The traditional PERS as ‘ancient history’

March 31, 2015 | by | 2 Comments

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/Fallen-woman.jpg” thumb_width=”150″ /]Something to think about. How many families and older adults are aware that the traditional PERS emergency pendant, which has been around for at least 40 years, is sadly outdated and in fact inadequate for those at greatest risk? While major advertisers on US media such as Life Alert, Life Call, ADT and Philips Lifeline present crisis situations where the older person is on the floor and is rescued after pressing the pendant button, they barely advertise their other available products that incorporate passive fall detection and cellular, even if somewhat inadequate for soft falls or unconsciousness. Families unwisely feel ‘protected’ when paying for traditional PERS, not realizing that more advanced technology is readily available and not that much more expensive. Moreover, and only mentioned in the context of his grandmother’s fall while in senior housing, there is a distinct recalcitrance of senior housing executives to rid their apartments of the (cheap) old pendants and replace them with (pricier) passive/cellular assistance systems, much less more advanced wearables/RFID systems or mobile/watch combinations. This Editor also notes that the major drugstore chains also sell PERS; while they trumpet wellness in their advertising, they are as behind the curve in this area as senior housing. Neil Versel in MedCityNews.

For our Readers: can we compare/contrast how the UK, EU and US are still wedded to traditional PERS after 40 years, and if more advanced forms are starting to take hold? Click on the headline to see comments, including this Editor’s opining on traditional PERS as ‘cash cow’.

Another go at a joint DOD-VA EHR? (US)

March 31, 2015 | by

As this Editor was Pondering the Squandering last week of $28 billion HITECH Act funds meant to achieve EHR interoperability but falling well short, we recalled another Big EHR Squander: the integration of the Department of Defense’s (DOD) AHLTA with the Veteran Affairs’ VistA, an iEHR effort which collapsed in February 2013 at a mere $1 billion, in addition to dysfunctional or failed upgrades in both systems at just under $4 billion [TTA 27 July 13]. For civilians, this may not sound like much for concern, but for active duty, Reserve and National Guard service members transitioning from active to civilian status (and back as they are activated), often with complicated medical histories, it means a great deal.

At least one Congressman who also happens to be a physician, Representative Phil Roe, MD (R-TN) wants to try, try again. According to Politico’s Morning eHealth of last Wednesday, his bill will offer “a $50 million prize to the creator of an integrated military-veteran medical records system.” plus another $25 million over five years to operate it. DOD is moving forward with an $11 billion bid for a new EHR, but Rep. Roe’s staff issued a statement that differs with the DOD’s–that the new EHR still has no provision for secure and relatively seamless interoperability with the VA system to streamline the transfer of claims. We wish the best to Rep. Roe, and hope he can overcome Congressional inertia and two huge bureaucracies amidst doubts on the DOD’s EHR award process. FierceEMR on Roe bill, award process and adoption concerns by GAO and others. Also Anne Zieger in Healthcare Dive, iHealthBeat.

Set that disease data free! A call to break down those data silos.

March 31, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/BlueSiloCollapsing-41.jpg” thumb_width=”175″ /]Awash in a rising sea of data generated by devices and analytics–around treatments, population health, costs–there’s a struggle to make sense of it. We’ve noted the high value and merchandisability of 23andme‘s genomic data (gained by individual user consent) [TTA 5 Mar], but our healthcare institutions which should be codifying and sharing disease and treatment data, largely do not. Those with rare or ‘orphan’ diseases struggle to find information, diagnosis, fellow patients, treatments. They sometimes win breakthroughs by, believe it or not, blogging, and having their articles widely disseminated. Reasons why? According to David Shaywitz in Forbes, they are:

  • Hospitals, even research based centers, struggle to codify their genotype and phenotype data of their patients in a meaningful way that would be usable for clinical decision making. We’ve also noted (oddly not Mr Shaywitz) the long implementation process of IBM Watson cognitive processing/decision making tools in healthcare, the concentration on single diseases and their spread into other industries plus third-party integration outside of healthcare [TTA 9 Oct 14].  (more…)

The King’s Fund’s ‘newspaper’ on health and the General Election (UK)

March 27, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/General-election.png” thumb_width=”150″ /]The King’s Fund is now participating in the runup to the 7 May UK General Election with Health and the election, a Paper.li format roundup of national health issues. Much of it centers around the present and the future of the NHS, and what The King’s Fund is tracking as the deterioration in service in such metrics as waiting times for A&E, cancer care and routine operations, coupled with growing deficits. Will the NHS be a deciding factor in the election, as the ITV report seems to indicate? The King’s Fund is gathering the coverage and tracking possible answers to that question. TTA is an official supporter of The King’s Fund, and their upcoming Digital Health and Care Congress 2015 on 16-17 June. TTA readers enjoy a 10% discount when using this exclusive link.

UnaliWear Kanega assistance watch makes Kickstarter goal

March 27, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/Unali-Kanega-new-iteration.jpg” thumb_width=”175″ /]The UnaliWear Kanega assistance watch [TTA 18 Feb] on Wednesday closed its Kickstarter crowdfunding over the top at $110,154. It has several features to promote safety for older people or the disabled, with fall detection, GPS and stand-alone cellular/Wi-Fi connectivity, but the most unique is voice recognition and command/response. Its latest prototype is half the case size as previously, with a more attractive analog watch face, which makes it a lot more MAYA (most advanced yet acceptable–Raymond Loewy), and a major improvement in form over your typical PERS or most GPS watches. With our usual caveat (if it does what it says it does in production), we applaud Jean Anne Booth and her team for their achievement–and we’ll be watching.

Your Friday superintelligent robot fix: the disturbing consequences of ultimate AI

March 27, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/Overrun-by-Robots1-183×108.jpg” thumb_width=”200″ /]Our own superintelligent humans–Elon Musk (Tesla), Steve Wozniak (Apple), Bill Gates (Microsoft) and Stephen Hawking–are converging on artificial intelligence, not just everyday, pedestrian robotics, but the kind of AI superintellect that could make pets out of people–if we are lucky. In his interview with Australian Financial Review, the Woz (now an Australian resident) quipped: ‘Will we be the gods? Will we be the family pets? Or will we be ants that get stepped on?’ (more…)

Google granted patent for sensor contact lens

March 27, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/google-contacts_1401174_616.jpg” thumb_width=”150″ /]On Tuesday, Google was granted a patent for its contact lens with sensors and embedded microchip. According to Time, the patent award was uncovered by WebProNews, which seems to be focused more on the problems of Google Glass than the patent, though the abstract and a development figure is included. The patent was originally filed in September 2012. We’ve previously noted that Google is partnering with Novartis/Alcon (their eyecare division) to further develop applications. The most prominent is glucose level detection for diabetics, but there is also a huge market in correcting presbyopia and autofocusing ‘zoom’ lenses [TTA 17 July 14] Of course, Google does not admit to any of this, telling a Time reporter that “We hold patents on a variety of ideas—some of those ideas later mature into real products or services, some don’t. Prospective product announcements should not necessarily be inferred from our patents.” So we should keep blinking.

Pondering the squandering redux: $28 billion gone out the HITECH window

March 27, 2015 | by

In 2009, the US Congress enacted the HITECH Act, as part of a much broader recovery measure (ARRA or ‘the stimulus’), authorizing the Department of Health and Human Services (HHS) to spend up to $35 billion to expand health IT and create a network of interoperable EHRs. Key to this goal of interoperability and seamless sharing of patient information among healthcare providers was achieving stages of ‘meaningful use’ (MU) with these EHRs in practice, to achieve the oft-cited ‘Triple Aim‘ of improved population health, better individual care, delivered at lower per capita cost. Financial incentives through Medicaid and Medicare EHR programs were delivered through multiple stages of MU benchmarks for hospitals and practices in implementing EHRs, information exchange, e-prescribing, converting patient records, security, patient communication and access (PHRs).

Five years on, $28 billion of that $35 billion has been spent–and real progress towards interoperability remains off in the distance. This Editor has previously noted the boomlet in workarounds for patient records like Syapse and OpenNotes. Yet even the progress made with state data exchanges (e.g. New York’s SHIN-NY) has come at a high cost–an estimated $500 million, yet only 25 percent are financially stable, according to a RAND December 2014 study. (more…)

Chronic care management with telehealth (US)

March 25, 2015 | by

Our readers, especially those in the US engaged with medical practices, might be interested in reading a two-part interview with Editor Donna by occasional TTA contributor Sarianne Gruber. We discuss the new model for Chronic Care Management (CCM) now included in what the Federal Government (CMS-Center for Medicare and Medicaid Services) pays physicians for Medicare patient visits and services. Telehealth, or in CMS terms remote monitoring, can play a vital role in the provision of care coordination, assessment, documentation, patient access and facilitation of self-management as part of the care plan, culminating in better outcomes at lower cost. Published in the new RCM (Revenue Cycle Management) Answers, a spinoff of HITECH Answers. Part 1.  Part 2

Data breaches top 120 million since 2009 (US)

March 24, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/02/Hackermania.jpg” thumb_width=”200″ /]“The medical industry is years and years behind other industries when it comes to security.”–Dave Kennedy, TrustedSEC CEO.

We admire the Washington Post for arriving at the conclusion we did in 2010–that healthcare organizations are uniquely vulnerable to cyberattack because of the high value of patient data, and an often lighter level of HIT security. But now we get the finger wag that ‘it’s only going to get worse.’ (Beyond 120 million breached records?) Data security, of which HIPAA patient information protection is a part, wasn’t primary for years, especially in organizations overwhelmed with transitioning EHRs, getting EMRs to speak with EHRs, Meaningful Use, new care and payment models, 30-day readmissions and ‘oh, by the way, how will we get paid?’ The Premera Blue Cross (Washington state) breach of 11 million records was the second largest in healthcare history (after Anthem Health‘s February bunker buster of a breach). Most breaches are from stolen laptops or shared/easy to guess passwords (or none at all)–but these have not been in the millions. Premera’s theft took place on 5 May 2014 and was only discovered in January; it included SSIs, bank information, claims data, patient name/address and date of birth. Those affected were in California and Alaska primarily, but also included Federal employees.

But Premera can’t say they were not warned. The US Office of Personnel Management’s Office of the Inspector General (OPM OIG) independently audited Premera in April 2014 detailing several vulnerabilities, including a lack of timely patch implementations, a lack of methodology to “ensure that unsupported or out-of-date software is not utilized” and insecure server configurations, and the need to upgrade physical access controls in their data center. FierceHealthIT

Premera’s medical files data may expose other payers, which in turn may legally come after Premera, according to FierceHealthIT.

Only now are health systems and practices focusing on securing all information  (more…)

Assistive tech for older adults gets fresh developer interest, funding

March 24, 2015 | by

Companies and investors are waking up to the potential of technology to assist both older people, wherever they live, and families to keep in touch, live more safely and to compensate for impediments created by physical or cognitive conditions. Ozy, an online news aggregator new to this Editor, notes the $5 trillion annually that boomers and older adults spend in what’s termed the ‘new old-age economy’ (AARP has previously termed it the ‘longevity economy‘) and that there’s money in tech solutions to their problems. Examples: the Lift Labs [TTA 1 Oct 13] stabilizing food utensil that cancels out most active tremors (as in Parkinson’s) while eating; Caremerge which has EHR, care coordination and secure messaging features for the care team in long-term and transitional care, but also connects families with a smartphone app and residents with reminders; GeriJoy [TTA 3 July 14], a tablet that combines an interactive pet avatar/companion with engagement, reminder and education tools for older and cognitively impaired adults.

While we’ve noted many developments along similar lines over the past ten years, interest and financial backing is aligning. (more…)

Radiation from smartwatches, wearables: real, alarmist, or the NY Times?

March 20, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]The Gimlet Eye has that certain half-baked radioactive ‘glow’. The healtherati are all aTwitter over a New York Times Style (!) section article that does the unthinkable–it dares to raise the question of the possible harm of radiation that wearables, including smartwatches as well as smartphones, might present to both adults and children. The writer, Nick Bilton, is a regular tech columnist.

After an unfortunate baiting for attention at the start, making an analogy of cellphone/wearable radiation to 1930s adverts with doctors ‘endorsing’ cigarettes, he for the most part tries to take a balanced approach. By the end, he lines it up like this. Bluetooth LE and Wi-Fi–no evidence of harm in adults. 3G/4G cellphone radiation–you may want to be careful. He points out that studies aren’t definitive. Older studies, such as the WHO’s, a Swedish and some European studies point to harmful (carcinogenic) effects from phones held extensively too close to the head, but nothing is definitive in causality as the CDC pointed out and additional studies have proven no conclusive evidence of harm. Conclusion–use anything 3G/4G with caution, away from the head, limit exposure by children or pregnant women. Cautious enough?

Oddly, he advocates Bluetooth headsets but doesn’t mention using speakerphone settings–and then, for the smashing windup, won’t put the Bluetoothed Apple Watch near his head. It’s a weirdly sourced (an alternative doctor the only one cited? Old studies?) and half-baked, partially tossed salad article. Consider: most wearables are–surprise, Bluetooth or Wi-Fi connected. But it does bring up the inconvenient question, only partially answered, of All Those Rads and What (If Anything) Are They Doing To Us.

What’s really interesting? The immediate, twitchy and prolonged press response. As they say in New Jersey, they are ‘jumping ugly’. (more…)

A mélange of short subjects for Tuesday

March 17, 2015 | by

ATA accredits American Well, Apple ResearchKit, diabetic contact lenses, Hackermania Falls on Indiana, patent trolls get a haircut, and more

The ATA (American Telemedicine Association) has gained more than 200 applications for their US-only Accreditation Program for Online Patient Consultations [TTA 17 Dec 14]. First past the post in accreditation is American Well’s Amwell virtual visit app, which will shortly be listed on the ATA consumer website SafeOnlineHealth.org. Release, MedCityNews….Stanford University, one of the five academic centers using the Apple ResearchKit, had a mind-boggling 11,000 signups for a heart health study–in 24 hours. The downside is that they may not be representative of the whole population [TTA 10 Mar, see 11 Mar update] including us Android users. 9to5Mac….The Google-Novartis glucose-measuring contact lens [TTA 17 July 14] for diabetes management just gained some Canadian competition–Medella Health in Kitchener, Ontario, founded by a team of (more…)

EHRs can’t exchange patient records? $$ in workarounds.

March 17, 2015 | by

Some of the Excedrin/Panadol Headaches (#11, #14, #23 and #54) in healthcare are around the very ‘miracle technology’ that was supposed to make it all seamless, non-duplicative, time/cost-effective and coast-to-coast–EHRs. The exchange of patient records between hospitals, within health systems between sites and with medical practices plus vice versa–works haltingly if at all. It works best within well-established, highly integrated delivery systems –the VA, DOD, Mayo Clinic, Kaiser, Geisinger, Intermountain Healthcare. But once you’re away from it–good luck. Where are the problems? The closed standards of the major hospital EHRs–Epic, Cerner, Allscripts, McKesson and brethren; the extreme customization most health systems demand (nay, a major Epic selling point!); structured versus unstructured data and how handled; a lack of a secure interoperability standard are but a few. Where is the gold? Getting patient health records exchanged, accessible and transportable, among systems that were essentially designed not to speak with each other. (more…)

Sweat analyzing sensor patch flies high at USAF Research Lab

March 13, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/USAF-sweat-sensor.jpg” thumb_width=”150″ /]Call them ‘sticky sensors’, biosensor tattoos or as you like, but there’s been a lot of research happening in the past three years around gathering biometrics from skin contact. Whether it’s the John Rogers ‘skunk works’ at University of Illinois at Urbana-Champaign measuring ECG, EEG and cardiovascular conditions; University of California-San Diego’s lactate and blood glucose monitoring; MC10’s Biostamp for infant temperature, head impacts and neurological disorders plus NewDealDesign‘s multi-purpose implants, skin is in. Though the Apple Watch was flummoxed (for now) by biometrics due to hairy arms and sweat [TTA 18 Feb], these sensors thrive on the latter. The US Air Force (USAF) Research Laboratory has been working on sweat analytic sensors for some time now [TTA 24 Apr 14]. (more…)

‘Rotting In Place’

March 11, 2015 | by | 2 Comments

Laura Mitchell, who was one of the key people behind GrandCare Systems and now is a marketing consultant and healthy aging advocate, has written an interesting article on LinkedIn Pulse, now on her website, springing off an AgingInPlaceTech article by Laurie Orlov.  Like the latter’s article, it commented on the Washington Post profile of Prof. Stephen Golant, whose POV on ‘aging in place’ was mostly that AIP is oversold–that in many cases, it’s ‘rotting in place in their own homes’. It’s a highly provocative topic with equally provocative statements and Ms Mitchell does take him to the woodshed, as does Ms Orlov in a different way. Prof. Galant seems to take a more moderate tone in his book (publicity perhaps?), citing (in the Amazon summary) that “older people often must settle for the least imperfect places to live. They are offered solutions that are poorly implemented or do not respond to the totality of their unmet needs.” a statement with which this Editor finds it difficult to disagree.

This Editor will largely cite her previous LinkedIn comment with a few embellishments/edits: (more…)