helps hospital hire top talent with the most robust database healthcare professionals and algorithms to predict who is open to new job opportunities
GetCompliant (HIPAAWithUs.com) Provides a full service platform for HIPAA compliance for physician practices (more…)

Telehealth in pediatrics: same statement, two opposing views

July 16, 2015 | by

Telehealth and telemedicine use in pediatrics is relatively limited at present and low profile. That may change with a statement published earlier this month in the journal of the American Academy of Pediatrics (AAP). It has been interpreted in two ways which are polar opposites. The first pictures telehealth and telemedicine as potentially practice-transforming (mHealth Intelligence), improving health outcomes in underserved communities through continuous care, and with high potential to benefit communication between the pediatric care team and patients in disease management. The second criticizes ‘episodic care in isolation’–telemedicine patient-doctor consults that take place with no previous relationship, history or physical exam (mHealth News)--as is the antithesis of the PCMH (patient-centered medical home) the AAP advocates. This Editor’s take: the statement supports both sides with a great deal of cautionary language. Pediatrics (full content).

46 percent of undiagnosed chronic disease discovered through corporate wellness program

July 14, 2015 | by

A HealthMine survey of corporate wellness program participants found that 46 percent of respondents who were diagnosed with a previously unknown chronic disease discovered it as a result of their wellness program. Corporate wellness programs have been light on ROI metrics (many are at heart incentive programs). While the survey was conducted by a provider of these programs (HealthMine’s Automatic Health) and should be seen in that light, it also indirectly confirms the proactive value of health screenings. Employees want more as well. Participants in an earlier survey that they would like programs to offer vision (74 percent), genetic testing (75 percent), blood pressure (73 percent), cholesterol (69 percent), cancer (58 percent), and hearing (58 percent). The MedCityNews article also makes the excellent point that employers, through these wellness programs, are directly or indirectly accessing employee personal health information–a legally fraught area.

A med reminder app that manages and delivers those pills

July 14, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/07/Pillpack_phone_and_watch1-482×362.jpg” thumb_width=”150″ /]Medication compliance apps have been with us almost since the start and have had a certain popularity. However, most are essentially alarm clocks reminding the patient to take what pill at what time. Some have added refill reminders and interact with pill dispensers or smart caps. They also require a lot of work to manually fill in medication and dosing information. PillPack goes another few yards by integrating one-stop pharmacy-based med management, coordinated through a database that aggregates identified patient prescription information from pharmacies and insurance claims.  (more…)

‘Uninvited Guests’

July 14, 2015 | by | 8 Comments

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/07/SmartFork3-small-Superflux.jpg” thumb_width=”150″ /]Wonder what it would be like to be older and ‘nannied’ by some of the ‘whiz-bang’ devices we promote as making life healthier and better? This short (4 minute) video dramatizes how a 70 year old man deals with the smartphone-connected devices–a food-monitoring fork, activity-tracking cane, pill dispenser and sleep monitor–his well-meaning children have provided to nag and monitor Dad at a distance. Dad dispenses with these annoying ‘uninvited guests’ in his own clever way. Produced by the UK/India-based design consultancy Superflux Lab for the ThingTank project, which explores the conflicts and frictions these IoT tools in the connected home can produce with humans. On Vimeo. Hat tip to Guy Dewsbury via Twitter.

“Who do I call?” when the cyberalarm goes off

July 10, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/02/Hackermania.jpg” thumb_width=”175″ /]A top read for the weekend is this short article by Gillian Tett in the FT on the lack of coordination in the US in not only protecting systems from cyberattack, but also the lack of coordination between public and private sectors in protection–and when something does go wrong. As Henry Kissinger famously said about Europe when various crises loomed, ‘who do I call?’

Indicators of a gathering storm are everywhere:

* Wednesday’s hours-long, still unexplained outages at the NYSE and United Airlines. (The Wall Street Journal website going down for a bit was the topping on the jitters)

* A joint report from Cambridge University and Lloyds insurance group, also released Wednesday, estimated that a hack shutting down the US electrical grid would create $1 trillion in damage. (more…)

AdhereTech’s smart pill bottle gets a new retro design

July 10, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/07/AdhereTech-pill-bottle-e1436497826583.jpg” thumb_width=”120″ /] My visit to CEWEEK in NY at the end of June was, in contrast to the 2014 edition, light on compelling health tech. One that stood out, for all the modesty of their display, was NYC-based AdhereTech. It’s a med reminder system pushed to the max: a pill bottle that dispenses normally, but collects and sends adherence data in real-time, with a system that analyzes and records the data. If a dose is missed, they send out customizable alerts and interventions to patients, using automated phone calls, text messages and other reminders. It also uniquely measures the level in the bottleso it can automatically notify the patient, provider and pharmacy about a refill.

When last we saw them, they had just won a spot in the inaugural (2013) Pilot Health Tech NYC program. They have redesigned the bottle to have a more compact, retro med bottle-like shape along with a brighter light and chime. (more…)

Payer reimbursement for telehealth, telemedicine gains in Delaware, Connecticut (US)

July 10, 2015 | by

Two states–Connecticut and Delaware–are now requiring private commercial insurers to cover telemedicine and telehealth services at parity with in-person visits. Connecticut was first, signed into law on 22 June but not starting till 1 January 2016. It covers not only video consults but distance care delivered both synchronously and asynchronously, such as store and forward transfers, and covers remote patient monitoring. It specifically omits audio-only consults, email, texting and fax (!). The Connecticut law also requires parity of payment with in-person visits to prevent lower reimbursements. Delaware’s law was signed 7 July to take effect immediately, and based on the summary is similar in breadth to Connecticut’s. Delaware is now the 29th state to enact telehealth/telemedicine reimbursement legislation. Articles written by members of the Foley & Lardner law firm. JD Supra, Lexology

On the Federal front, Representative Mike Thompson (D-CA) and three other members of the House of Representatives introduced H.R. 2948, the Medicare Telehealth Parity Act of 2015. It would remove the current geographic restrictions for telehealth (in the Federal definition including telemedicine), expand services, expand telehealth/RPM for additional chronic conditions and expand home care service into hospice and dialysis. It is a rework of last session’s H.R. 5380 and is at very early days having gone to a Congressional committee. Unfortunately its passage has a snowball-in-July chance with Govtrack.us giving it zero chance of enactment. Rep. Thompson’s website, FierceHealthIT, ATA-Jonathan Linkous support statement.

Previously in TTA: Telehealth reimbursement makes legislative progress in Texas, US House

Rock Health’s mid-year report: 2015 investment leveling off

July 10, 2015 | by

Rock Health‘s 2015 report is revealing in one aspect–that the authors try to put a game face on what is a flat situation in digital health investment for first half. Not even the most optimistic of the digerati expected a lift of 16 percent as we saw in 2014 versus 2013 [TTA 2 July 14], but the 8.7 percent fall off from 2014’s blistering $2.3 billion to $2.1 billion in 2015 year-to-date was unexpected. StartUp Health’s report indicated a slower start to 2015, though slightly less, so the reports correspond. Digital health still is growing faster than software, biotech and medical device.

Other highlights:

* The top six categories accounted for 50 percent of investment funding: wearables, analytics, consumer engagement, telemedicine, enterprise wellness, EHR/clinical workflow

*  In M&A action, this year’s first half has almost matched 2014’s full year total, but with only 13 percent of the investment. Most are digital health companies acquiring others for small amounts. (more…)

Novartis extends ViaOpta app for visually impaired to smartwatches

July 7, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/07/ViaOpta-Nav-Apple-Watch.jpg” thumb_width=”200″ /]New to this Editor (and I suspect our Readers) in assistive technologies for wearables are Novartis’ ViaOpta apps to aid the visually impaired and facilitate their independence as well as safety. Now available for smartwatches as well as smartphones, its features are primarily centered on assisting with navigation, including (new) points of interest and worldwide maps. Another new feature, recognizing and ‘reading’ both scenes and objects, is for smartphone only because it is dependent on the phone’s camera. Cues are both audio, vibration and visual (see left). Novartis claims this is the first wearable app designed specifically for the visually impaired and blind, now estimated at 285 million worldwide. It’s available in 11 languages and best of all, it’s a free download. Smartwatch demo is on YouTube. Novartis release. Mobihealthnews.

Breaking (holiday weekend) news: Aetna does the ‘deal deal’ with Humana

July 3, 2015 | by

Crap Game (Don Rickles): Ya make a DEAL!
Big Joe (Telly Savalas): What kind of a deal?
Crap Game: A DEAL DEAL.

—Kelly’s Heroes (1970), on getting the German Tiger tank and commander to help them in their bank heist

A $37 bn deal, that is. Announced on the Friday before the US Independence Day holiday (a day which may define media ‘black hole’), Aetna and Humana announced either their merger or the acquisition by the former of the latter, depending on what account you read. If approved by the Feds, the combination of #3 and #4 insurers (by revenue) respectively will exceed 33 million insured, making the combined entity #3 in insured individuals (after UHG and Anthem) and #2 in revenue. The announcement also stated that Louisville, Kentucky, Humana’s current headquarters, will continue to manage the Medicare, Medicaid and military Tricare businesses. Both are in Medicare Advantage, which is problematic due to market share and anti-trust considerations in at least four states, according to Reuters. (Humana has about 20 percent of national Medicare Advantage private policies.) We’ve previously noted the unfavorable comparison to the end stages of airline deregulation–consolidation reducing competition and consumer-favorable pricing. No word on the future of the Humana brand and marketing, which has always been executed well.

As to the outlook for digital health support–the prognosis by this Editor of this combination is, in the Magic 8 Ball’s answer, ‘reply hazy, ask later’.

  • Humana was known in the industry for being fairly open to opportunities and backed them with funding (Healthsense, Vitality, what remained of Healthrageous) under business such as Humana Cares. Humana at Home also owns a home care management company, SeniorBridge. Will this be of interest to Aetna in population health management, or an early ‘For Sale’?
  • Aetna, by contrast, has pivoted several times. CarePass consumer apps was a patient engagement experiment that proved the point that policyholders don’t want apps from insurers. Healthagen (an acquisition) was first positioned as an ’emerging businesses’ skunkworks of sorts umbrella-ing over iTriage (now integrated into the parent), ActiveHealth, Medicity and other digital health/analytics related businesses, then scaled back in early 2014 [TTA 28 Feb 14]. Repositioned as ‘population health management, the ACO business dominates.

Various reports: Daily Mail, Forbes (which likes it not at all and sees none of the touted ‘economies of scale’) and the WSJ.

Onward the 76 Hundred! Healthcare M&A, funding jam the news

July 3, 2015 | by

Healthcare mergers, acquistions, investments and joint ventures are doing their own Charge of the Light Brigade as we cross the mid-year bar.

* Onward the 76 Hundred! 7,600 startups around the world are developing solutions in digital health, according to accelerator/investor StartUp Health’s 2015 mid-year report. It also notes that ‘personalized solutions’ are the It Girl of digital health, and that data analytics/big data has fallen to third in investor interest after wellness/benefits (largely skewed by Zenefits) and patient/consumer 
experience received large funding rounds. Cheering news is that StartUp Health notes that investment in 50+ health companies is remaining steady. But the rest might be a bit frothy. The Gimlet Eye’s tut-tut: “whatever Zenefits is, it can’t produce enough Employee Wellness and manage enough HR to be worth an investment of $500 million”. For our Readers, we give you a direct link to their 2015 Midyear Funding Insights Report. (We await RockHealth’s take on the the Year to Date.)

* Onward with an IPO! Telemedicine darling Teladoc (TDOC, NYSE) is even more so with a smashing initial public offering, targeted to open at $19 which closed on Wednesday at $28 and today (Thursday) at same. Rosy forecasts abound despite those annoying losses ($12.7 million in 1st quarter ’14) and court action (Dallas News, TTA 9 June) . We at TTA are sticklers on terminology; still, we were happily surprised to see USA Today in our corner chiding Mr Gorevic on his misapplication of telehealth for telemedicine.

* Onward to Invest in Each Other! The new Allscripts-NantHealth deal gives new meaning to swap. EHR Allscripts bought a $200m, 10 percent equity stake in NantHealth, the health informatics chunk of Dr. Patrick Soon-Shiong’s NantWorks mini-conglomerate. Meanwhile another Soon-Shiong company bought stock valued at $100m in Allscripts. Neil Versel in MedCity News

* Onward from Amsterdam to Tel Aviv! MedCity News and Reuters also report that Teva Pharmaceuticals and Philips Healthcare have inked a joint investment (more…)

Nortek Security acquires Numera (Updated)

July 3, 2015 | by

Updated. Numera, which those of us with long memories remember as iMetrikus (before 2011, and also a Grizzled Telehealth Pioneer), announced late on Tuesday that it has been acquired by Carlsbad, California-based Nortek Security & Control. Nortek is known for security and home controls/automation (2GIG), with a significant holding in generally white-labeled traditional PERS units mostly under the Linear brand. Numera’s Libris and Libris+ PERS with telehealth connectivity will be sold under the Numera brand and be fitted into Nortek’s existing health-related business and home controls, according to the press release. The EverThere telehealth/activity/location reporting platform, according to Nortek’s FAQs, is especially important as this cloud-based health and wellness software platform can integrate into their home controls area. The transaction, according to Nortek, is valued at $12 million and they disclosed that the acquired businesses recorded unaudited net sales of approximately $5 million in 2014. It does not include the Numera Social behavior change/social engagement business which will be “rebranded”.

Upcoming international telehealth events

July 3, 2015 | by

In summer, the mind does turn to attending conferences in more interesting places. Here are three of interest:

27-29 July: 2nd International Conference on Health Informatics and Technology, Valencia, Spain at the Melia Valencia Palacio De Congresos. Information and registration

Their sister conference is the Global Conference on Telemedicine and eHealth at the Crowne Plaza Houston River Oaks. As it’s 17-19 August, in Houston, pack a personal air conditioner and dehumidifier. Otherwise, it’s a nice city with much to recommend it. Information. Both are organized by the OMICS Group.

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/07/guanoLogo.jpg” thumb_width=”125″ /]Finally, if you are looking for a startup boot camp and something truly different, here’s one with real ambiance. At M.E.S.H.–Medical Entrepreneur Startup Hospital–you’ll be camping in tents and sleeping in cots in a forest just outside of Berlin, Germany. 9-10 September. They invite investors as well–no information on if they get better tents. The objective? The fusion of humans and technology, including what gets under your skin.  Organizer is the interestingly named (and logoed) DocCheck Guano AG (above) along with KPMG and Grants4Apps.