A trip back in time to telecare, circa 2009–and maybe the future

August 29, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/08/Cape-May-Point-fade-to-dark.jpg” thumb_width=”150″ /]As the season winds down, our thoughts turn backwards. Your Editor remembers Jersey Shore vacations, travel, great airshows, collector car shows, old friends and good times. She also remembers When Telecare Was New (2006-9) with Living Independently Group (now Care Innovations), helping to pioneer the QuietCare system in senior housing. At that time, universities like Virginia and Florida were on the cutting edge in developing smart homes and pioneering systems for monitoring health in older adults and the disabled. Those smart homes and research initiatives vanished years ago, replaced by incubators, accelerators, the size of your funding round, Big Data, wearables, IoT….

Sigh. Your Editor is in Error. The University of Missouri is still at it 12 years later with its sensor-based behavioral/activity/proactive care system in the Tiger Place assisted living community near Columbia. And it seems much the same: bed and residential motion sensors, fall detection tracked by a variety of sensors, gait analysis and analysis of activity changes (changes in behavior=changes in health, which still doesn’t excite those in senior care the way it should) . You have to admire the persistence of vision the founders/researchers have had (Marilyn Rantz, professor emeritus with the School of Nursing, and Marjorie Skubic, a professor with MU’s College of Engineering). Their research model has now spread to 13 communities and hospitals in Missouri, and they are commercializing it with a former student, George Chronis, with Foresite Healthcare to convert it into a reliable, robust assisted living/hospital monitoring/care transition system with a simpler, affordable ‘health at home’ version. Besides the nostalgia and supporting fellow ‘true believers’, what they have designed is still needed AND not achieved by RFID (a big fizzle) or ancient PERS. We can all wish them luck in a competitive and much changed market. MU researchers taking sensor system from lab to marketplace (Columbia Daily Tribune)

Previously in TTA: Quantifying early detection capabilities of telecare (July 2012) and Editor Steve’s first look in October 2009 at ‘magic carpet falls’.

Telemedicine, telehealth underutilized in pediatric care

August 28, 2015 | by

In focusing on older adults on Medicare and secondarily the disabled, the use of telemedicine and telehealth is being overlooked for chronically ill children, especially those living at distance from specialized care. Children’s hospitals Many of these seriously ill children are either covered by parents’ employer plans or, if the family is low income, state Medicaid programs. This interview with Andrey Ostrovsky, MD, an attending physician at Children’s National Medical Center in Washington DC, notes the lack of incentive for innovative care which could utilize healthcare technology profitably. There is also a Medicaid waiver approval for telehealth reimbursement used for older person care, called the 1915(c) waiver for home-based and community services, which can be used for children. FierceHealthIT

Is the fitness tracker eventually going to lose to the smartwatch? (Updated)

August 28, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/08/LG-Urbane.png” thumb_width=”150″ /][grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/08/fitbit-charge.jpg” thumb_width=”150″ /]Which one would you prefer? 

The interest in fitness bands has quantifiably and substantially diminished since January, according to Argus Insights’ survey of online consumer reviews (!)–and since the debut of Apple Watch. And while Fitbit maintains its leadership in the band category (sorry Jawbone, though Editor Charles won’t be), the rising preference is for smartwatches like the Apple Watch and Android wear such as the Moto 360 and the LG Watch Urbane (pictured). While there’s a substantial price difference between smartwatches (~$350 versus under $150), and both Apple Watch and LG’s watches (versus LG bands) have limited fitness capability, there’s few new developments in fitness bands to create excitement. There have been enough problems with fitness band reliability, breakage, rising prices and a boredom with design to diminish interest while new brands enter the market, and smartwatch prices come down slightly. For the price, users also want more out of their watches. Neil Versel in MedCityNews.

Updated: Apple Watch, with 3.6 million units sold in 2nd quarter was immediately behind Fitbit with 4.4 million, according to IDC’s Worldwide Quarterly Wearable Device Tracker. 2 of every 3 smart wearables (capable of running third-party apps) was an Apple Watch. Another sign of the coming divide between fitness bands (which will be sold on price and fitness focus) and smartwatches (which will be sold on versatility as well as fitness justifying the higher price).  IDC release

Also by Mr Versel is a memorial to telemedicine pioneer  Dr ‘Red’ Duke. As a surgical resident at Parkland Hospital, he was on the team which saved the life of Texas Governor John Connally, shot with President John Kennedy in November 1963.

Integrating inexpensive lab testing, imaging to EHR–and vice versa

August 28, 2015 | by

In the Dr Eric Topol patient-driven world, personal lab testing would be walk in, keep retail hours and not even need a doctor’s order. That is the model for Theranos, a well-funded low cost blood testing company operating 43 centers in California, Arizona (no doctor order needed) and one Pennsylvania Walgreens. Their latest alliance is with EHR physician practice giant Practice Fusion, which claims about 112,000 doctors actively using its cloud-based, ad supported platform, claims to be the fastest growing US EHR with at present 100 million patient records. The Theranos reporting app, which also connects patients with doctors who can help interpret the results (MD Connect) integrates with other EHRs (though not listed) and now the results will also show in their Practice Fusion patient record. Practice Fusion is also integrating imaging center RadNet‘s results.

Since the late 2000s, Practice Fusion has historically been the game changer in cost (one of the first in the cloud) and in catering to smaller practices. They are good at managing their hype, but as Neil Versel points out, there’s been a CEO ‘change-lobsters-and-dance’, there are questions about revenue and their awaited IPO seems far away, especially given the recent market upset. Hospital EHRs Cerner, Epic and NextGen now all have lower-cost practice versions that integrate with hospital versions. An American College of Physicians (ACP) 2014 survey identified that Practice Fusion is third (and tied with others) among most used practice EHRs behind Epic and eClinical Works, though strongest in solo practices. On the polar opposite of Mr Versel’s skeptical article is this breathless Forbes piece which confuses partnerships with acquisitions. Perhaps self-made billionaire Theranos CEO Elizabeth Holmes may decide to buy Practice Fusion!

Another Tunstall Americas distributor acquisition

August 26, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /]Another press release from Tunstall Healthcare Group is also about Tunstall Americas, in this case the acquisition of Syracuse NY (Central NY State)-based Health Care Monitoring Systems (HMS). This continues this year’s strategy of purchasing or partnering with local home care providers. Like Mountain Home and Kupuna Monitoring (previously in TTA), HMS’ website prominently features a competitor–Philips Lifeline. Notable in the spare release is that the HMS founder notes “strong relationships with referral partners and government agencies.”  Release

Unicorns to Series A–health tech funding gained in (perhaps) the nick of time

August 25, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/08/1107_unicorn_head_mask_inuse.jpg” thumb_width=”150″ /]Money, money everywhere–unicorns get the headlines, but the companies are still (largely) small

Up until early August, this Editor would have assumed that our Readers would look at this funding roundup as a bracing windup to a largely positive eight months and a veritable Corvette Summer for healthcare technology funding. We may have to give back the keys a little sooner than we imagined. Will the dropping market affect digital health as 2008-9 did–‘out of gas’ for years? Or will it barely affect our motoring onward? Despite the Dow Jones average hitting an 18 month low today, we hope it’s closer to the latter than the former. though the new and big entrant to digital health investing is the country most affected, China.

Our roundup of the August Action includes ZocDoc, Fitbit, Alphabet, PillPack, Owlet and more, along with a few comments:

**ZocDoc, a NYC-based online medical care appointment service that matches patients with doctors by location and schedule, had the most sensational round with last week’s Series D funding of $130 million, giving it a valuation of $1.8 bn. It took over a year after the filing (June 2014) and was led by two foreign funds (London-based Atomico and Edinburgh-based Baillie Gifford) with additional funding from Founders Fund, which previously participated in raises of $95 million.

Though it claims 60 percent coverage in the US  and ‘millions of users’ (numbers which have been quoted for some years), ZocDoc won’t disclose profitability nor volume–metrics that would be part of any IPO.

Direction? Points given for deciphering this windy statement (quoted from Mobihealthnews): (more…)

September-October digital health events (US)

August 25, 2015 | by

While enjoying the last weeks of the Lazy Hazy Crazy Days of Summer (thank you Nat Cole, BBC clip), it’s time to put the fall’s upcoming events on the calendar, if you haven’t already. A selection starting with our partners:

  • Parks Associates’ Connected Health Summit (9-10 September)–see banner advertising above or here
  • ATA Fall Forum (16-18 Sept)–-see sidebar or here
    • If you are attending and would like to report on either conference, email Editor Donna (her schedule unfortunately does not permit her to attend)

Others of interest:

And in London, our partners at The King’s Fund have a wealth of events on their calendar into 2016.

Tunstall Americas allies with Apria Healthcare (US)

August 21, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”125″ /]Tunstall Americas continues its home care provider-centric strategy through an expanded product marketing relationship with Apria Healthcare. Apria, in addition to home care services, markets directly to customers a range of medical devices and durable medical equipment; they will be selling Tunstall’s brands under their medical alert category. This is the first we’ve seen in the US the Tunstall Vi and iVi pendant, along with the CEL cellular PERS unit. Tunstall will also be providing Apria with custom branded products, along with call center, ordering and fulfillment services.  Apria is the US’ fourth largest home care provider (2014 Home Care Market Outlook) with 1.6 percent of a highly fractionated market. Our sources tell us that the initial relationship precedes the Tunstall acquisition of AMAC.  PR Web

Is wearable IoT really necessary–and dangerous to your privacy?

August 21, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/08/is-your-journey-neccessary_.jpg” thumb_width=”150″ /]But does the average person even care? This Editor senses a groundswell of concern among HIT and health tech regarding the highly touted Internet of Things (IoT) and the dangers it might present. Our previous article reviewed the possibilities of hacking, system vulnerabilities in IoT networks and software bugs ‘bricking’ everyday objects such as refrigerators and cars. But what about wearables and the unimaginable amount of data they generate? Is it as unidentifiable as wearables makers claim? Columbia University computer science student Matthew Piccolella focuses in his article on healthcare ‘things’, primarily fitness trackers like Editor Charles’ favorite, Jawbone, but also clothing and even headsets that measure brain waves (Imec). Their volumes of data are changing the definition of healthcare privacy, which in the US has been synonymous with HIPAA. The problem is that health metadata are increasingly identifiable in a ‘big data’ world. (more…)

Situations Wanted

August 21, 2015 | by

If you are available to lend your talents to a new company in the digital health field, we invite you to list your information here.

Write up a short bio (or your elevator speech), what situation you are looking for, location (our readership is international,predominantly in the UK and US) and how you prefer to be contacted. This can be your LinkedIn profile, your email address or Twitter handle.

This may also be done anonymously through us if you prefer. Please email your Situation Wanted to Editor Donna. (We provide this as a free service to the digital health community.)

(And when you land, let us know–not only to remove it, but also so that we can tell your story!)

Now if you have a position that needs filling, see here….

Situations wanted, talent needed–list with us

August 18, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2012/12/crystal-ball.jpg” thumb_width=”175″ /]You don’t need a crystal ball to predict….As Summer winds down, thoughts turn to new situations and to fill those gaps in staff. Your Editors would like to assist those who are seeking a new situation–and those companies which have talent vacancies–in these pages. We are accepting new listings for both under the Jobs tab above. See ‘Who’s Available’ if you are looking, and ‘Who’s Hiring’ for positions. ‘Who’s Hiring’ is free for now; ‘Who’s Available’ will always be free as a service to our readers and for the digital health community.

Since 2005, Telehealth & Telecare Aware readers have been the most experienced and talented industry professionals in the UK, US, Europe and Australia. To reach them, you should be posting here. (And advertising–but that’s another story!)

Updated: We have two people now in ‘Available‘–a project manager with deep remote monitoring expertjse in UK and a Spanish industrial engineer with ‘silver market’ experience. No positions yet in ‘Hiring’–a missed opportunity. What company will be the first to correct this? For now, both types of listings are free.

Accenture projects that 50 percent of digital health startups fail after two years

August 18, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/08/Accenture-zombie_webready.jpg” thumb_width=”175″ /]Based on historical funding data and analyzing 900 healthcare IT start-ups, Accenture predicts that within two years of life, 50 percent will fail. These ‘zombie startups’, in Accenture’s charming term, burned through $4 bn in funding between 2008 and 2013. An additional $2.5 bn will go to fund digital health in 2015-16.

Does this mean that for the angels to the VCs, a visit to Las Vegas may be more fun? What remains can be mined for gold. There’s a wealth of IP–1,700 patents between the 900 startups analyzed–and experienced people who can be “aqui-hired”. Their solutions, despite failure, can be sound. Kaveh Safavi, managing director of Accenture’s global health care business, said, “Many digital startups that are dying or in danger of failure have developed solutions that can help traditional and non-traditional health care companies achieve their goals.” Mobihealthnews, iHealthBeat, FierceHealthIT. Accenture announcement.

Defense, VA EHR interoperability off the tracks again: GAO

August 18, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/04/Thomas.jpg” thumb_width=”175″ /] According to the US Congress’ Government Accountability Office (GAO), the birddog of All Things Budget, the Department of Defense (DOD) and Veterans Affairs (VA) missed the 1 Oct 2014 deadline established in the Fiscal Year 2014 National Defense Authorization Act (NDAA) to certify that all health data in their systems met national standards and were interoperable. Modernization of software–a new Cerner EHR for DOD, modernization of VistA– is also behind the curve with a due date now beyond the 31 Dec 2016 deadline until after 2018. Finally the DOD-VA Interagency Program Office (IPO), which shares health data between the departments, has not yet produced or created a time frame nor “specified outcome-oriented metrics and established related goals that are important to gauging the impact that interoperability capabilities have on improving health care services for shared patients.” iHealthBeat, GAO report

CAST-IAHSA Australia Technology Forum 31 August

August 18, 2015 | by

As part of the joint ACSA (Aged & Community Services Australia)-IAHSA (International Association of Homes and Services for the Ageing) conference 31 August-4 September in Perth, there will be a half-day session sponsored by LeadingAge CAST (Center for Aging Services Technologies) on 31 August. The conference will feature the tools which CAST has developed to help providers better understand, plan for, select and implement appropriate technologies to support self-management, independence and facilitate the delivery of services to the home. Featured speakers are from CAST–Majd Alwan–and from providers such as New York’s Selfhelp, The Salvation Army and It’s Never 2 Late. Session page. Conference information and booking.  Australian Ageing Agenda Technology Review

Can technology be a help in reducing loneliness?

August 18, 2015 | by | 2 Comments

Those who are older, disabled, new mothers and those who work from home often experience something in common–a feeling of isolation, of being in a vacuum. This Guardian article discusses how online networks targeting special interests can relieve that feeling: Mumsnet for new mothers, Scope for the disabled. For older people, Mindings (UK) can connect them to their own private network with text messaging, reminders, calendaring and photo sharing; it has been piloted by NHS Midlands and East as well as Suffolk County Council for dementia sufferers.

This Editor tried the artificial intelligence software powered chatbot Mitsuku recommended in the article, and found it monumentally silly after a minute of ‘dialogue’, kind of like a person you’ve met at a cocktail party with whom you find some common ground, only to find out that you’ve met a parrot, and not the Monty Python Dead Parrot.

One-on-one relationships that don’t need apps is in a related Guardian article where their writers take up Health Secretary Jeremy Hunt’s invitation for people to invite their elderly friends and neighbors into their homes for a chat and a cup of tea. (more…)

The NHS fail at encouraging digital health startups

August 18, 2015 | by

While Minister of Life Sciences George Freeman MP speaks very highly of the need for innovation and digital health in an NHS integrated health system, the reality is less encouraging for UK startups and their growth. The story of Big Health’s Sleepio and its move from the UK, told by Bloomberg, illustrates the difficulty that new companies and technologies have in fitting into a national framework, then selling into the 209 NHS regions plus related healthcare spenders. The long cycle and the narrowness of the frameworks are disincentives for many digital health technologies and their funders. Even if you win clients as part of being on the framework, when it expires after a few years, the business can be lost.

It’s hard to crack the code, and small companies are dependent on partners. A personal anecdote from this Editor’s time at Living Independently: the company achieved getting on a national framework with the QuietCare telecare product (2007) through partnerships with several larger telecare providers. We relied on them to offer QuietCare to the regions and councils. This had limited success and the US business far outstripped that in the UK.

Ten years ago, the situation was reversed. NHS, Government and council funding helped the earliest development and acceptance of telehealth and telecare, much as the Veterans Health Administration (VA) did with home telehealth and telemedicine in the US.  Other European markets and Canada have established private spending in this area, but these smaller markets–and funders– don’t have the potential that is possible in the US private market, even without reimbursement. The trend is reflected in investment: $4 bn in the US, less than €100 million in Europe. US developers now have a bonus in the potential of Asia, with China having the greatest interest and now funding. [TTA 23 July].  How the NHS Is Locking Out Britain’s Digital-Health Startups