Google granted patent for sensor contact lens
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
Data breaches top 120 million since 2009 (US)
We admire the Washington Post for arriving at the conclusion we did in 2010–that healthcare organizations are uniquely vulnerable to cyberattack because of the high value of patient data, and an often lighter level of HIT security. But now we get the finger wag that ‘it’s only going to get worse.’ (Beyond 120 million breached records?) Data security, of which HIPAA patient information protection is a part, wasn’t primary for years, especially in organizations overwhelmed with transitioning EHRs, getting EMRs to speak with EHRs, Meaningful Use, new care and payment models, 30-day readmissions and ‘oh, by the way, how will we get paid?’ The Premera Blue Cross (Washington state) breach of 11 million records was the second largest in healthcare history (after Anthem Health‘s February bunker buster of a breach). Most breaches are from stolen laptops or shared/easy to guess passwords (or none at all)–but these have not been in the millions. Premera’s theft took place on 5 May 2014 and was only discovered in January; it included SSIs, bank information, claims data, patient name/address and date of birth. Those affected were in California and Alaska primarily, but also included Federal employees.
But Premera can’t say they were not warned. The US Office of Personnel Management’s Office of the Inspector General (OPM OIG) independently audited Premera in April 2014 detailing several vulnerabilities, including a lack of timely patch implementations, a lack of methodology to “ensure that unsupported or out-of-date software is not utilized” and insecure server configurations, and the need to upgrade physical access controls in their data center. FierceHealthIT
Premera’s medical files data may expose other payers, which in turn may legally come after Premera, according to FierceHealthIT.
Only now are health systems and practices focusing on securing all information (more…)
Assistive tech for older adults gets fresh developer interest, funding
Companies and investors are waking up to the potential of technology to assist both older people, wherever they live, and families to keep in touch, live more safely and to compensate for impediments created by physical or cognitive conditions. Ozy, an online news aggregator new to this Editor, notes the $5 trillion annually that boomers and older adults spend in what’s termed the ‘new old-age economy’ (AARP has previously termed it the ‘longevity economy‘) and that there’s money in tech solutions to their problems. Examples: the Lift Labs [TTA 1 Oct 13] stabilizing food utensil that cancels out most active tremors (as in Parkinson’s) while eating; Caremerge which has EHR, care coordination and secure messaging features for the care team in long-term and transitional care, but also connects families with a smartphone app and residents with reminders; GeriJoy [TTA 3 July 14], a tablet that combines an interactive pet avatar/companion with engagement, reminder and education tools for older and cognitively impaired adults.
While we’ve noted many developments along similar lines over the past ten years, interest and financial backing is aligning. (more…)
Radiation from smartwatches, wearables: real, alarmist, or the NY Times?
After an unfortunate baiting for attention at the start, making an analogy of cellphone/wearable radiation to 1930s adverts with doctors ‘endorsing’ cigarettes, he for the most part tries to take a balanced approach. By the end, he lines it up like this. Bluetooth LE and Wi-Fi–no evidence of harm in adults. 3G/4G cellphone radiation–you may want to be careful. He points out that studies aren’t definitive. Older studies, such as the WHO’s, a Swedish and some European studies point to harmful (carcinogenic) effects from phones held extensively too close to the head, but nothing is definitive in causality as the CDC pointed out and additional studies have proven no conclusive evidence of harm. Conclusion–use anything 3G/4G with caution, away from the head, limit exposure by children or pregnant women. Cautious enough?
Oddly, he advocates Bluetooth headsets but doesn’t mention using speakerphone settings–and then, for the smashing windup, won’t put the Bluetoothed Apple Watch near his head. It’s a weirdly sourced (an alternative doctor the only one cited? Old studies?) and half-baked, partially tossed salad article. Consider: most wearables are–surprise, Bluetooth or Wi-Fi connected. But it does bring up the inconvenient question, only partially answered, of All Those Rads and What (If Anything) Are They Doing To Us.
What’s really interesting? The immediate, twitchy and prolonged press response. As they say in New Jersey, they are ‘jumping ugly’. (more…)
A mélange of short subjects for Tuesday
ATA accredits American Well, Apple ResearchKit, diabetic contact lenses, Hackermania Falls on Indiana, patent trolls get a haircut, and more
The ATA (American Telemedicine Association) has gained more than 200 applications for their US-only Accreditation Program for Online Patient Consultations [TTA 17 Dec 14]. First past the post in accreditation is American Well’s Amwell virtual visit app, which will shortly be listed on the ATA consumer website SafeOnlineHealth.org. Release, MedCityNews….Stanford University, one of the five academic centers using the Apple ResearchKit, had a mind-boggling 11,000 signups for a heart health study–in 24 hours. The downside is that they may not be representative of the whole population [TTA 10 Mar, see 11 Mar update] including us Android users. 9to5Mac….The Google-Novartis glucose-measuring contact lens [TTA 17 July 14] for diabetes management just gained some Canadian competition–Medella Health in Kitchener, Ontario, founded by a team of (more…)
EHRs can’t exchange patient records? $$ in workarounds.
Some of the Excedrin/Panadol Headaches (#11, #14, #23 and #54) in healthcare are around the very ‘miracle technology’ that was supposed to make it all seamless, non-duplicative, time/cost-effective and coast-to-coast–EHRs. The exchange of patient records between hospitals, within health systems between sites and with medical practices plus vice versa–works haltingly if at all. It works best within well-established, highly integrated delivery systems –the VA, DOD, Mayo Clinic, Kaiser, Geisinger, Intermountain Healthcare. But once you’re away from it–good luck. Where are the problems? The closed standards of the major hospital EHRs–Epic, Cerner, Allscripts, McKesson and brethren; the extreme customization most health systems demand (nay, a major Epic selling point!); structured versus unstructured data and how handled; a lack of a secure interoperability standard are but a few. Where is the gold? Getting patient health records exchanged, accessible and transportable, among systems that were essentially designed not to speak with each other. (more…)
Sweat analyzing sensor patch flies high at USAF Research Lab
‘Rotting In Place’
Laura Mitchell, who was one of the key people behind GrandCare Systems and now is a marketing consultant and healthy aging advocate, has written an interesting article on LinkedIn Pulse, now on her website, springing off an AgingInPlaceTech article by Laurie Orlov. Like the latter’s article, it commented on the Washington Post profile of Prof. Stephen Golant, whose POV on ‘aging in place’ was mostly that AIP is oversold–that in many cases, it’s ‘rotting in place in their own homes’. It’s a highly provocative topic with equally provocative statements and Ms Mitchell does take him to the woodshed, as does Ms Orlov in a different way. Prof. Galant seems to take a more moderate tone in his book (publicity perhaps?), citing (in the Amazon summary) that “older people often must settle for the least imperfect places to live. They are offered solutions that are poorly implemented or do not respond to the totality of their unmet needs.” a statement with which this Editor finds it difficult to disagree.
This Editor will largely cite her previous LinkedIn comment with a few embellishments/edits: (more…)
3rings Plugs in to reassuring families
Integrating mobile apps between clinicians and patients
Your Editors have noted many well-funded companies working in the wings to link up and find meaning in the hugeness of Big Data generated by a gazillion medical systems and devices (Validic, the recently seen QpidHealth at HealthIMPACT East). However what’s been scarce on the ground are companies that are front-end, point of service, integrating mobile communications between clinicians, then with consumers/patients, then with EHRs, operations and patient portals. We noted ZynxHealth at HealthImpact, interestingly part of media giant Hearst, but they confine their secure messaging to clinicians. Now spanning both worlds is an early-stage company, Practice Unite, out of New Jersey Institute of Technology’s (NJIT–metro NY-ers of a certain age remember it as Newark College of Engineering!) NJ Innovation Institute accelerator. Inspira Health Network, located in southern NJ, is adopting their single clinician/patient platform. In conjunction with Futura Mobility, this will facilitate clinician/patient secure texting, voice communications, patient-directed communications and delivery of EHR data. Practice Unite has previously developed apps for at least ten health systems and home care providers. Their three-minute demo here illustrates a very wide span among clinicians, hospital operations, home care operations and patient engagement. (This Editor will be finding out more on Friday when visiting their offices at the NJIT Enterprise Development Center in Newark.) Release.
The hypealicious, hyperluxus Apple Watch debut–what the healtherati are interested in
Ah, but let us get down to business and cut our swathe through the fog d’hype. (Editor Donna just walked in the door…)
As predicted and projected, the Apple Watch in stores 24 April in Australia, Canada, China, France, Germany, Hong Kong, Japan, UK and US goes light and standard on health measurement features: accelerometer, heart rate sensors, running and weekly activity reports. What’s different? Wrist burps you if you’re a lazy, sitting sod. (Not a great feature for deep meditators or napsters.) The leak from two weeks ago feinted health through downplaying the functionality of the Watch. Back in September, claims included blood pressure and stress monitoring. [TTA 18 Feb]
Now for the right cross. It’s not the Watch, it’s the ResearchKit. Apple gets serious in health apps beyond HealthKit, partnering with the stars in the medical research firmament. As reported: (more…)
Participate in the 2015 Global mHealth App Developer Economics Study
Click here to go to our exclusive link and participate in the survey. The survey is available till 26 April. Share your opinions and experience on how mHealth apps impact healthcare delivery now and in the next five years. Plus, every participant will receive the chance to win one of five free entry tickets to the mHealth Summit Europe in Riga, Latvia 11-12 May, where the results will be presented; a free copy of the 2015 report as well as the possibility to see initial results after completing the survey. Download link for the 2014 study (PDF).
TTA is a media partner of the 2015 Global mHealth App Developer Economics Study, and was a media sponsor of this year’s US mHealth Summit.
Smartphone health data, privacy concerns rear head at MWC
As Editor Charles is chronicling at the world’s largest mobile event, Mobile World Congress in Barcelona has a great deal of focus on healthcare–and that includes healthcare data security. Both telehealth monitoring and telemedicine virtual consults are increasingly phone-based. That data transmitting via and in virtual storage a/k/a The Cloud, including personal health records (PHRs), is overly assumed to be secure, but security protocols vary. “We are at the mercy of who the app providers are and how well they secure the information, and they are at the mercy sometimes of the cloud providers.” according to Kevin Curran of the IEEE. This article also points out that there’s real consumer concern that insurance companies will access their personal identified data via various databases, (more…)
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