Health data changes Down Under: My Health Record, Tim Kelsey and Telstra

September 22, 2015 | by

Australia’s federal government is hoping for a boost to its national personal health records system, starting with a renaming of Personally Controlled Electronic Health Record (PCEHR) to My Health Record. Proposed in the government’s $485 million budget announcement on eHealth is a resolution of implementation issues and introducing trials of participation models including designing opt-out approaches. Currently enrollment stands at a paltry 10 percent of Australians. Computer World (Australia) Hat tip to Mike Clark via Twitter

Come December, also taking the long trip there will be NHS England national director for patients and information Tim Kelsey to join Telstra Health as commercial director. Telstra is Australia’s largest telecom developing a footprint in health, and earlier this year acquired Dr Foster LLP, the UK-based health informatics company. Coincidentally (?), Mr Kelsey co-founded Dr Foster prior to 2006, when he joined the NHS to start up the information site NHS Choices. During his NHS tenure, Mr Kelsey faced numerous controversies which are detailed in the Guardian and IT news/opinion site The Register reports, mainly concerning the Care.data database for all English medical records. Concerns were raised about inadequate privacy, transparency and confidentiality provision in its design, and after a halt it has still not restarted, although 1 million people have preemptively opted out–another issue in common with My Health Record. According to the Guardian, “The scheme was recently labelled “unachievable” by a Whitehall watchdog, the Major Projects Authority, which said the future of the programme should be reassessed.” A successor to Mr Kelsey has not yet been named.

IMS Health report: mainstream health app adoption remains elusive

September 22, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/Key-findings2-thumb-IMS1.jpg” thumb_width=”200″ /]Despite 165,000 apps (and counting). A followup to IMS Health’s report of 2013, Patient Adoption of mHealth demonstrates how far mHealth has to go. Over 50 percent of apps have a single functionality, but connectivity to external sensors (e.g. wearables) has improved to 10%. 36 apps account for nearly 50 percent of downloads and 40 percent of all health apps have 5,000 downloads or less. Providers give limited if any guidance to consumers on app choice despite greater interest; ‘curation’ efforts, including IMS Health’s own [15 Dec 13], have largely failed. Other barriers to adoption are reimbursement (though many are free), limited healthcare system integration, regulator and privacy unknowns.

Where’s the progress? Chronic condition monitoring (left), with clinical trials more than doubling in the past two years, and focusing on treatment/prevention largely for older adults. These clinical trails are looking at mental health, diabetes, cardiovascular disease, weight management and oncology. IMS Health also recommends that users and stakeholders, including clinical organizations such as the CDC, ASCO and the Cancer Support Community tap into their clinical resources to develop and promote patient-centered apps. Download report (information required.)  A decidedly less cheerful take on the report is Stephanie Baum’s at MedCityNews.

Have we arrived at another, multi-functioning generation of telecare?

September 22, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/Onkol.jpg” thumb_width=”150″ /] Profiled in Reuters in an article on home monitoring for older adults is a desktop-sized, sleekly telecare unit called OnKöl (that’s On Call for those who wonder what an umlaut is doing there) for the home market. Debuting back in January at International CES, it monitors activity in an area of the home (that green eye looks like a vintage radio DuMont Magic Eye tuner) and is extended through home monitoring sensors such as bed, door and window. Like Lively, it also has an in-home wrist/pendant emergency alert device and is self-installed. But what’s new about it is its telehealth side–connecting via Bluetooth and USB cable to typical medical monitors such as weight scales, blood glucose and pressure, as well as a med reminder setup. These seem to be brand-agnostic. A unique safety feature is a caller ID recorder for tracking calls. Activity and health information are stored, with alerts going to designated family members. According to the article, the founder designed it for monitoring his mother recovering from colon cancer. The Milwaukee-based company is financed through Series A (Capital Midwest Fund, $2.8 million), moving towards Series B, and OnKöl will be in market early next year. What is not apparent (more…)

Philips tests diabetes app developed with Radboud UMC, Salesforce (NL)

September 18, 2015 | by

Philips Healthcare unveiled a prototype of a diabetes tracking app that also links to a secured social ‘community’ at this past week’s Dreamforce 15 conference in San Francisco. It was developed in conjunction with Salesforce and the Radboud University Medical Center (NL). Philips claims the app is the first to collect and connect data from EMRs, multiple personal health devices and patient self-reported data, with the patient directing sharing via private messaging and shared posts with providers and fellow patients (‘community’). It is built on the HealthSuite Digital Platform which is a product of Philips’ collaboration with Salesforce. The app provides tracking information to the patient on blood glucose levels, insulin use, nutrition, physical activity, mood and stress. The patient also receives data-driven feedback and coaching guidance. It will be ready before end of this year in select non-US markets. At Dreamforce, Philips demo’d their joint Virtual Health Record initiative, which is being promoted as “a digital toolkit that makes it easy for health systems, institutions and care providers to utilize the power of the HealthSuite Digital Platform technology in dedicated localized solutions.” Release

GE Healthcare staying together: CEO (updated)

September 18, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/04/2000px-General_Electric_logo.svg_.png” thumb_width=”150″ /]It’s ‘black and white’ but not GE blue all over! During an investor conference Wednesday, GE Healthcare’s CEO John Flannery insisted that “Bottom line is we have been black and white that all aspects of healthcare are part of our portfolio,” reported in Reuters. Investors have questioned the flatlining of both revenue and profit and the fact that GEHC doesn’t seem to fit well in the engineering/manufacturing bent of the Immelt-ized GE.

The speculation by investors and we in the healthcare press is rational. Earlier this year, GEHC announced the phaseout of the Centricity Enterprise (hospital) EHR. [TTA 15 April] Healthcare Financial Services and the services it would provide were also up in the air. Currently it lends to healthcare entities including hospitals and other health facilities to purchase equipment (made by GE) and real estate/facilities (not made by GE). Initial indicators was that GE would continue to finance what it sells. The real estate financing then is questionable, and undoubtedly an issue for healthcare facilities, as GE Capital has been sold. GE also sources funding for healthcare innovation through the Healthymagination Fund and GE Ventures, and of course has an interest in the Intel-GE JV, Care Innovations. What shape this financial arrangements will take in the future is not clear from the available information.

Also announced, according to Biospace, is $1 billion funding over the next five years for education to reach more than two million healthcare professionals worldwide–physicians, radiologists, technologists, midwives, nurses, biomedical engineers–geared to local needs. It will include new clinical, product application, technical and leadership training and education. A forward commitment of this magnitude does seem to confirm that GEHC is in the healthcare game.

Soapbox: The burning technological platform for person-centred care

September 18, 2015 | by

Rising demands of an aging population are putting increasing pressure on care providers across health and social care. But the technology and thinking that can help alleviate some of those pressures is analogue in a digital world, argues Tom Morton of Communicare247.

Analogue thinking in a digital world
Integrated, person-centred care is seen as a driving force for building public services around individual needs. It aims to bring care out of the hospital and into the community and home to cope with the growing burden of the 3 million people who will have over three long-term conditions by 2018. It will also help acute hospitals to address the ever increasing costs associated with our aging population.

Meanwhile life in our homes and communities is becoming fragmented. One in four (2.9 million) people aged 65 and over feel they have no one to go to for help and support, according to a 2015 report from Age UK and The Campaign to End Loneliness(1). With research indicating that social isolation leads to higher mortality, what point is there keeping people out of hospital, if only they are left home alone, and without the necessary support?

Person-centred care will have minimal success if we do not recognise this fact; people need someone to look out for them. And current approaches are not building the foundations that society needs to help grasp the nettle of providing round-the-clock personal care. (more…)

Conference report: MedCityNews CONVERGE

September 18, 2015 | by

Guest columnist Sarianne Gruber (@subtleimpact) attended Breaking Media’s annual MedCityNews CONVERGE two-day conference at Philadelphia’s Hyatt at Bellevue earlier this month, and has a few observations on the surface contradiction of innovation and health insurance.

Breaking Media rightly titled this year’s MedCity News conference “Converge”. Listening to the speakers, meeting the founders of new startups and talking to presenters, it became clear that today’s healthcare ecosystem is interdependent on the all the players to move the needle for better quality health. It was fascinating to learn was how innovation is breaking down the old silos of engagement, and is emerging from all the industry players, as well as joining at new intersections. The proliferation of better products, methodologies and engagement is closing the gap with more data, technology and ideas.

When you think of your health insurance company, usually two words comes to mind, cost and coverage. Keynote Speaker, Daniel Hilferty, President and CEO of Independence Blue Cross, wants to change the focus to consumer and care. Hilferty paralleled the new ventures at Independence to the work of the great innovator, Thomas Edison. Not only did Edison invent the light bulb, but his work is evidenced in the scalability of electricity that changed the world and how we now live.

In what directions is Independence Blue Cross converging? (more…)

Qualcomm Life, Cox Communications buy into integration–differently (US/FR) updated

September 15, 2015 | by

Qualcomm Life, known for building partnerships with independent companies to form a continuum in transitional/chronic care management utilizing the HealthyCircles platform [TTA 19 Dec 14], yesterday announced not a partnership but an acquisition–Capsule Tech, a company that builds systems for healthcare facilities, mainly hospitals, to collect and integrate data from myriad medical devices. Their medical device information system (MDIS) is dubbed SmartLinx and is used by 1,930 hospital clients in 38 countries. Headquartered in Andover, Massachusetts, Capsule has international offices in France, Singapore, China, Australia, UAE and Brazil. Majority owner was Turenne Capital, a French PE company. Acquisition terms were not disclosed. Release. Also Forbes, Neil Versel in MedCityNews.

Update: Fortune is quite bullish on how this aids Qualcomm in narrowing the quality gap of data transmission between the home and the hospital setting.

Cox Communications, the third largest cable and internet company in the US with ad media and business data divisions, is dipping more than a tentative toe in healthcare with last week’s acquisition of Trapollo, a program design/supply chain/logistics provider that currently works with multiple telehealth, telecare and monitoring device companies. Cox is clearly seeking another type of integration of their data carriage capabilities with systems and programs; they have also invested in HealthSpot Station’s virtual visit/telehealth kiosk and formed a strategic alliance with Cleveland Clinic. Release.

Neil Versel’s columns also note IBM Watson‘s growth and development of its own Care Manager with Apple HealthKit/ResearchKit [TTA 10 Sep] and Salesforce’s entry into patient management with Health Cloud, with another big announcement rumored to be on the way.

Eric Topol, Robert Wachter have a patient-centered conversation

September 11, 2015 | by

Ostensibly an interview about Dr Topol’s book ‘The Patient Will See You Now,’ it is more a discussion of Dr Topol’s thesis that patients in control of their data are upending the relationship between doctor (as authority) and patient. What Dr Wachter questions– is the lack of analytics to turn this into useful information for both doctor and patient. Dr Topol agrees that the data is outstripping the analytics:

The field has not been developed nearly the way it should be to get us to the virtual medical assistant, which integrates all relevant data about an individual and provides great data visualization back to that person. Once it does, we have a tremendous opportunity to help people, even to preempt illness.

Dr Topol is also widely depicted as an advocate of ‘DIY’ (do it yourself) medicine, but he is not; “This is more about acquiring diagnostic or monitoring data and still having an intimate relationship with a doctor to help guide the appropriate treatment.” Doctors will have to change their methods too. A worthy Weekend Read (and audio excerpt 08:05) in this month’s AHRQ WebM&M.

Previously in TTA: Dr Topol on his book at last year’s NYeC Digital Health Conference (contrasting with the central control-stop medical intervention at 75 advocacy of Ezekiel Emanuel); Dr Wachter on The Overdose (excerpted from his ‘Digital Doctor’ book)

IBM Watson Health adds 5 partners, 2 solutions

September 10, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/pillar.jpg” thumb_width=”150″ /]Breaking News  IBM Watson Health not only cut the ribbon on their new global HQ on Kendall Square in Cambridge, Massachusetts (and on their new General Manager Deborah DeSanzo), they also announced two more data crunching power platforms and five new partners.

  • The IBM Watson Health Cloud for Life Sciences is designed to help life science companies fast track the deployment of a GxP compliant infrastructure and applications while adhering to stringent requirements for hosting, accessing and sharing regulated data.
  • The IBM Watson Care Manager is a population health solution that integrates Watson Health, Apple ResearchKit and Apple HealthKit into a personalized patient engagement program to improve individual health outcomes.

The five new partners are Boston Children’s Hospital (pediatrics), Columbia University (Pathology & Cell Biology and Systems Biology), ICON plc (pharma clinical trial matching–Ireland), Sage Bionetworks (Open Biomedical Research Platform) and Teva Pharmaceuticals (treatments for chronic conditions–Israel). They join CVS Health, Medtronic and Yale University. On opening day, the new headquarters also hosted demonstrations by health ecosystem partners Best Doctors, Modernizing Medicine, Pathway Genomics, Socrates and Welltok. Release (PDF)

Previously in TTA on IBM Watson Health: their big announcement at HIMSS 15 and we do wonder about their work with the VA on clinical reasoning and mental health.

The intent is good, the name–Hackfest–is unfortunate (Updated)

September 10, 2015 | by | 3 Comments
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/CI_Hackfest_15.jpg” thumb_width=”150″ /]Given another Big Blue Cross data breach (below), the juxtaposition of a release from Intel-GE Care Innovations is, how do we say, jarring. A great trumpeting of a prestige event 18-20 September in conjunction with the Stanford Center on Longevity on the Stanford University campus. “Inspiring a reconfigured care delivery process bringing care to the home and uniting patients, family caregivers and professional caregivers with the traditional clinical care team.” which will “…change the status quo. The event will bring together clinicians and care providers, health plan leaders, family and professional caregivers, patients, designers, engineers, students and faculty to explore the meaning and definition of a care team.” Yes they can be ‘hack(ing) a strategy to redefine the care team’…but given the tens of millions of health records hacked, breached and stolen in this year alone, is this the best name Stanford and Care Innovations could think of?  ‘Hackfests’ and ‘hackathons’ usually are coding or programming competitions, which long predate the negative use of ‘hack’ for malicious entry into systems. Even events in that context are increasingly met with raised eyebrow.

‘Hackfest’ for this is a stretch. Message to both: care teams need redefining, but it’s time for a better, and more descriptive, name. A ‘****-palooza’ (a voguish term in US), anyone?

Update: A Care Innovations spokesperson and this Editor had a Twitter conversation–a TweetFest, so to speak:

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/Care-Innovations.png” thumb_width=”450″ /]

Readers–what do you think? Is this Editor overly sensitive to the ‘h’ word? She might be…click on the title to see Comments.

Hackers hit another Blue Cross, put 10.5 million members at risk (Breaking)

September 9, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/02/Hackermania.jpg” thumb_width=”150″ /]BREAKING NEWS This time the data breach is at Excellus Blue Cross Blue Shield, which covers upstate New York (Rochester-Syracuse area). It was discovered by Excellus on 5 August but dated back to 23 Dec 13, and reportedly has compromised members’ names, addresses, telephone numbers, Social Security numbers, financial account information and in some cases sensitive medical information. According to the AP/NBC, it also breached other divisions of Excellus and the corporate parent, Lifetime Healthcare: Lifetime Benefit Solutions, Lifetime Care, Lifetime Health Medical Group, The MedAmerica Companies and Univera Healthcare. The source of the hack has not yet been determined.

Excellus joins fellow BCBS members Anthem [TTA 11 Feb], soon to be merging with Cigna, with 80 million; Premera Blue Cross [TTA 24 Mar] with 11 million, Care First with a ‘bag o’ shells’ 1.1. million [TTA 2 June]. The pattern has been such that the national Blue Cross Blue Shield Association (BCBSA) announced in July that it will offer all 106 million of its members identity protection starting next January. (Note for our mathematicians: Anthem has millions of non-BCBS members) Chinese hackers are suspected in the Anthem breach.

FierceHealthPayer broke the story, in this Editor’s estimation, to the healthcare trade area. Rochester Democrat & Chronicle. Excellus message to policyholders. The NBC/AP report also has a video interview with Eugene Kaspersky of the eponymous anti-virus software (and whose Kaspersky Lab was also a hacking victim earlier this year)

Updated via the Rochester Democrat & Chronicle:  FireEye is becoming the ‘go-to’ security company for health organization breaches–Excellus hired them in the wake of the Anthem breach and they discovered the vulnerability facilitating the breach.

Is ‘pure’ robotic telesurgery nearing reality?

September 9, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/Nicholson-Center-FL.jpg” thumb_width=”150″ /]Moving beyond robot-assisted surgery (e.g. the well-accepted use of the daVinci system with prostate surgery), controlled by a surgeon present in the operating room, is telesurgery, where a remote surgeon uses a robot to fully perform surgery at a distant location. The Nicholson Center at Florida Hospital in Celebration, Florida, which specializes in training surgeons and technicians in leading (bleeding?-Ed.) edge techniques, is studying how internet latency (lag time to the non-techie) affects surgical effectiveness. Latency is defined in this case as “the amount of delay a surgeon can experience between the moment they perform an action to the moment video of the action being carried out at the surgery site reaches their eyes.” Their testing so far is that internet latency for surgery between hospitals has a threshold of 200-500 milliseconds before dexterity drops off dramatically (not desirable)–and that given the current state of the internet, it is achievable even at a mid-range distance tested (Florida to Texas). Making this a reality is highly desirable to military services worldwide, where expertise may be in, for example, Germany, and the casualty is in Afghanistan. It would also be a boon for organizations such as the Veterans Health Administration (VA) where resources are stretched thin, rural health and for relief agencies’ disaster recovery. ZDNet

How technology can help fight elder abuse–ethically

September 9, 2015 | by

The increasing awareness of abuse of older people by their caregivers, whether at home or in care homes/assisted living/nursing homes, invites discussion of the role that technology can play. This presentation by Malcolm J. Fisk, PhD, co-director of the Age Research Centre of Coventry University, in the BSG Ageing Bites series on YouTube looks at technologies viewed by level of control and intrusiveness:

  • Social alarms, which include pull cords (nurse call) and PERS–what we think of as ‘1st generation’ telecare: high level of control, low intrusiveness–but often useless if not reachable in emergency
  • Activity monitoring, which can be room sensor-based or wearable (the 2nd generation): less control, slightly more intrusive–also dependent on monitoring and subject to false positives/negatives
  • Audio and video monitoring, while achieving greater security, are largely uncontrolled by the older person and highly intrusive to the point of unacceptability. (In fact, some feedback on tablet-based telehealth devices indicates that a built-in camera, even if not activated, can be regarded with suspicion and trigger unwanted reactions.)

The issues of consent, and balancing the value of autonomy and privacy versus factors such as cognitive impairment, personal safety and, this Editor would add, detecting attacks by strangers and not caregivers, are explored here. How do we ethically observe yet respect individual privacy? This leads to a set of seven principles Dr Fisk has published on guiding the use of surveillance technologies within care homes in the latest issue of Emerald|Insight (unfortunately abstract access only) Video 11:03. Hat tip to Malcolm Fisk via Twitter.

Telehealth patient engagement program improves orthopedic outcomes

September 5, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/orthocare_06.png” thumb_width=”150″ /]VOX Telehealth‘s patient engagement program with Bon Secours St. Mary’s Hospital in Richmond, Virginia, which was announced back in January [TTA 12 Jan], published results for its pilot last month, and they appear to be outstanding. VOX’s model is ‘episode of care’, over a 90-120 day span starting 30 days prior to surgery to 60-90 days post-procedure; the online/tablet platform delivers educational content, reminders and notes on potential symptoms that ties into a customizable by patient alert escalation and notification system. The goal is to reduce post-discharge complications and readmissions, in this case for hip and knee replacement patients, through managing expectations and better preparation by the patient. And the results reported are encouraging:

  • 92 percent of enrolled patients were discharged directly to home–the US average is only 30 percent
  • Length of stay dropped to 1.6 days, nearly 50 percent lower than the US average of 3.7 days. It is lower than Bon Secours’ average of two days.
  • There were 0 readmissions after 30 days, compared to the US average of 6 percent
  • Patient satisfaction was also high: (more…)