Politico: massive hacking of health records imminent

July 2, 2014 | by

Politico is a website (and if you’re in Foggy Bottom-ville, a magazine) much beloved by the ‘inside government’ crowd and the media ‘chattering classes’. With some aspirations to be like Private Eye but without the leavening sharp satire, the fact that they’ve turned their attention to–gasp!–the potential hackathon that is health records is amazing. They mention all the right sources: Ponemon, HIMSS, the American Medical Association, BitSight, AHIMA. In fact, the article itself may be a leading indicator that the governmental classes might actually do something about it. This Editor applauds Politico for jumping on our battered Conestoga wagon with the other Grizzled Pioneers. We’ve only been whinging on about data breaches and security since 2010 and their researchers could benefit from our back file.

And speaking of 2010, the Department of Health & Human Services (HHS) is doing its part to close the budget deficit by collecting data breach fines–$10 million in the past year. A goodly chunk will be coming from New York-Presbyterian Hospital/Columbia University Medical Center: $4.8 million for a 6,800 person breach (iHealthBeat) where sensitive records showed up online, readily available to search engines. And yes, we covered this back on 29 Sept 2010 when breaches were new and hushed up. Politico: Big cyber hack of health records is ‘only a matter of time’

Oddly, there is nary a mention of Healthcare.gov.

Philips, Salesforce dive into health data integration

July 2, 2014 | by

Philips Healthcare and Salesforce announced last week their partnership to construct a connected, multi-point and collaborative data platform to benefit providers, payers and patients. The initial step is the launch later this summer of the Philips eCare Coordinator app for healthcare providers and a patient-centered Philips eCare Companion app, which will uptake data from Philips Healthcare medical devices into a variation on the Salesforce1 cloud platform. What’s emphasized in the releases and information from media sources is that it will be designed as an open platform for other device and software providers. (Data security problems down the line are anyone’s guess.) While Philips’ global CEO was part of the announcement and it’s expected that Philips will be lead dog for this, the only two customers mentioned were US and Salesforce’s. There were also few details on how clinical staff would access and use the data.

Cui bono from this? Philips of course, which of late has been lagging (more…)

ReWalk robotic exoskeleton clears FDA

July 2, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/ReWalk-side.jpg” thumb_width=”130″ /]Finally one of the several exoskeletons under development to aid paraplegics to walk has gained FDA approval for its ‘personal’ version for use at home. The Argo ReWalk [TTA 21 Nov 13 and 2011 coverage] enables mobility for many paraplegics and mimics natural gait through wearable brace supports, motion sensors and a computer-based control system. Crutches are used for additional stability. It also has a rehabilitation version for clinical settings. The importance of mobility, even if limited, cannot be exaggerated. Wheelchair-only mobility can lead to muscle deterioration, blood clots and heart conditions. As part of the de novo clearance, ReWalk will be doing a post-market study for FDA to determine adverse events. One of the early adopters is Captain Derek Herrera, who works for the Marine Special Operations Command and whose unit is being donated by the MARSOC Foundation.  ReWalk release and website. Medgadget, MedCityNews, NBC.

23andme and FDA: making nice?

July 2, 2014 | by

In a reversal from the ‘¡No pasarán!’ (‘They shall not pass!’) position 23andme and its QS fans famously took back in the winter and spring [TTA 2 Apr, with prior links] vis-a-vis FDA on interpretation of genetic tests, this report from VentureBeat indicates that 23andme is holding out an olive branch. It’s not your usual cutting. It’s an application for Bloom’s Syndrome, a rare inherited genetic disorder, which FDA just accepted. Adding to it is that CEO Anne Wojcicki is a carrier of this disorder. VentureBeat’s speculation is that if successful, the Bloom’s Syndrome application would be the template for future test applications. The tone on both sides has grown conciliatory. For example: sitting on the same Congressional panel on healthcare last Tuesday was an FDA physician directly involved in the approval situation and Ms Wojcicki. There was a well-timed, quite emollient interview with Ms Wojcicki in the Wall Street Journal this past weekend. Certainly a factor is that 23andme is still growing, but less quickly–up 150,000 from its pre-FDA contretemps level of 550,000. And its funders, even though closely related to Ms Wojcicki, hate to wait on numbers which are certainly below projections.

Ka-ching! Mid-year digital health funding hits $2.3 B: Rock Health

July 2, 2014 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/stick_figure_push_up_arrow_400_clr.png” thumb_width=”120″ /]It’s geometric! Rock Health’s total of $2.3 billion in digital health funding as of June 2014 just rocketed through the $1.97 billion 2013 full year total. Year over year to date, it’s up over 16 percent. And there’s stardust on every sub-sector: software, digital health, biotech and even medical device, the laggard (negative growth) in previous reports. Funding rounds must have taken vitamins, because they are 50 percent larger on average at $15 million versus last year’s $10 million. But there’s the same concentration on big deals like NantHealth, Flatiron Health, Alignment Healthcare and Proteus, heavily skewed towards payer administration, digital health devices, data analytics and healthcare consumer engagement. But the clouds on the horizon are there. Last year’s disproportion in seed/Series A accelerates, and the ‘down the line’ weakness continues with proportionally fewer companies reaching B, C and D rounds. Crowdfunding has also lost its luster–50 percent off with Indiegogo dominating–but its blowout with Healbe GoBe [TTA 26 June, CEWeek] accounted for 41 percent of total crowdfunding dollars; MedStartr stayed in the game at a distant second. IPOs haven’t been great, the ‘digital health index’ is an underperform yet funders are still itchy to cash out multi-round companies like Practice Fusion (EHR/billing), Proteus and ZocDoc via IPO. VentureBeat. Rock Health report on Slideshare.

Technology which resonates with the 50+ consumer

July 1, 2014 | by

If you are a health tech developer, entrepreneur or marketer lost in the forest of the 50+ market, Laurie Orlov of Aging in Place Technology Watch and the new Boomer Health Tech Watch just handed you a map with her latest study for AARP, Challenging Innovators: Matching offerings to the needs of older adults (link to PDF). To appeal successfully to the multiple segments and sub-segments of 50+, there’s more to it than a strong belief that your tech would have been just the thing for your mum or grandmere. The hurdles like reluctant long-term care providers and tech-unfamiliar older adults are significant. Misreading the market, making the tech too complex or identifying it too strongly with ‘old folks’ usually lead to ‘lights out’. Ms Orlov’s pointers take you through testing, crowdfunding, accelerators, the right way to price disrupt, transition point mapping, partnerships and more. A recommended guide.

Over at Aging in Place, Ms Orlov serves up another idea with The ideal wearable for seniors – why not a much-modified PERS which incorporates smartwatch/fitness band capabilities such as dehydration monitoring, activity, blood pressure and other tracking, putting them up on a smartphone app.

Verizon’s ‘white label’ telemedicine service debuts

June 30, 2014 | by | 2 Comments

Verizon is evidently sticking with its strategy of enterprise marketing when it comes to digital health. The Verizon Virtual Visits service released last week enables a video chat with a clinician via smartphone app (3G/4G OK as well as Wi-Fi; the full mobile enablement Verizon states as a key differentiator versus competitors such as American Well, MDLive and Teladoc) or alternatively, web portal. Prior to the average 30 minute chat, the service verifies eligibility and co-pay information, presents patients’ self-reported histories, symptoms, medication allergies and other information, then collects the co-pay; at the close if needed, an e-prescription via SureScripts is sent to the patient’s pharmacies. Verizon presents this as as a ‘white label’ service for groups such as health systems, insurers and health plans who will determine their unique co-pay and clinician mix. Clinicians can be contracted through Verizon’s provider network or, in a health system, their own or an in-house/contract mix. Neither clients nor third-party medical provider(s) have been announced yet, but VentureBeat states that the clients will be publicized in the next few months, which is deflating. Information Week, The IHCC. Verizon release.

Soapbox Round 2: ‘disruptive innovation’ debate disrupts ‘the chattering classes’

June 30, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/06/img_5.jpg” thumb_width=”180″ /]It’s a Blackboard Jungle out there. Clayton Christensen rebuts Jill Lepore on most–but not all–of her views on his theory of disruptive innovation [TTA 24 June] aired in a New Yorker cover story. The forum is a follow up interview (20 June) with BusinessWeek. (Hat tip to Tom Boyle commenting on the original Soapbox. Also see a just-released HBR video interview, link below.)

Your Editor agrees with his point that his theories have been developed and updated far beyond his first (1997) book, ‘The Innovator’s Dilemma’, the only one she refers to.  (Similarly, I am most familiar with ‘The Innovator’s Prescription’ of 2008, but we’ve commented on his more recent relevant work, readily searchable here.) This is, unfortunately, her argument’s major flaw. It is akin to ceasing your review of WWII history with A.J.P. Taylor and Cornelius Ryan; as fine foundationally as they are, the scholarship and strategic debates will extend far beyond our lifetimes.

Mr Christensen in his rebuttal is appealingly modest in bringing up where he got it wrong (the iPhone), where his model has gone off (in 2002, a mathematician from Tuck demonstrating the causal mechanism as incorrect to that point) and that he still sees problems with the theory. Moreover, her strongest point is one he agrees with: (more…)

CEWeek NYC (Part 1): health tech moves to the front

June 26, 2014 | by

CEWeek NYC, Metropolitan Pavilion/Altman Building (@CEWeekNY)

Part 1

The Consumer Electronics Association (CEA) stages events in New York twice yearly–at the start of both summer and winter, the latter as a preview of International CES in January. CEWeek NYC is a bit of an overstatement–it’s Tuesday-Thursday. It was apparent on today’s main day (Wednesday) visit that beyond the lead dogs of ever-larger HDTVs, in-car audio/smartphone integrators and marvelous audio speakers small and large, something else was different. Health tech was right behind them in prominence, including related areas of robotics and 3D printing. (This builds on CEA’s own trumpeting of the 40 percent growth of the ‘digital health footprint’ at this year’s CES. Hat tip to Jane Sarasohn-Kahn.)

Presentations got the Gordon Ramsay treatment and were re-plated as bite-sized sizzling steak tips. Also different was the format. Instead of a long, dozy general press briefing several flights up at the huge top of the Met Pavilion at 9am, then rushing to the show floors before the crush of buyers, the floors opened to press only for a generous two hours. Then fast-moving keynotes and conference presentations of no more than one hour started at 11am in an intimate downstairs room. Alternatively, the centrally located demo stage between the show floors hosted 15 minute presentations. Other than occasionally having to wait in a narrow hall as the downstairs room emptied between presentations, both were wise moves. Very workable and very low on the Tedium Scale. Three of the eight Wednesday presentations were robotics or health tech-related, not including the closing FashionWare wearable tech show. The proportion is the same on Thursday.

Notable on the show floor:

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/06/0625141011.jpg” thumb_width=”170″ /]The latest fitness band/watch is not a brick, mercifully. Withings formally debuts tomorrow the Activité watch (left) which looks like a fine Swiss analog chronometer, not a slab on the wrist. It’s a man’s watch size on a woman, a bit slimmer and simpler than a Breitling, and connects to your smartphone using the Withings HealthMate app to track activity, swimming and sleep monitoring. You also get time (analog, yes!) and alarm clock, all powered by a standard watch battery so none of the recharging shuffle. Available in the fall at $390, but if you are a dedicated QS-er with style…. Also VentureBeat. (more…)

CEWeek NYC (Part 2): wearables, robots, telehealth gone to the dogs!

June 26, 2014 | by

CEWeek NYC, Metropolitan Pavilion/Altman Building (@CEWeekNY)

Part 2

Over in FashionWare-ville….

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/06/0625141038.jpg” thumb_width=”170″ /]The Healbe GoBe 100% Automatic Body Manager turned out to be a big draw at this pavilion, for reasons that to the casual visitor were not apparent. Its claim: it automatically estimates both calorie intake and calories burned through measurements taken by an impedance sensor to measure tissue resistance, based on blood glucose being converted to liquid in tissues and the amount of liquid released. Having been through the now-vanished-into-thin Airo affair (with its fictional mini-spectrometer for detecting nutritional blood metabolites from food consumption, TTA 23 Nov 13), I was skeptical of Healbe’s claims and told co-founder and managing director George Mikaberydze (left) just that. He patiently explained how it works to me and seemed to be sincerely understanding of my skepticism. He briefly demoed the display on his smartphone, which was hard to track as it indicated negative caloric burn and was partly in Cyrillic, but these numbers were relative to…?

It turned out that I was not the first to question, and he was well prepared.

Healbe turns out to be quite controversial. The company raised over $1 million on Indiegogo this March/April, prominently featured in its well-produced GoBe materials and in its PR communications. It’s promising delivery in September. On researching this, (more…)

Swoon or mourn? Smartwatch action: Misfit, MS HealthVault, Glance

June 26, 2014 | by

The smartwatch is nowhere near dead (check the beautiful Withings Activité at CEWeek), but its future, along with pure fitness bands, is a complicated thing. Three moves by small to giant companies further add color to (or complicate) the picture, including an ‘aftermarket’ add on for your current watch:

  • Misfit joins up with the Pebble smartwatch. The Misfit Shine, which has enjoyed much appreciation by the D3H as the ‘elegant button’, announced it will distribute its tracking app and algorithm technology to smartwatch makers. Pebble is the first and not exclusive. Sonny Vu, not known for his subtlety, is quoted in VentureBeat: “If I kept making just fitness trackers, I would be out of business in 12 to 18 months.” Misfit will continue to sell Shine in the US and internationally for at least another few quarters to meet demand for a fitness-only tracker. It shows you how quickly the weather changes: with $23 million in hand, and a Series B last December of $15.2 million, they are pivoting–quickly. John Sculley and other bluechip investors like Khosla Ventures and Norwest Capital obviously see a boulder in the road.
  • Microsoft moving to get into the smartwatch biz. Their patent filing of 2012 was just the first move but both Forbes and VentureBeat have confirmed rumors the device is a go. And they have a core of techies (Xbox) to work on it and the perfect place for the data: Microsoft HealthVault. Nothing like a smartwatch to jolt some life into a moribund PHR!
  • Love your plain old watch but just want to soup it up? Slip Kiwi Wearables’ Glance under your watch instead and get fitness tracking plus smartwatch functions. Kiwi already has the app for the Kiwi Move but Glance seems to have more such as interaction with your phone calls. Think of it as an aftermarket accessory, especially if you’re a traditionalist in watch form factor and/or don’t have the long green for Withings. In Kickstarter funding now with a price point of $65, but they are less than halfway towards their $150,000 goal with only six days to go. Gizmag

Soapbox: Is ‘disruptive innovation’ a theory gone off the tracks?

June 24, 2014 | by | 2 Comments

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/04/Thomas.jpg” thumb_width=”200″ /]Having publicly stood as a huge fan of Clayton Christensen’s theories of disruptive innovation, particularly the ‘broken circle of innovation’ as an explanation of our current economic stagnation (if not ‘stagflation’ which was a hallmark of my early adulthood and yes, now) and disruption in healthcare (even if it hasn’t started yet because it’s been sidetracked), this Editor was prepared to savage, demolish and otherwise lay waste to a New Yorker article by Jill Lepore (a Harvard professor of American History, for Pete’s sake).

Having read and digested the article, I am surprised in largely agreeing with Prof. Lepore. She brings forth certain weaknesses and concerns I had about the entire Weltanschauung of disruptive innovation, first as an overarching theory equivalent to Darwin’s theory of evolution. There is a veritable industry around disruptive innovation which she outlines, reminding me that hype of this type around any theory I find profoundly irritating because theories are just that–to be reality checked early and often, just like voting in the 1930s in Jersey City, New Jersey. Prof. Lepore then points out where fellow Harvard Prof. Christensen didn’t paint the complete picture (e.g. Bucyrus, US Steel) and–to me quite importantly–discounts external events and even aggressive, defensive business strategy (as Ron Hammerle’s Soapbox on sidetracked innovation pointed out). Many of Prof. Christensen’s acolytes ignore history (and business strategy) altogether in a near-religious form of Determinism-by-Innovation.

There is also another circle–a circular logic prevalent in Mr Christensen’s theories summarized aptly by Ms Lepore: (more…)

TripleTree ‘Viewpoint’ on hospital of the future

June 24, 2014 | by

Healthcare investment bank and advisor TripleTree has produced a ‘Viewpoint’ report on ‘the hospital of the future’, examining the proposition that the place for delivery of even acute care may not be a hospital at all due to health tech, robotics and architectural innovation (this last hearkening to TTA 22 April). “High-quality healthcare is frequently described as delivering the right care to the right person at the right time in the right place. This report focuses on the right place. It describes the ongoing evolution of healthcare real estate and offers realistic insight to the characteristics of the hospital of the future.” And rather than hospitals becoming more hotel-like, hotels may become post-surgery ‘home health’ centers. Many other intriguing possibilities in this Report (free download).

Project ECHO using telemedicine to limit, treat hepatitis C virus

June 21, 2014 | by

Two US government agencies plus the American Medical Association (AMA) are piloting a program to better diagnose and treat the hepatitis C virus (HCV). The Centers for Disease Control (CDC) is the lead in this Arizona and Utah-based project, with the Office of the National Coordinator for Health IT (ONCHIT) and the AMA creating new clinical quality measures and clinical support tools. The objective is to identify what works to treat HCV infections and then develop a scalable methodology. The program will integrate telemedicine (video consults), public health data analysis and outreach  to primary care physicians, academic centers and public health officials. CDC/ONC release/blog posting,  iHealthBeat, Health Data Management. Hat tip to Editor Toni Bunting.

‘Silver’ no longer, it’s ‘Lifelong Tech’

June 21, 2014 | by

International CES’ Silvers Summit now Lifelong Tech. An indicator that the focus in ‘aging tech’ is now less on imposing monitoring systems on older people and more on enabling people of all ages to live better is the name change of one of the ur-events of digital health. The focus is now on the 50+ (78 million strong in the US). With the drop in age is a substantial broadening of interest in technology from smartphones to longevity and social connectedness as well as the traditional safety and improved quality of life. Lifelong Tech will debut at 2015 International CES 6-9 January 2015, though the change isn’t on their materials or website yet. Organizers (Living in Digital Times) remain the same. This Editor will be seeing their short and sweet wearable tech presentation (no windy panels of corporate execs) next Wednesday.  Release

Is consumer digital device engagement sticky? Or just the hype?

June 20, 2014 | by

A wonderfully cranky essay by Laurie Orlov on her new blog Boomer Health Tech Watch might make you think The Gimlet Eye was her guest writer (see below). Ms Orlov observes the ratched-up noise level around wearables, fitness bands, smartwatches (in which your Editor will be drenched quadrophonically next Wednesday at CEWeek NYC, glutton for punishment as she is). Yes, we’re swooning around Apple Health [TTA 3 June] and having a minor swivet around Samsung’s Simband and SAMI [TTA 2 June]. The bucket of cold water in Ms Orlov’s grip is the high dropout rate among fitness band users (33-50 percent, cited from Endeavour Partners and NPD Group); this Editor will also add the devices’ relative inaccuracy, fragility and glitches [TTA 10 May]. But ‘the investor community (via the media) clearly IS being transformed, at least temporarily’ as well as outside the health industry, by a belief that these devices will push the world into Quantified Selfing for the Masses. Will wearables herald our arrival at the New Jerusalem of Health? Certainly it’s been trumpeted and tromboned by the D3H (Digital Health Hypester Horde) badly needing a fresh fave rave. But can digital health survive another Hype Curve dive? Can we? The Consumerization of Health Care — is it working?

Further in this jugular vein, Business Investor, in a superficial swipe, dubs smartwatches uncool just because they trail fitness bands by six points. They did a better job in March delving into the real challenges that wearables face: smartwatches look and feel like a brick on your wrist (Ed. D’s term), Google Glass is socially unacceptable in many quarters (banned in Silicon Valley!) and wearables are still in Early Adopter-Ville.

Update: Ms Orlov just sent to this Editor a brief comment with a link to a thoughtful NY Times article not only on The Trouble with Apple’s Health App, but also how the barriers are more subtle–and more common-sensical–than the hype around how consumers are eager to register every burp on a PHR (they’re not), they don’t want to be nagged by technology (easier than your mom to be rid of) and the group that needs it most (the old, poor) has the least, for now, access to it. But largely ignored by the D3H.

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”75″ /]On assignment off Cape May, New Jersey inventorying readiness of coastal defense fortifications. Just between us. Shhhh!