Drawing a parallel between healthcare and … newspapers

May 12, 2015 | by

…is the point that Dave Chase, who founded patient information/engagement portal Avado and sold it to WebMD in 2013 (and with them until last month), is making in this Forbes article. As newspapers found their readership leaving in droves for online websites that delivered ‘news they could use’ faster and more interestingly, healthcare systems are finding that their patients are finding healthcare services outside their bricks-and-mortar:

  • Onsite workplace clinics (including telehealth/telemedicine hybrids such as HealthSpot Station–Ed. Donna)
  • Direct primary care providers such as Iora Health, Qliance, DaVita’s Paladina Health
  • Retail clinics: MinuteClinic, TakeCare Health
  • Medicare Advantage-only programs such as CareMore [TTA 5 May] and Healthcare Partners
  • Domestic medical tourism by large, self-insured companies for elective surgeries

This Editor would argue that these forces are at work even in (and perhaps because of) centralized payment systems, and are worldwide, not just in the US. Certain communities such as Rochester, NY, Dubuque IA and Seattle are focusing on lower healthcare as attractions to business–and countries such as Costa Rica, Mexico, Brazil, Singapore, Hungary and India are capitalizing on US-quality facilities and doctors to gain medical tourism for elective and self-paid surgery.

ATA’s hottest trend: advancing to Healthcare 2.0 via personalized healthcare

May 12, 2015 | by

Guest columnist Dr Vikrum (Sunny) Malhotra attended ATA 2015 earlier this month. This is the third of three articles on his observations on trends and companies to watch.

For those who attended the American Telemedicine Association‘s meeting in Los Angeles, the overarching trend was how a personal healthcare system is taking shape. The three pillars include: care anywhere, care networking and care customization.

The ATA stage opened with a keynote speech by Dr Sanjay Gupta about celebrating new innovation and technology advancements. This is the year where healthcare models are being built around patients in the home to support patient autonomy.These three pillars of personalized healthcare are being made possible by disruptive technologies, wearables/implantables, social networks and analytic technologies to automate remote care. Wearables and biosensors allow patients to move anywhere without interfering with day to day schedules while allowing for optimized data collection.

Access to care anywhere has been a challenge and is becoming realized through providing cheaper wireless tools that takes it to far corners. Dr Gupta focused on the use of telemedicine for delivery of care and its utility for improving access. He endorsed it as a tool for providing care for those with limited healthcare accessibility and locally for more a mainstream solution to a larger healthcare problem. We have seen telemedicine become mainstream (more…)

Short takes for a spring Friday: wounds, babies and ‘frequent fliers’

May 8, 2015 | by

Starting off your spring weekend….WoundMatrix, which uses generally older model smartphones to take pictures of wounds which are uploaded either to their own or to a destination clinical platform, with proprietary software that helps a clinician analyze the wound remotely and then to track healing progress, has gone international with Honduras’s La Entrada Medical and Dental facility run by non-profit Serving at the Crossroads, and in Rwanda in the care of nearly 1000 patients by the Rwanda Human Resources for Health Program, established by their Ministry of Health with the cooperation of several American universities. At ATA they also announced a new release of software. Release (PDF attached)….A BMJ (British Medical Journal) article critiquing the surge in what we call ‘telehealth for the bassinet set‘ scores the Mimo onesie (Rest Devices), the Owlet sock and the Sproutling band as taking advantage of concerned parents. It’s too much continuous monitoring of vital signs that can vary and yet be quite normal, and no published studies on benefit. A reviewer did find that Owlet is in clinical tests at Seattle Childrens and University of Arizona. MedPageToday (BMJ requires paid access)….A surprise from Philips, which we in the US associate with the Lifeline PERS. They have quietly moved into telehealth focusing on post-discharge programs that target the most costly patients, often dubbed ‘frequent fliers’ based on their frequent stays in hospital. The ‘Hospital to Home’ telehealth pilot with Banner Health in Arizona, dubbed for them the Intensive Ambulatory Care (IAC) program, focuses on the top 5 percent of complex patients which are the highest cost and most care intensive. IAC results among 135 patients over six months reduced hospitalizations by 45 percent, acute and long-term care costs decreased by 32 percent and overall cost of care by 27 percent. However, is this program continuing–or transitioning their patients?  iHealthBeat, PR Newswire

Redesign of Kinect to detect, prevent Parkinson’s freezing of gait (UK)

May 8, 2015 | by

Two researchers at London’s Brunel University have repurposed a common Microsoft Kinect game controller to detect and help prevent the freezing of gait (FOG) that is a common result of Parkinson’s disease. FOG strikes without warning–the muscles freeze and the sufferer generally falls. To both detect falls and help prevent them, the Brunel researchers mounted a laser projector on the ceiling controlled by the Kinect. If a fall happens, it initiates a video conference call to assist the person. The prevention comes in with projecting visual cues–lines ahead on the floor, which has been found to help unfreeze the muscles. According to the Brunel release, it has passed proof of concept stage and is moving to patient trials. The further proof will be if this can scale. Brunel University News

ATA trend #2: is this the ‘second generation’ of remote patient monitoring?

May 8, 2015 | by

Guest columnist Dr Vikrum (Sunny) Malhotra attended ATA 2015 last week. This is the second of three articles on his observations on trends and companies to watch.

During the course of the ATA conference, I was inundated with the concept of “dumb” data whereby biosensors track patient clinical data and will alarm to clinical staff if outside designated parameters. However, the call center filter between the patient’s data and physician is often a primary cause of increased unnecessary admissions. The Sentrian Remote Patient Intelligence Platform (Sentrian RPI) received recognition for its advancement in utilization of sensors, enabling healthcare providers to utilize this “dumb” data and make it “smart”. For clinicians like myself, this was a new way of looking at an age old problem: “How do we safely and comprehensively support physician decision making at a standard high enough to detect pathologies earlier and more accurately?”

Sentrian has used machine learning to support the work of a dedicated clinical team by monitoring patient data 24/7 to detect subtle signs that warn a family member or care provider of future problems through biometric patterns of thousands of patients, comparing their medical histories, vitals and health information. This novel approach to remote monitoring won Sentrian the ATA President’s Innovation Award. (more…)

ATA trend #1: Is a sustainable RPM infrastructure fact or fiction?

May 8, 2015 | by

Guest columnist Dr Vikrum (Sunny) Malhotra attended ATA 2015 last week. This is the first of three articles on his observations on trends and companies to watch.

The advancement of remote patient monitoring is a visible trend from the American Telemedicine Association’s 2015 meeting, with care moving from the doctor’s office and being shifted to the patient’s home. A more diverse range of data is being collected for patients to facilitate more informed decision making at the patient visit and after the patient is away from the practice. As information is being collected and monitored on a more comprehensive basis, we have seen creative modalities to view a broad array of data points that would typically have been collected in a doctor’s office with the hopes of early diagnosis and preventive care, versus reactive care.

Patient autonomy has now come to the forefront and network infrastructure is being built to support that shift. Wearables, implantables and home based lab/ urine diagnostic kits are becoming smaller, cheaper, less invasive, wireless and cloud-based so that patients can be monitored without interfering in day to day living. (more…)

ATA 2015: Day 1 news

May 5, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/05/ATA-15-show-floor.jpg” thumb_width=”250″ /] HealthSpot/Xerox, Sentrian/Scripps, American Well, Honeywell, vitaphone, more

HealthSpot unveiled the first results of its partnership with (and investment by) Xerox, leveraging their HIT cloud infrastructure and back-end for the HealthSpot Station. The telehealth/virtual consult walk-in kiosk has targeted over 30,000 retail pharmacies with a newly developed consumer retail pharmacy personal health record (PHR). Upgraded patient and portal interfaces process insurance claims through a payment data feed and integrates with EMRs. Release….The US/UK predictive data/remote patient intelligence company Sentrian, winner of this year’s ATA Innovation in Remote Care award, is a part of a year-long 1,000-patient COPD remote patient monitoring study by the Scripps Translational Science Institute (STSI) with members of Anthem’s CareMore health plan. The goal is to use the Sentrian platform data to accurately detect COPD patient decompensation in advance to reduce avoidable hospital readmissions, which on average in the US is 1 out of 11 within 30 days of discharge. Release….American Well launched a platform for individual physicians to connect with current patients (more…)

Teen inventor develops video communicator, med dispenser debuting at ATA 2015

May 5, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/05/dispenser.jpg” thumb_width=”150″ /]Teen inventors come up with interesting designs and apps at science fairs and codeathons, but it’s unusual when a 15 year old brings to market an assistive technology product targeted to remote caregiving and socialization of much older people. This is the case with iC Loved Ones, a smartphone/tablet + independently controlled med dispenser for remote caring. A desktop PC, smartphone or tablet loaded with the iC Loved Ones app remotely controls the dispenser, delivering medications in pre-loaded dishes. A separate smartphone or tablet, which can be positioned anywhere in the home on the provided stand, is used for video chat and virtual visits. The auto-answer setup (more…)

Ford disconnects research on heart attack-sensing car seat

May 4, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]The Gimlet Eye returns and hopes that Ford has a better idea, because this wasn’t it. The automaker announced over the weekend that it is abandoning research on car seats that would detect cardiac anomalies such as a heart attack and then (presumably safely) bring the car to a halt (and also presumably, call for medical assistance). A corporate statement to the FT stated that Ford was ‘transitioning’ to other projects, based on advances in consumer wearables. No indication of spend out of a $5.5 billion budget. Undoubtedly, the potential for sensor problems in seats and the danger of shutting down a car while driving were insurmountable. No tears though…. (more…)

10th Anniversary Article 1: The Next Ten Years of Telecare

April 29, 2015 | by | 1 Comment

This year, on the 10th Anniversary of Telehealth and Telecare Aware, we have invited industry leaders nominated by our readers to reflect on the past ten years and, if they wish, to speculate about the next ten. Here is the first article, with a UK focus, by Dr Kevin Doughty.

Many of us are frustrated at how little progress there has been in the deployment and acceptability of telecare during the past decade. Yet, despite warnings that an ageing population was about to bankrupt the NHS (and health insurance schemes elsewhere in the world), and that access to social care for older people was being withdrawn at such a rate that it could only be afforded by the wealthiest in society, our health and social care systems have just about survived.

But this can’t go on, and in England over the past 12 months: (more…)

Nursing homes vs. hospitals for primary senior care

April 29, 2015 | by

Another way to reduce unnecessary hospitalizations? A recent New York Times article has kicked off a debate on whether many procedures for older adults can be better delivered in a nursing home or skilled nursing facility (SNF) setting rather than in-patient hospitals. Already serving many seniors for rehabilitation and residential care for multiple chronic conditions and old age-related debilities, the dreaded transfer to hospital may be lessened by a combination of outpatient procedure and installation of 24-hour nursing at these homes. Unbelievably (to this Editor) many of the 16,000 nursing homes in the country do not have round-the-clock nursing staff; only five states require 24/7 registered nurse coverage on site and there is no Federal requirement. An advantage is that minimizing hospital stay also minimizes hospital-acquired infections, patient distress (more…)

Care Innovations, UMMC Telehealth Center to expand care outside the home

April 29, 2015 | by

Intel-GE Care Innovations, which markets both telehealth and telecare (QuietCare, one of the pioneers in behavioral telemonitoring) products, announced today a broadened relationship with the University of Mississippi Medical Center’s Center for Telehealth. CI will help them to establish the Innovation Living Lab which will create and evaluate new models of care via remote technology and techniques for behavioral change. The Lab will open at UMiss’ Venyu Technology Center sometime in 2016. UMMC and CI’s goal is to extend care models so that the home is a key location for care delivery. In the past year, both had partnered on the Diabetes Telehealth Network. CI since their change of management has made several interesting moves in the past year, including grouping telehealth systems under Health Harmony and creating a Validation Institute. Business Wire.

Scanadu raises $35 million in Series B, develops for China market

April 29, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/04/Scanadu-Scout.jpg” thumb_width=”150″ /]Eric Topol’s Doctorless Patient takes one step closer to reality. The Scanadu ‘tricorder’ vital signs diagnostic ‘hockey puck’ received a major vote of confidence on Monday where it counts–funding. Their Series B of $35 million came from nine investors, led by Tencent Holdings, Fosun International and including Three Leaf Ventures, AME Cloud Ventures, Redmile Group, Relay Ventures, I Globe Partners, Fenox Venture Capital and CBC Capital. Three Leaf, AME and Relay also invested in their Series A. Tencent, Fosun and CBC are Chinese; I Globe is from Singapore. Why the Asian interest? It turns out that China is extremely interested and forward thinking in mobile healthcare–it has a lot of rural area to cover, all health-underserved, as is the rest of Asia. The introduction of the company was made by Jerry Wang, a Yahoo founder and former CEO.

Scanadu is also nearing market: Fortune reports that a $199 consumer version of the Scanadu Scout will be released in 2016, pending FDA approval, and in development is a urinalysis test, Scanadu Urine, an app that would analyze the color of a testing stick. (more…)

Global HIT, digital health VC funding falls 35% in 1st Q 2015: Mercom Capital

April 28, 2015 | by

Mercom Capital Group, a research and communications group, tracks global VC funding, mergers and acquisitions in the digital health area and notes a distinct slowing of activity, except for mobile health. They tracked $784 million in 142 deals in Q1 2015 compared to $1.2 billion in 134 deals in Q4 2014. Leading are consumer health companies with $437 million in 98 deals, then healthcare practice-centric companies, with $347 million in 44 deals–both dropping over $200 million each versus the previous quarter. Mobile health companies had $282 million in 56 deals; app companies accounted for $220 million. In transactions, mobile health led with $578 million, with UnderArmour’s acquisitions of MyFitnessPal and Endomondo. Since 2010, digital health companies have raised almost $10 billion. Mercom Capital release (the full study will run about $300-500). mHealthIntelligence notes that M&A activity is steadily rising in the healthcare sector. Also iHealthBeat.

Figure 1: an Instagram for medical professionals

April 28, 2015 | by

Secure, free medical image sharing, access and collaboration is the idea behind Canadian startup Figure 1. It provides a platform for medical professionals, who are largely ‘verified’ with a blue tick (check)–a process the company is doing across 40 countries–to upload pictures into feeds, make comments and bookmark. While anyone can join, images are also put through a fairly strict vetting and access process to preserve patient privacy. They have to be deidentified, patient consent provided via signature (country-specific consent forms held by the doctor), and edited using their special software so that faces aren’t showing and identifying metadata deleted. Doctors have been using it for virtual consults and for teaching. The idea is not all that new–ClickCare has had a similar service for iPhone/iPad/iPod since 1995, but it is a paid subscription service. Available in the Apple Store and Google Play for North America, Australia, New Zealand, South Africa, and across Europe. What is the economic model, however? Guardian. Hat tip to Guy Dewsbury via Twitter.

When remote monitoring ends, what happens to patient outcomes?

April 28, 2015 | by

They do not maintain improvement, just as we thought. A just-published study fills a significant gap in telehealth knowledge. The study published in the Journal of Medical Internet Research (JMIR) analyzed the long-running Partners HealthCare-Massachusetts General Hospital Connected Cardiac Care Program (CCCP) for patients with heart failure. They matched 174 patients participating in the 120-day program between January 2008 and August 2012 with an equal number of control patients, all with heart failure, previously hospitalized and receiving care at MGH. The program patients were provided with a ViTelNet monitoring hub plus devices–a digital weight scale, a blood pressure cuff and meter, and a pulse oximeter–as well as receiving patient education plus unscheduled education intervention from nurse care coordinators when results trended out of pre-set ranges.

During the 120 day program, the program patients (predictably) had consistently lower hospitalization rates versus the control group at the 30, 60, 90 and 120 day marks, though the differential narrowed over time. But after program completion, in the study’s follow up eight months after the end of the four-month program (see one year below), the program group’s hospitalization rates increased to exceed the control group’s. Mortality rates remained lower though not statistically significant:

(more…)