An app to help make life easier for a reported 24 million COPD patients in the US has been developed jointly by Mount Sinai Hospital, the affiliated National Jewish Health Respiratory Institute in New York and LifeMap Solutions. The COPD Navigator app encourages patient self-management through visualizing patient data and patterns, including symptoms, medication, treatment adherence, and quality of life, coupled with alerts about local air quality and weather which can dramatically influence risk. Patient data is transmitted to their physician, with an emphasis on fitting into office workflows. LifeMap is also tracking when the patient uses an inhaler through their self-designed Bluetooth LE device, though it uses any Apple HealthKit enabled inhaler. (more…)
Possible early detection test for chronic traumatic encephalopathy (CTE)
A research study published today in the Proceedings of the National Academy of Sciences (US) presents the results of screening 14 retired professional American football players with suspected CTE. Using a tau-sensitive brain imaging agent, [F-18]FDDNP, the California and Illinois-based researchers were able to detect the abnormal accumulation of tau and other proteins, in the distinct CTE pattern, in the brains of living subjects who had received, during their playing careers, multiple concussions and head trauma. Of the 14, one had been diagnosed with dementia, 12 with mild cognitive impairment and one with no symptoms. Previous studies, such as Robert Stern, MD‘s pathfinding research at Boston University and for the NFL (see below), have been primarily post-mortem on brains donated for research, although Dr Stern’s last presentation at NYC MedTech and Inga Koerte, MD of the Ludwig-Maximilians-Universität München (LMU) have also used brain scan information on live subjects in their studies.
Where this differs is that the imaging agent injected binds to the tau (more…)
ELabNYC Pitch Day 2015
Thursday 3 April, Microsoft’s NY Technology Center, Times Square NYC
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/04/Elab.png” thumb_width=”100″ /]The third annual Pitch Day for the now 20 startup/early-stage life science, biotech and healthcare technology companies in the ELabNYC (Entrepreneurship Lab Bio and Health Tech NYC) is a culmination of their year-long program participation in this NY Economic Development Corporation (NYCEDC)-supported program. The entrepreneurs in the ELabNYC program primarily come from from the doctoral and post-doc programs from New York’s many universities, from CUNY to Columbia, from many parts of the world, and most have experience within the city’s multitude of major health research institutions from The Bronx to Brooklyn. New York is also a center of funding for life science and health tech ventures; it’s #2 with NIH awards totaling $1.4 billion. For the past few years, NYEDC has also supported these companies with finding access to capital, specialized space (e.g. wet labs such as the million square feet at Alexandria Center alone, plus Harlem Biospace and SUNY Downstate in Brooklyn) and partnerships with major companies such as Celgene, Eli Lilly, Pfizer and GE Ventures.This Editor will concentrate on health tech companies–eight, up from five last year [TTA 17 Apr 14]. Each company pitched for five minutes on its concept, its current state of advancement (including pilots/customers), its team and a funding timeline. It was a very different mix from last year’s class, which focused on compliance, diagnosis, dementia and concussion. These companies focused on niches which are either not being served well or to substantially reduce costs. Nearly half the entrepreneurs were women, a substantially greater number than one usually sees in the biotech/health tech area. Short impressions on our eight, with links to their Executive Summaries on the 2014-15 ‘class page’: (more…)
A telecare device that may solve the ‘soft fall’ and unconscious problems (UK)
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/04/MonitorGO-cropped-small-232×300.jpg” thumb_width=”150″ /]Guy Dewsbury of the eponymous Gdewsbury independent research consultancy brought to this Editor’s attention his recent commission for West Yorkshire-based MonitorGo in evaluating their new smartphone-based personal alarm. He analyzed the device’s features here in a comparison chart and writeup, versus what is commonly available in the market. If it reliably does what it says it does (our normal caveat), it could be a big step beyond the Ur-Pendant, addressing our (and Neil Versel’s) concerns earlier this week on the persistence of ‘ancient history’ PERS [TTA 31 Mar].
It goes well beyond common mPERS as well. There are 12 features, including GPS location, hard fall detection and 24/7 third-party help line monitoring (via Medvivo), but the key differentiating features are the soft fall detector, unconsciousness/inactivity detection and false alert detection/response–as well as usability as a simplified smartphone with unlimited calls to UK landlines and 250 mobile-to-mobile minutes. (more…)
“Data moves at the speed of trust”–RWJF report
The report issued today by the influential Robert Wood Johnson Foundation (RWJF), ‘Data for Health: Learning What Works’ advocates a fresh approach to health data through greater education on the value/importance of sharing PHI, improved security and privacy safeguards and investing in community data infrastructure. If the above quote and the first two items sound contradictory, perhaps they are, but current ‘strict’ privacy regulations (that’s you, HIPAA), data siloing and the current state of the art in security aren’t stemming Hackermania (or sheer bad data hygiene and security procedures). Based on three key themes, the RWJF is recommending a suite of actions (see below) to build what they term a ‘Culture of Health. All of which, from the 10,000 foot view, seem achievable. The need–and importantly, the perception of need–to integrate the rising quantity of data from all these devices, pry it out of its silos (elaborated upon earlier this week in ‘Set that disease data free!), analyze it and make it meaningful plus shareable to people and their doctors/clinicians keeps building. (‘Meaningful’ here is not to be confused with the HITECH Act’s Meaningful Use.)
But who will take the lead? Who will do the work? Will the HIT structure, infrastructure and very importantly, the legal framework follow? We wonder if there is enough demand and bandwidth in the current challenged system. Release. RWJF ‘Data for Health’ page with links to study PDF, executive summary which adds details to the recommendations below, more.[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/04/Data-For-Health-Advisory-Committee-RWJF.png” thumb_width=”400″ /]
Fitness/wellness trackers have amazing potential–to annoy
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/04/keep_calm_and_smash_watch.jpg” thumb_width=”150″ /]Your Editors have previously noted some interesting personal experiences with fitness bands/trackers. Editor Charles, at last report, was on his third Jawbone Up in a year; this Editor has remained immune to their mostly clonky charms (tempted by the classic Swiss watch looks of Withings Activité [TTA 26 June 14], put off by the $450 price, but now notes that the sporty, analog Activité Pop is available in the US at $150.) Even if not among the Quantified Self avant-garde, we who write about tech can deal with most of it without blinking too much. Over at FierceMobileHealthcare, Judy Mottl, a regular writer for their FierceHealthIT website, took “the plunge into the wearable device pool” and hit her head on the bottom. Her experience of mostly frustration with the app, bad data generation, inability to sync with the smartphone, saying you’re awake/sleeping when not and so on indicates that this is one wearable she should have returned to the store–or treated according to our picture. Is this one isolated example or a more common experience than the healtherati who adore wearables let on?
There’s some evidence that the leaders in fitness bands realize their shortcomings on the app side. Fitbit acquired fitness coaching app developer, FitStar, for at least $17.8 million. Mobihealthnews
Update 2 April: Editor Charles reports on his third Jawbone Up, and his daughters’ experience:
I took to wearing the third Jawbone UP the other way round – i.e. with the two ends in line with the back of my hand, and the thicker bit in line with the inside of my hand and that seems to have done the trick. However my older daughter (more…)
EHRs: now safety, info exchange concerns (US, AU, CA)
What’s this? EHRs reducing, not increasing, safety? Reports from both the US and Australia seem to indicate another spanner (US: wrench) in the EHR works, aside from the laggardness in achieving the HITECH Act’s goals [TTA 27 Mar].
- The Joint Commission, which is the chief US accreditation and certification body for healthcare organizations and programs, and thus to be taken very VERY seriously, released a Sentinel Event (Patient Safety Event) Alert yesterday. It warned of EHR-related adverse events affecting patient health, resulting from incorrect or miscommunicated information entered into EHRs. Interfaces built into the technology can contribute and studies have documented mixed results in the systems’ ability to detect and prevent errors. It identifies eight key factors,led by human-computer interface, workflow and communication and clinical content, that can lead to a sentinel event and three major remedy actions. While the JC does take pains to confirm the positive effects of well-designed and appropriately used EHRs, with strong clinical processes in place, it is the first ‘red flag’ this Editor can recall (more…)
The traditional PERS as ‘ancient history’
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/Fallen-woman.jpg” thumb_width=”150″ /]Something to think about. How many families and older adults are aware that the traditional PERS emergency pendant, which has been around for at least 40 years, is sadly outdated and in fact inadequate for those at greatest risk? While major advertisers on US media such as Life Alert, Life Call, ADT and Philips Lifeline present crisis situations where the older person is on the floor and is rescued after pressing the pendant button, they barely advertise their other available products that incorporate passive fall detection and cellular, even if somewhat inadequate for soft falls or unconsciousness. Families unwisely feel ‘protected’ when paying for traditional PERS, not realizing that more advanced technology is readily available and not that much more expensive. Moreover, and only mentioned in the context of his grandmother’s fall while in senior housing, there is a distinct recalcitrance of senior housing executives to rid their apartments of the (cheap) old pendants and replace them with (pricier) passive/cellular assistance systems, much less more advanced wearables/RFID systems or mobile/watch combinations. This Editor also notes that the major drugstore chains also sell PERS; while they trumpet wellness in their advertising, they are as behind the curve in this area as senior housing. Neil Versel in MedCityNews.
For our Readers: can we compare/contrast how the UK, EU and US are still wedded to traditional PERS after 40 years, and if more advanced forms are starting to take hold? Click on the headline to see comments, including this Editor’s opining on traditional PERS as ‘cash cow’.
Another go at a joint DOD-VA EHR? (US)
As this Editor was Pondering the Squandering last week of $28 billion HITECH Act funds meant to achieve EHR interoperability but falling well short, we recalled another Big EHR Squander: the integration of the Department of Defense’s (DOD) AHLTA with the Veteran Affairs’ VistA, an iEHR effort which collapsed in February 2013 at a mere $1 billion, in addition to dysfunctional or failed upgrades in both systems at just under $4 billion [TTA 27 July 13]. For civilians, this may not sound like much for concern, but for active duty, Reserve and National Guard service members transitioning from active to civilian status (and back as they are activated), often with complicated medical histories, it means a great deal.
At least one Congressman who also happens to be a physician, Representative Phil Roe, MD (R-TN) wants to try, try again. According to Politico’s Morning eHealth of last Wednesday, his bill will offer “a $50 million prize to the creator of an integrated military-veteran medical records system.” plus another $25 million over five years to operate it. DOD is moving forward with an $11 billion bid for a new EHR, but Rep. Roe’s staff issued a statement that differs with the DOD’s–that the new EHR still has no provision for secure and relatively seamless interoperability with the VA system to streamline the transfer of claims. We wish the best to Rep. Roe, and hope he can overcome Congressional inertia and two huge bureaucracies amidst doubts on the DOD’s EHR award process. FierceEMR on Roe bill, award process and adoption concerns by GAO and others. Also Anne Zieger in Healthcare Dive, iHealthBeat.
Set that disease data free! A call to break down those data silos.
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/BlueSiloCollapsing-41.jpg” thumb_width=”175″ /]Awash in a rising sea of data generated by devices and analytics–around treatments, population health, costs–there’s a struggle to make sense of it. We’ve noted the high value and merchandisability of 23andme‘s genomic data (gained by individual user consent) [TTA 5 Mar], but our healthcare institutions which should be codifying and sharing disease and treatment data, largely do not. Those with rare or ‘orphan’ diseases struggle to find information, diagnosis, fellow patients, treatments. They sometimes win breakthroughs by, believe it or not, blogging, and having their articles widely disseminated. Reasons why? According to David Shaywitz in Forbes, they are:
- Hospitals, even research based centers, struggle to codify their genotype and phenotype data of their patients in a meaningful way that would be usable for clinical decision making. We’ve also noted (oddly not Mr Shaywitz) the long implementation process of IBM Watson cognitive processing/decision making tools in healthcare, the concentration on single diseases and their spread into other industries plus third-party integration outside of healthcare [TTA 9 Oct 14]. (more…)
The King’s Fund’s ‘newspaper’ on health and the General Election (UK)
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/General-election.png” thumb_width=”150″ /]The King’s Fund is now participating in the runup to the 7 May UK General Election with Health and the election, a Paper.li format roundup of national health issues. Much of it centers around the present and the future of the NHS, and what The King’s Fund is tracking as the deterioration in service in such metrics as waiting times for A&E, cancer care and routine operations, coupled with growing deficits. Will the NHS be a deciding factor in the election, as the ITV report seems to indicate? The King’s Fund is gathering the coverage and tracking possible answers to that question. TTA is an official supporter of The King’s Fund, and their upcoming Digital Health and Care Congress 2015 on 16-17 June. TTA readers enjoy a 10% discount when using this exclusive link.
UnaliWear Kanega assistance watch makes Kickstarter goal
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/Unali-Kanega-new-iteration.jpg” thumb_width=”175″ /]The UnaliWear Kanega assistance watch [TTA 18 Feb] on Wednesday closed its Kickstarter crowdfunding over the top at $110,154. It has several features to promote safety for older people or the disabled, with fall detection, GPS and stand-alone cellular/Wi-Fi connectivity, but the most unique is voice recognition and command/response. Its latest prototype is half the case size as previously, with a more attractive analog watch face, which makes it a lot more MAYA (most advanced yet acceptable–Raymond Loewy), and a major improvement in form over your typical PERS or most GPS watches. With our usual caveat (if it does what it says it does in production), we applaud Jean Anne Booth and her team for their achievement–and we’ll be watching.
Your Friday superintelligent robot fix: the disturbing consequences of ultimate AI
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/Overrun-by-Robots1-183×108.jpg” thumb_width=”200″ /]Our own superintelligent humans–Elon Musk (Tesla), Steve Wozniak (Apple), Bill Gates (Microsoft) and Stephen Hawking–are converging on artificial intelligence, not just everyday, pedestrian robotics, but the kind of AI superintellect that could make pets out of people–if we are lucky. In his interview with Australian Financial Review, the Woz (now an Australian resident) quipped: ‘Will we be the gods? Will we be the family pets? Or will we be ants that get stepped on?’ (more…)
Google granted patent for sensor contact lens
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/google-contacts_1401174_616.jpg” thumb_width=”150″ /]On Tuesday, Google was granted a patent for its contact lens with sensors and embedded microchip. According to Time, the patent award was uncovered by WebProNews, which seems to be focused more on the problems of Google Glass than the patent, though the abstract and a development figure is included. The patent was originally filed in September 2012. We’ve previously noted that Google is partnering with Novartis/Alcon (their eyecare division) to further develop applications. The most prominent is glucose level detection for diabetics, but there is also a huge market in correcting presbyopia and autofocusing ‘zoom’ lenses [TTA 17 July 14] Of course, Google does not admit to any of this, telling a Time reporter that “We hold patents on a variety of ideas—some of those ideas later mature into real products or services, some don’t. Prospective product announcements should not necessarily be inferred from our patents.” So we should keep blinking.
Pondering the squandering redux: $28 billion gone out the HITECH window
In 2009, the US Congress enacted the HITECH Act, as part of a much broader recovery measure (ARRA or ‘the stimulus’), authorizing the Department of Health and Human Services (HHS) to spend up to $35 billion to expand health IT and create a network of interoperable EHRs. Key to this goal of interoperability and seamless sharing of patient information among healthcare providers was achieving stages of ‘meaningful use’ (MU) with these EHRs in practice, to achieve the oft-cited ‘Triple Aim‘ of improved population health, better individual care, delivered at lower per capita cost. Financial incentives through Medicaid and Medicare EHR programs were delivered through multiple stages of MU benchmarks for hospitals and practices in implementing EHRs, information exchange, e-prescribing, converting patient records, security, patient communication and access (PHRs).
Five years on, $28 billion of that $35 billion has been spent–and real progress towards interoperability remains off in the distance. This Editor has previously noted the boomlet in workarounds for patient records like Syapse and OpenNotes. Yet even the progress made with state data exchanges (e.g. New York’s SHIN-NY) has come at a high cost–an estimated $500 million, yet only 25 percent are financially stable, according to a RAND December 2014 study. (more…)
Chronic care management with telehealth (US)
Our readers, especially those in the US engaged with medical practices, might be interested in reading a two-part interview with Editor Donna by occasional TTA contributor Sarianne Gruber. We discuss the new model for Chronic Care Management (CCM) now included in what the Federal Government (CMS-Center for Medicare and Medicaid Services) pays physicians for Medicare patient visits and services. Telehealth, or in CMS terms remote monitoring, can play a vital role in the provision of care coordination, assessment, documentation, patient access and facilitation of self-management as part of the care plan, culminating in better outcomes at lower cost. Published in the new RCM (Revenue Cycle Management) Answers, a spinoff of HITECH Answers. Part 1. Part 2
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