DARPA testing electricity to self-heal the body

October 7, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/10/darpa-electrx-electric-prescriptions-2.jpg” thumb_width=”200″ /]I sing the self-healing Body Electric! With apologies to Ray Bradbury, in this Editor’s view, DARPA’s ElectRX research is almost revolutionary, yet logical. Like a pacemaker, it monitors a condition (like heartbeat) and if ‘off’ stimulates the organ through an electric shock. Scale it to a nano-sized neuromodulator and you have ElectRX. In broad terms, a tiny device, perhaps delivered by a needle, analyzes an anomaly and delivers an electrical signal to nerve pathways to correct it. For diabetics, it could stimulate insulin production; to treat depression, control inflammation in the brain; for PTSD patients, stimulate the vagus nerve for neural plasticity. Controlling inflammation has other benefits, such as in spinal injury and in TBI. While the Gizmag article spends time musing on ‘super-soldiers’ and the negative aspect, this Editor sees this research on the relationship between neural circuits and health as a significant development for both medicine and for Version 3.0 of digital health. DARPA web page on ElectRX.

Is digital health going to add to Digital Big Brother Watching You?

October 6, 2015 | by | 1 Comment
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/10/Doctor-Big-Brother.jpg” thumb_width=”150″ /]“They’re watching me on my phone. They’re watching me on Facebook. They’re even watching me when I want to hide. Machines are a form of intelligence, and they’re being built into everything.”–Dr Zeynep Tufekci

The world of digital health is largely based on tracking–via smartphones, wearables, watches–and analytics taking and modeling All That Data we generate. Are we in compliance with our meds? Are we exercising enough? How’s our A1c trending? Drinking our water? All this monitoring–online and offline–is increasingly of concern to Deep Thinkers like Dr Tufekci, a reformed computer programmer, now University of North Carolina assistant professor and self-proclaimed “techno-sociologist.” At IdeaFestival 2015, she took particular aim at Facebook (surprisingly, not at Google) for knowing a tremendous amount about us by our behavior, of course using it to anticipate and sell us on what we might want. The ethics of machine learning are still hazy and machines are prone to error, different than human error, and we haven’t accounted for machine error in our systems yet. Like that big health data that mistakes a daughter for her mother and drops critical health information from a patient’s EHR [TTA 29 Sep]. A thought-provoker to kick off your week. TechRepublic 

Related: The Gimlet Eye took a squint at Big Brother Gathering and Monetizing Your Big Blinking Data–data mining, privacy and employer wellness programs–back in 2013, which means the Eye and Dr Tufekci should get together for coffee, smartphones off of course. While Glass is gone, the revolt against relentless monitoring is well-dramatized in the well-watched video, ‘Uninvited Guests’. And we can get equally scared about AI–artificial intelligence–like Steve Wozniak. 

Digital health supporting daily living with autism

October 6, 2015 | by

A developing area for healthcare tech is in the assistive technology (AT) area–in this instance to support those with autism. The spectrum of abilities and capabilities here is very wide–as are the needs. Some major challenges: organization, communication, managing stress levels, managing transitions in everyday living as a college student with autism must. Last week’s Autech 2015 at Old Trafford, Manchester spotlighted AT such as Brain in Hand, a smartphone/tablet app that touches on all three: it helps with planning daily activities, logging stress levels, providing help with coping strategies and if it is overwhelming, a direct connection to a support worker at the Wirral Autistic Society. Other promising technology includes biometric wristbands to monitor signs of stress and provide feedback to identify and work to modify the autistic person’s reactions; the Kaspar assistance robot for socializing children; the Proloquo2go tablet app which speaks for those without speech by using speech-producing icons. AT for the autistic is at the very early part of the development curve, but this Editor could see dual or triple uses for these technologies for those with TBI, stroke or dementia. Studies on cost savings are early, but the Brain in Hand test in Devon estimated a 100-200x savings: £300-500/week for social care versus £20/week for the service (but does this include the live support worker?) There’s an app for that: how assistive tech changes lives of people with autism (Guardian)

Related: on a late adult diagnosis of autism, how it is to live with it on your own (Guardian)

Connected health to help cure–physician burnout?

October 6, 2015 | by

Here’s an interesting proposition: digital health tools such as telemedicine, telehealth and mobile health can help to reduce physician burnout. Except that if one is looking for support points in this HCI Healthcare Informatics article, one would be hard pressed. There’s no link to QuantiaMD‘s study (a 225,000-member US physician community), an inexplicable lapse. Your persistent Editor tracked it down, and found it connects the dots a bit more. It starts with the proposition that nearly half of doctors wouldn’t recommend medicine as a career to their children, then identifies a key frustration–“healthcare technologies that sap time and money are among the top reasons.” The solution? Other “emerging technologies—in the form of telemedicine, mHealth tools, and connected health devices—may actually help reverse this trend of physician burnout.” The paper then describes how telemedicine virtual visits, giving patients telehealth tools which will aid compliance and monitoring, especially with new treatments, and the opportunity to improve care all are Good Things. But not entirely convincing that these can be effective in mitigating the complex reasons why behind doctor burnout. Read the QuantiaMD study for yourself. Hat tip to Stuart Hochron, MD, JD of Practice Unite via LinkedIn

Blueprint Health’s 8th Demo Day: 8 new companies show their stuff

October 6, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/10/blueprint-health1.png” thumb_width=”150″ /]Last Friday, in the middle of a NYC nor’easter, Blueprint Health had its eighth Demo Day, where startup companies in this accelerator’s latest three-month Summer class, having worked on their innovations and developed a business plan, ‘graduate’ and ‘pitch’ their audience. There’s been a shift over the past few classes to B2B-oriented digital health, from reducing readmissions through geolocation (Position Health)  to HIPAA compliance (HIPAAfix) to streamlined billing for chronic care management (Oculus Health), but half are more consumer-oriented companies, providing more accessible genetic testing (Bind Health), workplace stress reduction (Psocratic) and point of service lending to patients with high-deductible health plans (Crediyo). The other two companies are MedPilot (simplifying patient billing and debt through electronic billing) and DocDelta (streamlining provider talent search). Annually, Blueprint Health’s invites in about 20 digital health companies with an investment of about $20,000 each, has graduated 68 companies and hosts in their space over 24 digital health companies. Release. Company profiles.

Better’s fast fail, ending health assistance service 30 Oct

October 2, 2015 | by | 1 Comment
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/10/Better.png” thumb_width=”150″ /]Better is sadly not. This two-year old service that provided personal health assistance, including a real, live health assistant, to guide members through health questions, the thickets of insurance claims, finding doctors and specialists, apps and more, announced earlier this week that it was ending operations as of 30 October. While it was announced via their Twitter feed on Tuesday, most of the industry learned of it through Stephanie Baum’s article in MedCityNews today. Better formally debuted only 16 months ago [TTA 23 Apr 14] and at the time this Editor felt that it was a service in the right direction, a kind of ‘concierge medicine for the masses’ needed when individuals have to direct more and more of their own care.

A solid start, as our Readers have seen, does not guarantee success, but this fast fail is still fairly shocking. A concern at the time was the pricing for the full service model at $49/month, which later became the family price (individuals were $19.99/month). CEO/co-founder Geoff Clapp was among the most Grizzled of Health Tech Pioneers; he had been a co-founder of Health Hero/Health Buddy from 1998 to its sale to Bosch Healthcare, a very long pull in telehealth, and he had spent much of his post-Health Hero time generously advising other startups. Yet despite the involvement of blue chip Mayo Clinic as a service provider, its financial backing from their investment arm and socially-oriented VC Social+Capital Partnership, it managed to raise only its initial seed funding of $5 million (CrunchBase).

So what happened? (more…)

76 percent of post-surgery patients prefer telehealth followup: study

October 2, 2015 | by

A 50-patient study at Vanderbilt University Medical Center in Nashville, Tennessee found that online-only post-surgical followup was acceptable to 76 percent of patients after uncomplicated surgery (hernia repairs, laparoscopic gall bladder). These patients, all of whom had internet access and a smartphone, tablet or digital camera, took their own pictures of their surgical site and transmitted these digital images through an online patient portal established by Vanderbilt. Both patient and doctor communicated through the portal to discuss follow-up care (though not necessarily at the same time). Another plus was that the online visits took significantly less time for patients (15 versus 103 minutes) and surgeons (5 versus 10 minutes). The surgeons reported a comparable effectiveness number–68 percent–for both online and in-person visits. Clinic visits were more effective in 24 percent and online visits for 8 percent. What was also notable was that no complications were missed via online visits. The program used to analyze images, typically used in wound management, was not disclosed in the study, which was performed between May and December last year. mHealthNews, Journal of the American College of Surgeons (abstract only)

NJ Innovation Institute gains $49 million HHS grant

October 2, 2015 | by

The New Jersey Innovation Institute (NJII), a New Jersey Institute of Technology (NJIT) corporation, has been selected as one of 39 health care collaborative networks participating in a Health and Human Services (HHS) program, the Transforming Clinical Practice Initiative. According to their announcement, NJII was selected as a Practice Transformation Network and over four years will receive up to $49.6 million for technical assistance support to help equip 11,500 clinicians in the New Jersey region with tools, information, and network support needed to improve quality of care. This is part of a $685 million HHS program awarding grants to 39 national and regional health care networks to help equip more than 140,000 clinicians with the tools and support needed to improve quality of care, increase patients’ access to information, and reduce costs. This is in addition to an $2.9 million grant from the Office of the National Coordinator for Health Information Technology (ONC-HIT) announced in August for sharing of quality data through its New Jersey Health Information Network (NJHIN). Through its Innovation Labs (iLabs), NJII brings NJIT expertise to key economic sectors, including healthcare delivery systems, bio-pharmaceutical production, civil infrastructure, defense and homeland security, and financial services. Release via Ridgewood Patch, HHS release. Hat tip to contributor Sarianne Gruber via LinkedIn.

Personal health ‘big data’ exchange is all good, right? Perhaps wrong.

September 29, 2015 | by

Many of our recent stories have touched on ‘big (health) data’ as Achieving the Holy Grail–how it can be shared, how it can work with the Internet of Things and how poorly implemented personal health record (PHI) databases can derail national health systems (and careers) [TTA 22 Sep]. They are, after all, 1) extremely difficult to design to preserve privacy and 2) must satisfy patients’ requirements for easy use as well as privacy including opting out. But when despite all good intentions, data goes awry, the consequences can be severe.

  • A daughter applies for health insurance from Aetna, and her mother’s medications, about which she had no knowledge, are attributed to her. How? Data mining off Milliman’s IntelliScript data service which mixed up the records.
  • EHR exchange can spread errors such as a dropped critical health or medication record. One led to the death of an 84 year old woman. VA also had a problem with its EHR (not cited but likely VistA) slotting medication histories into the wrong patients’ files. An Australian hospital mixed up discharge files in electronically sending them to doctors. The more records are exchanged, the more possibility there is for propagation of errors.
  • More information is shared with third-party suppliers; survey companies are increasingly tapping into these databases to send annoying, potentially privacy-invading treatment questionnaires to individuals.

Bloomberg Business’ conclusion is that this could be a problem, but much beyond the tut-tutting doesn’t get into solutions. The Pitfalls of Health-Care Companies’ Addiction to Big Data

A ‘feel-good’ car seat to reduce driver stress

September 24, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]In-car massage and therapy? A notion that gets The Gimlet Eye off the beach…again! Now a Canadian (HQ’d France) auto design company (sixth largest globally) gets into the wellness act with a prototype car seat that when you are stressed, gives you 1) a specific massage and 2) more refreshing air. Sensors built into the seat monitor respiration and heart rate, gauging stress and energy level. If your energy is low, you get an energizing massage; stressed, a relaxing one. Faurecia’s ‘Active Wellness’ seat was announced at the big Frankfurt Auto Show, and while it didn’t drown out the breathless hubbub around Volkswagen’s dodgy diesel emissions (turn on that refreshing air!), it made the Drudge Report. The non-contact sensors are from Hoana Medical in the US; Faurecia also worked with the Spine Research Institute at Ohio State University to develop the algorithms and signal processing. It also connects to wearable fitness devices so the ‘read’ begins when you start ‘er up. While Eye have no need for any of this being A Million Miles From Dull Care on A Dot On The Map, the poor New Yorkers living through this week’s UN General Assembly/Pope Francis Traffic Disaster do today and almost every day. But they’ll have to wait till 2020. Yahoo!Canada

Does telemedicine video quality influence clinical acceptance?

September 24, 2015 | by

A pointer for connected health designers. An Australian study reviewing telemedicine virtual consults examined the technical factors that may influence clinical acceptance. It compared the quality of cellular (3G) connectivity with broadband fiber-based service during virtual visits. While overall clinicians rated the telemedicine visits highly–equivalent to or better than a home visit 76 percent of the time and conducting a video consult compared with a home visit as equivalent or better 90.3 percent of the time–the lower audio/video quality of the visits over a 3G data connection versus broadband was apparent, enough that ‘statistically significant associations were found between audio/video quality and patient comfort with the technology as well as the clinician ratings for effectiveness.’ The high failure rate of 3G was also dramatic–23.5 percent of visits calls dropped.

The study was conducted at south Australia’s Flinders Telehealth in the Home (more…)

ROBOSOFT’s Kompaï-2 assistive robot debuts, wins award (FR)

September 24, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/steve-kompai-19may11.jpg” thumb_width=”200″ /] [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/Kompai.png” thumb_width=”200″ /]It’s a far cry from May 2011, when Founder Steve visited with the early version of the French Kompaï assistive robot for what is delicately termed ‘frail people’ (left). Kompaï-2 (second left), still with the tablet in the front, appears a bit taller and has acquired a backpack basket (for wine, a baguette, Le Matin), a rotating torso, laser autonomous navigation, a 3D camera, facial expressions and a new color. Other new features include physical assistance features plus the ability to assist with position changes, walking and medications to reduce caregiver workload. (more…)

ONC gets in study game in designing the Consumer Centered Telehealth Experience

September 23, 2015 | by

ONC (the Office of National Coordinator for Health Information Technology, HHS) in the spring conducted a design session on creating a more consumer-centered telehealth experience, commissioning the engagedIN research firm to help select a panel, run it and produce the study. The white paper focuses on how telehealth can either further fracture or integrate PHR (study pages 7-11), and what’s needed to make telehealth and telemedicine more convenient and effective for consumers. The panel avoided the big telemedicine providers (a bone that Mobihealthnews picks with the study) which typically dominate these panels–to this Editor a positive action–but included other telehealth providers like Qualcomm Life, Care Innovations and Zipnosis, as well as the US’ largest user of telehealth, VA Home Telehealth. Among the key drivers of telehealth are HHS’ and private insurers (UHC) shift to value-based payments; CMS’ target of 50 percent of Medicare value-based care is cited (page 5). There are nine principles at the end (pgs 13-16) to guide the way forward. Designing the Consumer Centered Telehealth and e-Visit Experience (PDF) (Though it is confusing why e-Visit was used rather than ‘virtual visits’ or, in fact, telemedicine.)

The difficulty in bringing telehealth to those needing it most

September 23, 2015 | by

California’s Center for Connected Health Policy, which is the National Telehealth Policy Resource Center, has published a study which concludes that community health centers (CHC)–a general term covering Federally Qualified Health Centers (FQHC) and Rural Health Centers (RHC)–have difficulty sustaining telehealth programs to support the underserved and ill with chronic conditions including mental health without grants or other subsidies. Consultant Milliman studied five California CHCs and determined that other than financial, major impediments to successful implementation were structural: complex billing and reimbursement rules, and difficulty tracking telehealth visits through multiple EHRs that weren’t necessarily compatible with each other or with billing systems. Many of these CHCs cannot financially provide telehealth without grants or other subsidies. This study holds lessons for telehealth companies which are working with ACOs, hospital discharge programs and practices in rural areas, as well as the Indian Health Service. Study (link to PDF), Healthcare Informatics, California Healthline  Hat tip to Elizabeth Olis of Viterion Digital Health

FDA, new technology approval and the Ossification Tango (US)

September 22, 2015 | by

When it comes to new technologies–and drugs for that matter–the worst thing that can happen to your invention is to receive a letter from FDA that you have been classified into Class III. Based on regulations passed by Congress in 1976, there are three FDA classes primarily based on device risk. Exception: Class III. Anything not ‘substantially equivalent’ to an existing device is automatically put into Class III, regardless of risk level. Author and health tech legal advocate Bradley Merrill Thompson of Epstein Becker Green takes a comprehensive review at this flawed and outdated system that puts groundbreaking health tech at an extreme disadvantage in his latest article on regulation in Mobihealthnews. (more…)

IoT’s biggest problem? Communication of Things.

September 22, 2015 | by | 3 Comments
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]The Gimlet Eye joins us for a ‘blink’ from an undisclosed, low-tech dot on the map. The fave rave of 2015 is IoT, the annoying shorthand for Internet of Things. Well, can Aunt Madge go into a store and buy an Internet Thingy? But it seems fundamental that The Things Speak with each other, if only to compare football scores and conspire against their owner to drive him or her Stark Raving Mad by producing too many ice cubes in the fridge, turning lights on/off at the wrong times or sending out for a deli order of 20 pounds of Black Forest sliced ham. Our fear about The Things was in considering that they could be hacked in doing Things Against Their Will and Not In The Owner’s Manual. But never mind, it’s not this we should be concerned about, or whether Uncle Aloysius will go off-roading in his Google Galaxie after it’s hacked for fun by an eight-year-old Black Hat. It’s that practically all of these same or different brand TVs, parking meters, cars and health/activity monitoring devices to make life simple for Auntie and Oncle are built on different platforms without a communication protocol. The Eye is now relieved of the fear that IoT devices will be crawling out of the water onto her faraway from dull care beach anytime soon. But you may not be. The Biggest Problem with the Internet of Things? Hint: It’s Not Security (Tech.co) Hat tip to follower @ersiemens via Twitter