Deloitte’s consumer view of technology acceptance in home health

March 5, 2016 | by

The Deloitte Center for Health Solutions (DCHS), the research division of Deloitte LLP’s Life Sciences and Health Care practice, conducted six focus groups late last year to gauge the acceptance of technology in home health. They tested two main home health scenarios among 42 younger (<44) and older (45-64) adults, both drawn from healthy and chronic condition patients and with a mix of demographics.

In this qualitative study, the two scenarios tested were: technology that would help manage chronic conditions and tech to promote healthy living. The first scenario gives a very advanced vision of chronic care management that involves telehealth, telemedicine and residential monitoring in the management of chronic conditions (diabetes and CHF). The second involves lifestyle factors including eating, activity and exercise management and managing travel.

Some findings in the report summarized and linked for download here, including implications for companies:

  • Overall they were open to and optimistic about using technology to enable better home care of older adults who require it–including embedded sensors.
  • ‘Smart home’ has appeal, but there is a preference for the less intrusive (stove burner/cooking range sensors, fall detectors) and resistance to perceived invasions of privacy (sleep, bathroom and activity monitoring).
  • They understood the balance of reward and risk in consideration of broad categories of nutrition, physical activity, prevention, and dealing with an acute episode (see quadrant below, click to enlarge)
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/03/us-lshc-hcc-march1-my-take-p1.png” thumb_width=”200″ /]

Center Director Harry Greenspun, MD’s in his Health Care Current blog notes that TECS has the capability of providing services formerly provided only in a doctor’s office or hospital in the home, but “One question remains, “How quickly will consumers adapt and accept new technologies that bring care into their home?”–then answers his own question.

All of these innovations have given us a level of insight and capability we could not have imagined even a few years ago. At the same time, each raises privacy concerns.

So why do we do it? Because we get something out of it.

 

‘VC tourism’ in Health Tech Land is over (updated)

March 4, 2016 | by

The ‘silly money’ is packing its bags and taking the next flight from the Coast. An exceedingly tart take out of Fast Company confirms what your Editors have noticed in Rock Health and other year-end reports. Funding for digital health may have surpassed $4.2 billion in 2015, but it barely eked over 2014’s total of $2.3 billion despite rising geometrically since 2011 [TTA 16 Dec 15, revised by Rock Health since then]. Since then, we’ve had the Trouble Every Day of ‘unicorns’ (overreaching) Theranos and (ludicrously) Zenefits [TTA 17 Feb]; EHR Practice Fusion stalled out and cutting 25 percent of its staff, hoping to be acquired by athenahealth–or anyone (Healthcare Dive); shaky Fitbit shares [TTA 20 Feb]. Perhaps the high point was last year’s ‘Corvette Summer’ with yet another big round to a company yet to fulfill its promise, ZocDoc [TTA 15 Aug 15]. Even Castlight Health with decent revenue (still at a loss) has been dubbed an ‘absolute horror show’ when it comes to its share prices, if you were foolish enough to buy it at or near its IPO.

Fortunately a large dose of sanity may prevail among VCs with a sobering realization–no different than five or ten years ago–that investment has to be strategic and far longer than the usual 18 month-and-out time frame. Too many companies have systems which work the same niche–you don’t need 50 companies doing these things: data analytics for care management, patient engagement platforms, med reminders or diabetes management. [We’ve already noted the ‘sameness’ in companies getting funded in 2015, almost as if investors were seeking reassurance in similarity, a sure sign of a coming fail–TTA 30 Dec 15.]

Developers must fill a need–uniquely. And have a superb business plan, squeeze the nickels till they squeak and forget about the party culture. Investors: Dumb Money For Digital Health Will Vanish As Quickly As It Came In

 

Telehealth reimbursement: a major growth obstacle overcome this year?

March 4, 2016 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/03/Hurdle.jpg” thumb_width=”150″ /]Will 2016 be the year where the hurdles are jumped? Telehealth systems and platforms are becoming more comprehensive and compatible with mobile technologies. While there are still discussions (arguments!) as to telehealth remote patient monitoring effectiveness in care models, with the occasional naysaying short-term or IVR study ‘proving’ RPM doesn’t work, the long-term positive VA Home Telehealth results since 2003, and the large body of research prove otherwise when integrated within a chronic or transitional care model. Yet at $14 million or .0025 percent, it was in 2014 a tiny part of Medicare payments because of CMS’ emphasis on rural telehealth at that point (and still). Medicaid (state programs for low-income children and adults under CMS oversight and administered through private payers) is more generous, with most states providing some payment and some having parity (with in-person visits) regulations.

A retrospective look at telehealth reimbursement is in a just-published paper by the Health Care Cost Institute (full PDF of report) which analyzed thousands of claims from four major insurers (Aetna, Humana, Kaiser Permanente and United Healthcare).to track trends in telehealth billings from 2009-2013. Key findings are summarized by senior counsel René Quashie of leading health tech law firm Epstein Becker Green in this article. It’s evident that the private payer sector didn’t exactly lead the way on commercial adoption of telehealth and telemedicine.

Here, the public sector is forcing change. Medicare rules on chronic care management changed for year 2015 to permit telehealth integration, and while complex (and not especially generous), CMS has further expanded them for ACOs in the Medicare Shared Savings Program (MSSP) and for new Next Generation ACOs. Yet only 20 percent of ACOs in the 2015 MSSP program actually used telehealth in care programs.

You can understand why from practices’ past experiences with payers. Becker’s Hospital Review cites from excerpts that while telehealth claims reimbursement on average rose 2009-2011 from $60 to $68/visit, in 2013 they dropped precipitously to $38. For all the hand-wringing over mental health, psychiatrists get the short end once again: a diagnostic interview exam (which is generally 1-2 hours if not more) cost $200 via telehealth (telemedicine) and $288 when the exam was conducted in person, but reimbursement was $77 and $105 respectively. After needing to invest in equipment and software, it’s understandable why physicians don’t look forward to getting paid less for their trouble.

But the argument is that things are changing for the better, and that is advocated by Nathaniel Lacktman, partner of tech law firm Foley & Lardner in his optimistic article in Advance Executive Insights, which maintains that 2016 is going to be the Year of Telehealth and remote patient monitoring. (more…)

Chubb Care System adds communities (UK)

March 4, 2016 | by

Chubb Community Care launched the Chubb Care System at the end of last year [TTA 13 Dec 15], and following up, they have already become the approved technology adviser and provider for the Northern Housing Consortium and the Knowsley Housing Trust’s Bluebell Park Apartments. KHT provides housing for 27,000 residents in Knowsley. The Chubb Care System is a hybrid communication/monitoring system for residents in sheltered and extra care housing to communicate with staff and integrates with TECS, telehealth and fire/safety devices and systems. As Editor Charles put it, some have portrayed Chubb as the weakest of the ‘big three’ telecare providers, and it is heartening to see them move forward quickly.

 

Tunstall and Boots go High Street with retail PERS (UK)

March 3, 2016 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/03/Boots-Main-Logo.jpg” thumb_width=”150″ /]Boots has entered the direct-to-consumer PERS business with Home Assist, supplied by Tunstall Healthcare. It’s a conventional (non-mobile) base unit and pendant with 24/7 response to Tunstall’s call center and a temperature sensor that will alarm at cold temperatures. The basic PERS is priced at £34.79 ($49) inclusive of VAT for the unit and a £19.99 ($28) monthly charge. Adding fall detection, the prices rise to £46.79 and £25.19. The most expensive option adds a smoke detector, reassurance calls and a bogus caller alarm for £58.79 and £31.19. Some end users may qualify for VAT-free pricing due to a qualifying disability or long-term illness, which lowers rates by £7-9. According to our former Editor and occasional contributor Mike Burton, this is a first for any High Street chemist and ups the game for all PERS and alert systems. It’s also a natural move, given that the US outpost of the Walgreens Boots Alliance has direct sold Tunstall (and earlier, AMAC) PERS units for 10 years. (Walgreens’ base monthly rate is about the same at $29.99 monthly for the same unit, but no unit cost on an annual contract.)  Home Assist website (Tunstall UK/Boots). The in-store leaflet link on the Boots website features Boots locations in London and Leeds only, along with a full application.

 

Care Innovations’ ‘record growth in 2015’; replaces CEO; GE departs partnership

March 3, 2016 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]Care Innovations‘ recent (undated) press release (discovered as a LinkedIn update), if read without a Gimlet Eye, could be read as another one of those ‘good news’ releases that build company awareness and get it picked up on websites such as TTA. Certainly there’s a nice spin of positive news for remote monitoring technologies, particularly more complex ones in vital signs monitoring and broadening out their applicability. (More on those below.) But the observant eye will pick out a couple of ‘aha!’ moments at this company that got slipped in, but not slipped by, the Eye.

The first is that GE has departed the building. Always the junior partner except for the very beginning in 2009, GE apparently exited sometime after December based on the last press release with Intel-GE identification issued 1 Dec 2015. The boilerplate company description is no longer ‘Intel-GE Care Innovations’ but now ‘Care Innovations, a wholly-owned subsidiary of Intel Corporation’. Lift your eyes to the company logo at the top left of the web page, and there it is, ‘An Intel Company’. GE is not fully cleansed, still to be found on product pages such as Health Harmony and QuietCare, as well as the copyright line at the bottom of each web page. (More work to be done)

The second is the appearance of CI’s new CEO, Randy Swanson, in the executive quote and on the ‘team’ website page. His bio notes that he’s a 17-year Intel finance/business development veteran, at one point with responsibilities in the Digital Health Group. Tea leaf readers might well surmise that Intel will now emphasize profitability at CI after the major repositioning and partner expansion during the 2.5 years of Sean Slovenski’s tenure (a non-Intel’er departed in January to Healthways, TTA 13 Jan).

The release also has a few more interesting moments. (more…)

ATA 2016 announces keynoters

March 2, 2016 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/03/ATA2016Bannerv2-1.jpg” thumb_width=”200″ /]American Telemedicine Association 2016 Conference and Trade Show
Sat 14-Tues 17 May, Minneapolis Convention Center

ATA 2016 is the world’s largest and most comprehensive meeting focused on telemedicine, digital, connected and mobile health. Over 6,000 healthcare professionals and entrepreneurs in the telemedicine, telehealth and mHealth area are expected to attend the 75+ sessions and visit the over 300 exhibitors in the main hall. Keynote speakers announced are:

  • Nicholas Negroponte, co-founder of the MIT Media Lab
  • James Peake, former US Secretary of Veterans Affairs
  • John Noseworthy, MD, President and CEO of the Mayo Clinic
  • David Shulkin, MD, Under Secretary of Health for the VA
  • Jack Resneck, Board of Trustees, American Medical Association
  • Jonathan Perlin, MD, PhD, MSHA, MACP, FACMI, President, American Hospital Association
  • Reed Tuckson, President, Board of Directors, American Telemedicine Association

Register today through 15 April to save $150. More information here on schedule, keynotes, housing and Minneapolis (which is lovely in the spring when the snow is all gone!). TTA is again a media partner of ATA’s annual meeting.

UK Telehealthcare’s London MarketPlace

March 2, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/03/UKtelehealthcare.jpg” thumb_width=”150″ /]6 April, 10am – 3pm at London Fire Brigade HQ, 169 Union Street, London SE1 0LL  

UK Telehealthcare is organizing its first MarketPlace for 2016 at the LFB to commemorate its 150 years of service to the community. About 30 exhibitors will be presenting the latest in assistive technologies for the home including telecare, sensor-based and safety/alert. Best of all, it is free to professionals in social care, healthcare and security. See PDF attached or contact Gerry Allmark.

 

Technology for Aging in Place 2016

March 2, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/03/elderly-smartphone.jpg” thumb_width=”150″ /]Laurie Orlov’s updated view of technologies that assist home caregiving/living, and her observations on trends for both boomers and those well over 65, is hot off the (virtual) presses and available here on her website. It is US-market oriented, but the trends explored here will be of interest internationally. The focus in this study is home-based systems for safety, alerts, activity/location tracking (telecare), home care/caregiving tools and what this Editor would call ‘health monitoring light’–med minders and logging apps versus medically-oriented telehealth (vital signs, save for AliveCor) and telemedicine (virtual visits/consults).

Highlights:

  • In communication, internet non-usage among 75+ has declined to 50 percent over the past 15 years.
  • The tablet form factor is losing ground as smartphones get bigger. Older adults and smartphones are beginning to ‘get along’ partly as they grow larger, but also that feature and simple phones are becoming less available.
  • Also losing ground is senior housing–residents are delaying entry to assisted living until they are mid 80s and frailer. Savings and debt in the boomer group is low and high, respectively.
  • Investors are caring more about home care, with large investments ($80 million) in three regional home care worker startups: Honor (San Francisco), Home Hero (Los Angeles), and Hometeam (New York/New Jersey), caregiving apps and chronic care management (CareSync, with an $18 million raise).
  • Dementia care support tools are (finally) developing into its own category.

Surprising conclusions: PERS alerting stays strong, but changes to be mobile-enabled and more cosmetic; a lot of convergence of categories and forms; and the term ‘health tech’ will replace ‘digital health’. Oh my!

The big show begins: HIMSS 2016

February 27, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/02/HIMSS-2016.png” thumb_width=”150″ /]Now that Mobile World Congress, which increasingly features mobile healthcare tech like International CES, is wrapping, probably the world’s largest healthcare oriented conference, HIMSS, will be kicking off on Monday the 29th in Fabulous Las Vegas. ‘Connected health’ and security is a part of it, along with its traditional emphasis on HIT and traditional devices. If you are going, you’ve likely made your arrangements months ago. There’s a lot of guides out there on making the most of the conference, but this Editor recommends Roberta Mullins’ quick guide to HIMSS highlights in HIE Answers. For the fun parts of HIMSS and a link to the HIMSS16 mobile app, here’s Roberta again, plus HealthcareITNews’ roundup (though the chapter events are sold out).

We’ll be noting the news from our New York perch. If you have news, insights or comments you’d like to see here (objective and not promotional), please email this Editor. (These will be used at editorial discretion.) TTA has been for years a media partner of HIMSS Connected Health Conference/mHealth Summit (which, rumor has it, will happily be returning to December this year). 

Upcoming will be the other US ‘big show’ in telehealth and telemedicine, ATA 2016, 14-17 May in Minneapolis, where we again are media partners. More on ATA in coming weeks!

 

Bioidentical, dissolvable brain implants for monitoring injury

February 27, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/02/1499.jpg” thumb_width=”150″ /]A pressure and temperature sensor which sits on the surface of the brain to monitor intracranial pressure and temperature changes has been developed by an international team from South Korea and the US. Currently, implantable sensors are used for monitoring victims of severe traumatic brain injury (TBI), but these sensors carry risk of inflammation and infection. In initial testing, this new sensor has been found to be fully biocompatible (no inflammation or scarring) and dissolves in a few weeks. It can also be modified in other ways to monitor other brain functions, such as acidity and the motion of fluids, or deliver drugs. Published in Nature. Summary in the Guardian.

 

 

Telehealth in Brazil: a special JISfTeH issue

February 27, 2016 | by

The Journal of the International Society for Telemedicine and eHealth (JISfTeH) turns to Latin America in its latest issue with a focus on the versatile ways that telehealth has been used in Brazil. Nine papers range from distance healthcare education to store-and-forward imaging to building rural telehealth networks. Brazil’s government has supported remote care initiatives with the development and implementation of projects at the national, state and municipal levels. The telehealth model primarily has been connecting universities to primary care in remote cities (of which there are many!) with an emphasis on education and assistance. Topics include the nine-year-old telehealth project in Minas Gerais between Rio de Janiero and Brasilia, and its declining use; distance learning in dentistry; usage in the Amazon region and legislation. Registration required, but the journal is open access. Hat tip to its lead editor, Prof. Maurice Mars of the University of KwaZulu-Natal, South Africa.

 

 

If Silicon Valley were a rose, it would be wilting

February 20, 2016 | by

Does this signal a new ‘trough of disillusionment’? The lead in this story is one of the major practice EHRs in the US–Practice Fusion. From a high valuation in 2013 of $635 million as a healthcare darling (free to doctors, ad supported), it burned through $4 million cash per month while revenue missed targets by 10 percent, chased after rainbows such as telemedicine, overhired, overperked and overpartied in the office. Now with a quarter of their staff pink-slipped, a new CEO is trying to bail them out. Most of the other examples aren’t healthcare, but huge deals by VCs are slowing, companies are discounting the price of their shares, taking on debt to not dilute shares, laying off employees and subletting their space. Adding to this is the glut in wearables and a slowdown in demand for single-purpose devices, leading to a 20 percent loss today in value in shares of Fitbit (MarketWatch). Like the ‘oil patch’ in the upper Midwest, the San Francisco area is feeling the chill that never really left the rest of the country. And ‘unicorns’ may become an endangered species. Wall Street Journal

The widening gyre of insurers covering telehealth (telemedicine?) (US)

February 20, 2016 | by

Is a tipping point nearing? Soon? An article in Modern Healthcare that contains a heavy dollop of promotion headlines ‘telehealth’s’ adoption by insurers such as Blue Cross Blue Shield of Alabama, Anthem and Highmark. When read through, it’s mainly about telemedicine (video consults) but does touch on the vital signs monitoring that’s the basis of telehealth. Video consults through Teladoc and other services such as Doctor on Demand and American Well are gradually being reimbursed by private insurers, despite the concern that it would actually drive up cost by being an ‘add-on’ to an in-person visits. Medicaid increasingly covers it, and states are enacting ‘parity’ regulations equalizing in-office and virtual visits including, in many cases, telehealth. Yet the move for coverage is hampered by lack of reimbursement to doctors, or the perception of limited or no payment. Even Medicare, a big advocate for alternative models of care, currently pays little out for telehealth–$17.6 million on a $630 million+ program. The Congressional Budget Office is skeptical, despite the savings claimed by CONNECT for Health Act in both the Senate and House [TTA 12 Feb]. Virtual reality: More insurers are embracing telehealth

A deserved goring of whiz-bang unicorns Theranos and Zenefits (updated)

February 17, 2016 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/08/1107_unicorn_head_mask_inuse.jpg” thumb_width=”150″ /]A blog posting this Editor wish she had written. Fred Goldstein, who is a consultant to healthcare systems focused on building accountability and improving population health, has pressed a sharp point to the sparkly bubbles surrounding two Silicon Valley billion-dollar valuation darlings, Theranos and Zenefits, on their playing fast and loose with basic regulations.

Some background for our readers. It’s a pile-on with Theranos, which has been stepped on by FDA for their nanotainers [TTA 20 Nov 15], then whacked by the Centers for Medicare and Medicaid Services (CMS) last month for ‘deficient practices’ at their California testing lab (a remedial plan has been filed this week) and likely losing its lucrative Walgreens Boots deal if problems aren’t fixed in 30 days (having already lost its program with Capital Blue Cross in the Harrisburg area of Pennsylvania). According to Bloomberg, its proprietary testing is now used in only 1 of every 200 tests. Zenefits claims to be the ‘first modern benefits broker’ with cloud-based software designed to simplify and automate such HR tasks as health insurance signups for small businesses, but its software that facilitated skating around required licensure requirements by its staff got its CEO forced out by a key investor, Andreessen Horowitz. (And it gets worse…read on….)

It’s so…whiz-bang! (Updated) Your Editors, past and present, have made hash (corned beef and otherwise) of companies promising revolutions in healthcare since our inception. ‘Whiz bang’ (more…)

A Hollywood ending? Medical center’s $17,000 ransom to recover systems from hack attack

February 17, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/02/Hackermania.jpg” thumb_width=”150″ /]‘Hollywood’ Hulk Hogan is getting a workout! (UPDATED)

Hollywood Presbyterian Medical Center paid $17,000 (40 bitcoins) last night to hackers to regain control of its IT systems after last week’s ‘ransomware’ attack forced them offline. According to CEO Allen Stefanek, “The quickest and most efficient way to restore our systems and administrative functions was to pay the ransom and obtain the decryption key.” HealthcareITNews has the details and the full CEO letter/press release, including that no patient or employee information appears to have been compromised.

Obviously there will be more to follow including the usual opining, but in this resolution and spin, a bad precedent has been set in this Editor’s view. Labeling it a ‘low-tech’ attack shines a Klieg light (this is Hollywood after all) on the vulnerability of this hospital’s system. They now have the decryption key to the malware, but what other bad code and general mischief is buried in their systems to crop up later?  Another question: was the inflated bitcoin number floated to make the paid ransom seem ‘affordable’? Is this a Hollywood ending where all is happy, or is this an episode in the continuing soap opera of ‘Hospital as Cash Machine’?

Our original article follows: (more…)