‘Brain Games’ on preventing, diagnosing sub-concussive brain trauma

May 16, 2014 | by

Tuesday 13 May, presented at NYC MedTech-the NYC Medical Technology Forum, at Troutman Sanders LLP, Chrysler Building, New York City

In a packed (agenda and attendees) two hour evening meeting, three presenters detailed the latest research on the clinical signs of chronic traumatic encephalopathy (CTE), along with new technologies for detecting it as it happens and diagnosing it plus monitoring recovery: Robert Stern, PhD, professor of neurology and neurosurgery at the Boston University School of Medicine and a leading clinical researcher on CTE (as our long-time readers know) ; Isaiah Kacyvenski, head of the sports segment of electronics designer MC10 which developed the Checklight head impact indicator for Reebok; and Uzma Samadani, MD, PhD, co-founder of Oculogica which presented at ELabNYC a few weeks ago.

Dr. Stern’s presentation reviewed his clinical work with primarily NFL players in how CTE manifests in both behavior patterns and the brain. His focus remains on sub-concussive trauma, the ‘bottom of the iceberg’ in his analogy, and its cumulative, long-term effects.  Repetitive brain trauma–neuronal shearing which is produced by linear, lateral and rotational forces to the head–produce a cascade of brain changes leading to destruction of brain tissues that show as dark patches on post-mortem samples and scans. These differ from Alzheimer’s disease in the abundance of tau protein distributed fairly early in life around the brain’s blood vessels and in the depths of the cortical sulci, where Alzheimer’s signature beta amyloid does not locate. Dr. Stern’s research also incorporates the behavioral changes that precede diagnosis: the emotional ‘short fuse’, the difficulty in memory, accidents, suicide, drastic changes in behavior and impulse control. There are many examples of degeneration and early death among players [TTA 6 Dec 12 which also refers to Dr. Stern’s research published in Brain; also see TTA 5 June 2013 on his German Center presentation which has additional background on his and his team’s research.]

In addition to the work he has done relating to (American) football (he is on the NFL Players Association brain injury committee and his research was instrumental in the PA’s lawsuit against the NFL), he studies other contact sports such as hockey (brain injury clusters (more…)

Risky hospital business: happy device hacking, insider data breaches

May 10, 2014 | by

A heap of ‘insanely easy’ hospital hacking–but no harm done: Essentia Health’s head of information security, Scott Erven, set his team to work–with management approval–on hacking practically every internal device and system over two years, and found that most were ‘insanely easy’ to hack. They successfully hacked drug infusion pumps, EHRs, Bluetooth-enabled defibrillators, surgery robots, CT scanners, networked refrigerator temperature settings and X-ray machines with potentially disastrous results. Where the common security holes are in networked equipment: lack of authentication, weak passwords, embedded web services and the list goes on. Mr Erven presented this at an industry meeting in April, without naming brands or devices as he’s still trying to fix them. Essentia Health operates about 100 facilities, including clinics, hospitals and pharmacies, in Minnesota, North Dakota, Wisconsin and Idaho–and should receive much credit for facilitating this study. This is the environment into which we will be plonking tons of patient information in PHRs and telehealth monitoring. Pass the painkillers. Summary in HealthIT Outcomes, much more essential detail in Wired worth the read.

The ‘Maybe No One Will Notice’ Data Breach:  The recent incident at the University of Massachusetts Memorial Medical Center in Worcester illustrates the difficulty that even academic medical centers have with detecting data security breaches, particularly when they are small, sneaky, over time and by an insider. UMass uncovered a series of low-profile breaches by a former employee who helped himself to patient information such as name, address, date of birth and Social Security number–and may have used it to open up credit card and mobile phone accounts. Only four records appear to have been misused in this way, but at least 2,400 records were estimated to be improperly accessed–over 12 years, which made it even more difficult to find. Perhaps the employee was funding retirement? HealthcareInfoSecurity

The ‘Ambulance Chaser’ Data Breach: What better way for lawyers and shady outpatient clinics to get accident patients fresh from the ER (ED), than to have someone on the inside feeding them patient information? (more…)

Smartwatches, fitness trackers: overload in several ways

May 10, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/acitivity-trackers_wellocracy_chealth-blog-kvedar.jpg” thumb_width=”150″ /]Dedicated Quantified Selfers, who have more than one device strapped to their arm and wrist, know that when like measurements are compared from two different devices (e.g. step counts, weight, activity, blood pressure), like stock or mutual funds, their performance will vary. Sleep trackers are among the worst offenders. But newbies just ‘into’ this may be confused. Not to worry! The prescription from Dr Kvedar is: “Expecting these consumer devices to have scientific accuracy is unrealistic. Expecting them to help you keep your activity level top of mind and measured in context from day to day is realistic and in most cases helpful.” They set a tone and help motivation, with other tools such as social groups and coaching. Reassuring words, especially as Dr Kvedar has launched Wellocracy to help individuals to understand that.

There’s of course pressure from clinicians to upgrade fitness monitor readings to clinical quality so they can use it…but absolutely no clarity on exactly how they would use it, a seemingly contradictory statement which centers on the quality of analysis and what alerts would be pushed to the clinician, who memorably has his or her ‘hair on fire trying to do what they do right now.’   (more…)

Finally a curb on ‘patent trolls’? (US)

May 9, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/09/TROLLS-1992-008.jpg” thumb_width=”150″ /] Those nasty patent trolls–those (largely) non-practicing entities (NPEs) which buy up patents to license them. Yet most of their revenue stream comes from pouncing on startup and early-stage companies to challenge their patents and systems, extracting la mordida to avoid further legal action. Now the Federal Trade Commission (FTC) has moved to curb one egregious practice: deceptive demand letters. The FTC issued an order to MPHJ Technology Investments LLC (MPHJ) banning its allegedly deceptive letters to companies which MPHJ considered to be infringing on its scanning technology. MPHJ filed first a draft complaint, and now a legal action against the FTC in the US District Court for the Western District of Texas, alleging violations of the First Amendment on free speech. Under US law, ‘deceptive’ may not be good enough–their letters threatening lawsuits must be shown to be ‘objectively baseless.’ The FTC requested dismissal of MPHJ’s suit this past Monday. Their rejoinder: the suit would disrupt its work.  National Law Review, Law360 (subscription/Lexis Nexis access required).

Previously in TTA on patent troll strategies and how companies defend themselves:  TTA 13 Sep 13, 10 Feb 13. (Also search on ‘patent troll’, ‘MMRGlobal’ and ‘patent infringement’.

A kudo for kiosks: HealthSpot Station adds $8 million funding

May 9, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/booth-Dr.-Jenkins-with-attendant-300dpi-website.jpg” thumb_width=”150″ /] In a week of small funding announcements, HealthSpot announced an add of $8 million to its 2013 $10 million round, totaling $18.3 million of a $20 million offering (SEC filing). Investors are not disclosed. In three years, HealthSpot has raised an impressive total funding of $23 million (CrunchBase), although the company is still in pilot in a handful of locations around their Ohio HQ and reports minimal revenue. The company’s hosted, fully enclosed kiosks with both telehealth monitoring and virtual consult capabilities debuted at the end of 2012 at International CES New York. According to their website, their markets are facility waiting rooms, pharmacies, schools, military bases and prisons. Their partnerships have been notable: EHR Netsmart, telemedicine network Teladoc and a co-location arrangement with Canadian pharmacy kiosk MedAvail [TTA 23 Jan]. They are also on the board of the Alliance for Connected Care lobbying advocacy group [TTA 13 Feb], which will certainly aid their cause by plumping for increased telehealth coverage by Medicaid beyond the present 20 states and Medicare beyond rural special programs. Yes, they will be at ATA 2014, if you are attending. Mobihealthnews

Countdown to ATA 2014

May 8, 2014 | by

It’s nine days and counting to the start of ATA 2014 in Baltimore, Maryland. For 25 companies, Sunday’s (18 May) highlight will be the Venture Summit held by the ATA and law firm Jones Day. The Summit will feature a morning of lessons from mentors and practice pitches from up-and-coming companies to gain tips and pointers. In the afternoon, selected companies will participate in meetings matching them with investors based on unique interests to provide one-on-one time to connect. Release (PDF). The full conference kicks off on 19 May. If you haven’t registered, here’s the place to do so. Disclosure: TTA is a media partner of ATA 2014.

Finding ‘The Way to Wellville’

May 8, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/Esther-Dyson-Road-to-Wellville.png” thumb_width=”170″ /]Here’s the challenge set up by tech angel investor (EDventure Holdings), philanthropist and astronaut-in-training Esther Dyson and her team at the interestingly named HICCup (Health Initiative Coordinating Council):  set up five communities of up to 100,000 people to see which one can achieve the greatest improvement in health and vitality over five years. The winner receives an award of up to $5 million. Like a startup, each community sets its own plans, pitches promising health initiatives to funders, negotiates with suppliers and measures impact; HICCup acts like a board of advisors. According to Ms Dyson, “The motivation is not to help these nice people in five cities to have better lives. It’s to prove a business model and to generate evidence and facts.” Some factors might be to start school later so children can have more sleep, or working with supermarkets to stock healthier foods and study shopping/buying patterns. But ‘The Way to Wellville’ starts ASAP; community applications deadline is 23 May and from the probable ten picked in June, a site visit to seven or eight to pick the Final Five . HICCup website, announcement on HICCup blog, Wall Street Journal article (PDF-subscription content), HIT Consultant article by Fard Johnmar of Enspektos/DHPV 2014.

Previously in TTA: an architect’s vision of ‘wellness districts’ in rural areas

digihealth pulse Virtual 2014

May 8, 2014 | by

19-21 May 2013, Virtual

Can’t make ATA 2014? Possibly the first fully virtual conference in digital health, DHPV 2014 has 25+ speakers and is fully accessible online plus archived (helpful as all times are NY/Eastern). Speakers include Unity Stoakes of StartUp Health, Esther Tyson of HICCup (The Way to Wellville–more here), Bertalan Meskó, MD, PhD: medical futurist, Matthew Holt of Health 2.0, Ryan Beckland of Validic [TTA 27 Jan], Jim Lefevere of Roche digital marketing, and more. Register here: pre-event price is $195.97 which goes up on 10 May to $225.97.  Agenda  Hat tip to Fard Johnmar of the Enspektos digital health consultancy organizing the event.

UK-centered review of mobile health tech

May 6, 2014 | by

Perhaps it’s the focus of this US-based Editor, but other than the occasional feature in the Guardian, Times or Telegraph, there are few articles on digital health written as general audience overviews of problems to be solved and relative capabilities of devices, rather than whiz-bang gadget fests. Thus this Editor’s attention to one just published in TechAdvisor/PC Advisor. Springing off of Quantified Selfer Dr Larry Smarr’s early diagnosis of Crohn’s disease, and based on his principle of ‘devices can help us notice trends before they become serious’, the writer reviews enabling tech such as mobile ECG AliveCor; Azoi’s Wello iPhone case/Android peripheral measuring heart rate, blood pressure, temperature and lung capacity; the overabundance of unproven health apps leading to the NHS’ Choices HealthApps library [TTA 9 May 13, RSM meeting summary 22 Apr] and web-based Vitrucare from Dynamic Health Systems for long-term chronic condition management. Oddly the article mentions Qualcomm and the Tricorder X Prize without in the same (heavy) breath, Scanadu. (Ed. Note–a check of their blog indicates no update on their delayed shipments due to production problems, TTA 5 Apr) Medical apps and devices are placing the future of healthcare in the palm of our hands

65 years of health informatics

May 6, 2014 | by

The surprising fact is that healthcare informatics, so associated with IT and computers, started well before computers in wide use*–65 years ago by Germany’s Dr. Gustav Wagner, founder of the German Society for Medical Documentation, Computer Science and Statistics which continues today as the GMDS. This infographic published in HealthWorks Collective presents other milestones on the timeline such as the influential paper published in 1959 by Ledney and Lusted on the use of computers in medical diagnosis and therapy. Unfortunately the UK and European advances of the period and forward are passed by in the graphic’s US focus. To fill in the historical gaps: Vanderbilt University Department of Biomedical Informatics backgrounder, Health Informatics/Wikipedia  Hat tip to reader William T. Oravecz of Saint Francis Care, Connecticut.

*Computers were developed for WWII war work: codebreaking Colossus [UK, which broke the German High Command’s codes on the Lorenz SZ-40] and the ENIAC [US Army 1946, for ballistic computation!]

Phobic? There’s an app for that.

May 2, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/phobia10.jpg” thumb_width=”150″ /]Everyone has certain fears or things that have a high ‘eeewwww’ factor (see left). Phobious, a new app, uses virtual reality on a smartphone that after several sessions of gradual exposure, desensitizes the user to potentially disabling fears such as dentists, insects, flying and dogs. (Can it work in the backyard when you’re about to be attacked by bees and Godzilla-sized weeds?–The Gimlet Eye) It was developed by a group from Barcelona by way of Charm City a/k/a Baltimore, Maryland, participating in the prestigiously backed DreamIt Health Baltimore accelerator’s 2014 class. The app is currently available for $49 in the Apple App Store and Google Play, with a 3D goggle device VR system due in September at $149–$299 with two psychology sessions. According to MedCityNews, the founders are seeking $750,000 in funding, plan to develop a clinical quality version and obtain FDA clearance and CE Marking. The progress in VR therapy made in less than four years is startling when this Editor considers the price of the CAREN system (Motek and Polycom) which was tested on Iraq and Afghanistan veterans back in June 2010: $500,000. (Ed. note: if you have a phobia about typos, don’t look at the Phobious website!)

Concussion diagnostics a hot area

May 2, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/Cerora-Simon.jpg” thumb_width=”150″ /]Diagnosing concussive and sub-concussive head blows both in sports and on the battlefield have been challenging, and your Editors have chronicled several approaches. One of the 2014 graduates of NYCEDC’s ELabNYC was Oculogica; their EyeBox CNS records three key eye movements in a 4 1/2 minute test to determine whether they fit a normal box pattern, with subsequent exams determining rate of brain recovery [TTA 17 Apr]. (We’ll be seeing more of Oculogica at NYC MedTech 13 May, along with MC10 which helped to develop the Checklight impact indicating skullcap with Reebok, seen at last November’s CES preview [TTA 15 Nov 13] and winning CES’ 2014 Design & Engineering award.) Now out of Bethlehem, Pennsylvania is Cerora’s MindReader, developed out of Lehigh University, Ben Franklin Technology Partners of NE Pennsylvania and in the first StartUp Health Academy/GE Entrepreneurship class. It is a wireless dry contact EEG reader which combined with other biosensor data and clinical observation aids speedy diagnosis. The reader is worn either on Google Glass or a headset (pictured above left on CEO Adam J. Simon, PhD). It’s in early days and still in testing; the baselines alone will need data from at minimum tens of thousands of subjects beyond the current testing on Lehigh U. athletes. Dr. Simon is also projecting use for sub-concussion injury, Alzheimer’s, PTSD and other neuropsychiatric disorders. Lehigh Valley Live, release on presentation at the American Academy of Neurology Annual meeting 30 April, WFMZ Ch. 69 News (video)

Babylon app for booking GP visits debuts (UK)

May 1, 2014 | by

Making news out of Tuesday’s Wired Health UK 2014 at the Royal College of General Practitioners (RCGP) in London is Babylon. From the app (iPhone, Android), appointments with a GP or specialist can be booked 12 hours a day, six days a week, with one of the almost 100 part time salaried and on call doctors in Babylon’s system or a BUPA (private healthcare/insurance system) physician. Also bookable through the app are diagnostic kits and blood tests;  X-rays or scans would be at a partner facility. Have a question or want to check your symptoms? The app directs your text and pictures to a doctor or nurse. Need a prescription? Delivered to your home or a nearby pharmacy. Record storage is on your phone. All for £7.99/month for basic service or £24 per consult–both low prices that seem to be introductory (a/k/a not profitable) or for light users. Babylon is registered with the Care Quality Commission, an independent healthcare regulator, and has designated body status from NHS London.

Founder Ali Parsa, a former Goldman Sachs banker who previously founded Circle, approvingly says that booking an appointment is as simple as ‘booking a Hailo cab’ (in NYC, Uber). This is a more complete model than a ZocDoc or Vitals (US appointment services) with testing and a symptom checker, but it does not seem to have a video consult (more…)

Amazon’s new wearables ‘store’ needs a location guide

April 30, 2014 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/04/amazon.png” thumb_width=”150″ /]Amazon’s flashy ‘wearable technology store’ which debuted today (29 April) is touted by a company representative as “…an exciting category with rapid innovation and our customers are increasingly coming to Amazon to shop and learn about these devices.” It features all the trendiest fitness bands too: Misfit Shine, the new Jawbone Up24 sleep tracker, smartwatches, wearable cameras, healthcare devices and even an Editor’s Corner with Advice for the Wearable-Lorn. The store is well stocked for fitness/wellness devices and smartwatches, but the shelves are bare for healthcare devices: the 12 listed include sleep tracker Lark, Withings and BodyMedia along with the exceedingly pricey HeartMath and iHealth telehealth products. The unfortunate problem is for those without the direct link to find the store. A search will divert you to a list of products. It isn’t listed under Electronics, nor if you search ‘wearable technology’, not listed under Departments or the show results for category bar (both at left). It’ll be fixed, being Amazon, and it does point to the now high profile of wearables. Amazon release, Silicon Republic (which features Amazon as a tech employer) Hat tip to Contributing Editor Toni Bunting, who reminded this Editor today that none of this appears on Amazon.co.uk!

Ear implant crossed with gene therapy for auditory repair (AU)

April 29, 2014 | by

A hopeful Pointer to the Future for those with hearing loss–or, in fact, with nerve damage of other types–is the research out of the University of New South Wales (UNSW) on their developing a DNA-based genetic treatment, delivered by a cochlear implant, to restore hearing in deafened guinea pigs. The recombinant DNA enters the cochlear cells to produce neurotrophins, proteins that cause auditory nerve endings to regenerate, improving pitch perception and tonal range. Unfortunately the effect lasted only a few months, so that further work is required before the treatment even nears human trials. Study co-author Gary Housley also cited other implant-extending usages, such as deep brain stimulation used in Parkinson’s disease treatment and retinal implants. Published this month in Science Translational Medicine (abstract only, subscription required for full access.) The Verge, Engadget (short UNSW video included)

The ‘grey’ market is where it’s at for ‘quantified selfing’

April 29, 2014 | by | 1 Comment

Surprisingly in the tech-addicted (and young-skewing, based on subject matter) Gigaom is this short piece on how health tech companies are missing the boat by targeting the young, healthy fitness addict or plain addicted-to-the-data Quantified Self (QS) market, rather than those over 50 and their families. ‘Simple’ and unobtrusive are the keywords, especially for what the late and much missed MetLife Mature Market Institute termed the ‘old-old’–those over 80. Mentioned are home activity monitoring systems such as Lively, BeClose and GrandCare Systems supplanting the PERS pendant (Lifeline) and the additional alert capabilities offered by GreatCall/Jitterbug. (This Editor will also mention a new telecare system entering the European and Americas markets, Essence Care@Home, which premiered at Mobile World Congress 2014. More on this in the next few days.) What’s notable about the article is the emphasis on the market size (via expert Laurie Orlov): $2 billion now, ten times that in 2020. What’s incomplete about the article is no ‘look-ahead’ to how devices like smartwatches (and watch-like forms such as AFrame), sensor-based wearables which connect to smartphones–and sensor-equipped smartphones, tablets and even Glass-type devices with simple apps which can help with self-or group-monitoring, prompts for those with cognitive difficulties, and more. Worldwide, we are also running out of carers [TTA 24 April]. Who will crack the code on tech for seniors?