Watched closely as part of Samsung’s various moves in health (here in the US heavily promoting the S5’s heart monitoring capabilities) is their unveiling of a reference hardware called the Simband, a wristband designed for interchangeable body sensor modules yet in fact to be developed. Its platform is dubbed Samsung Architecture for Multimodal Interactions (SAMI) and is part of an open ecosystem which invites developers “to design and integrate their own sensor technology and, through the SAMI platform, develop applications and algorithms for wearables.” The design was in partnership with the biosensing institution Imec and will be available before end of 2014.(Gizmag) Coming before Apple’s Worldwide Developers Conference (WWDC) and the rumored announcement of the Healthbook iOS app [TTA 22 Mar]…the Samsung-Apple wars continue, and not in court. Also Gizmodo
‘Fashionable safety’ alert device for women
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/Guardian-Angel-necklace.jpg” thumb_width=”150″ /]Out of Singapore is a pretty silver necklace or bracelet that does more than adorn: with the press of its small silver button, it can help the wearer get away from an uncomfortable or harassing situation in a public setting (like the workplace, a bar or party) by sending that ‘nick of time’ fake call to your iPhone by Bluetooth LE. Or if held down for over 3 seconds in an emergency, it sends an SOS text, coordinates and a Google Map link via the phone to designated recipients (not law enforcement.) The Guardian Angel pendant was developed by ad agency JWT Singapore to support AWARE (Association of Women for Action and Research) in Singapore through a 10 percent per unit donation, and is available at local retailer My Room Retail or internationally via their website for US$120 (UK£71) plus shipping, handling and optional bracelets. What isn’t clear is if a smartphone is needed–the website indicates that an app must be downloaded from the Apple AppStore but the Daily Mail article says it works with any phone. Also PSFK review, ABC (US) News. What’s a little disappointing is that the first function (‘get me away from this creep’ self-call) is being more widely touted than the second (‘the creep is coming after me with handcuffs, and he’s not a cop’ SOS). This Editor also wonders how reachable the necklace in particular would be in a truly dangerous situation. But it is certainly better than the alternative. Hat tip to Editor Toni Bunting.
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/03/first_sign_clip-1.jpg” thumb_width=”120″ /]In TTA 6 March we covered another ‘fashionable safety’ item, the First Sign hair clip, which is more violent crime deterrence and recording-oriented. It senses impact and sends audio/video/GPS location to monitors plus designated recipients along with a pre-recorded announcement that it is gathering evidence. It succeeded in its Indiegogo financing round and is available for pre-order here for estimated November delivery at $50-75 plus monitoring. But so far, fashion hasn’t made its way into the maddeningly institutional PERS design (though Chubb has given it a whirl with its Glasgow competition recently.)
A random walk through ATA 2014
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/ATA_Button_color_filled.jpg” thumb_width=”150″ /] Editor Donna attended ATA 2014 on Monday only. This article is a set of impressions (mainly) of the exhibit floor and visits to a number of select booths.
Donna, it’s Baltimore. You’re not in NYC or Las Vegas.
Arriving after a long trip to a city you used to visit regularly, but haven’t been to in over 30 years, is disorienting, especially when you are heading on a fair spring day to a section that didn’t exist then. The Inner Harbor and Camden Yards resemble Atlanta, not necessarily a bad thing since the parts of ‘Charm City’ they replaced were largely past ‘gentrification’. The Baltimore Convention Center was unexpectedly huge, the distance to registration made longer by a taxi driver who dropped me off at another entrance two blocks away. Any resolve I had to drop in on the many educational sessions was dissuaded by the sheer length of the halls. The thick Exhibit Guide confirmed that the show floor filled two city blocks–a challenge to cover and spend time with my appointments before the close of the day.
Was it a hardware show, a software show or somewhere in between?
You could make a case for both views. One observer I walked with at the start compared it to a radiology trade show–all hardware. Yet a closer look indicated that the hardware–the PCs, tablets and smartphones–was there to show software that integrated: systems to track patients, distribute information, workflows, store and forward images and reports. It was about enabling secure consults, platforms, interoperability, two-way data flows, mitigating readmissions and putting telehealth, telemedicine and education into provider and patient hands. It was also about making the business case. It was most definitely NOT about gadgets and single purpose peripherals, though the latter were still quite visible. The old picture of telehealth closed systems, of proprietary monitoring devices feeding data onto a proprietary PC platform where it’s seen by a care manager, is so 2011.
Noteworthy: the growth in specialized services like telepsychiatry, teleneurology, teleradiology and teledermatology. Contrast: despite VGo‘s ubiquitous telepresence robots accosting you on the floor, a tablet-faced robot following a nurse down the hospital hall and ‘consulting’ with patients will likely still be a rarity.
Patient engagement on top
Traditional telehealth device makers are connecting their devices and opening up their reporting platforms to be accessible to patients. But there are bumps along the way in this transition. A&D Medical has gone ‘Wellness Connected’ with a mobile app (more…)
Tunstall’s unhappy lenders and the consequences of debt service
A ‘slipped under the radar’ story (in this Editor’s judgement, based on the lack of news references) is Bloomberg News’ exclusive on last week’s (12 May) meetings between Tunstall Group Ltd and its creditors over the company’s recent performance. According to Bloomberg’s sources, the meeting was called “after income plunged and management changed following a refinancing in September.” In a statement from Charterhouse that cleverly tap-danced past the reason for the meeting, “Tunstall continues to be a successful, profitable, cash-generating business and comparable to many other organizations, experiences short-term fluctuations in performance.” and “The group has been impacted by a number of factors including specific market factors and the continued strength of sterling against the major-trading currencies.” The business has also been hurt by delays in awarding major contracts, according to the statement.
From the Bloomberg article:
As Tunstall’s profits have declined, its ratio of debt to earnings before interest, taxes, depreciation and amortization increased to 5.6 times as of March, from 4.7 times in September, the people said. The loan terms in the March test dictated that the leverage ratio shouldn’t exceed 6.3 times, they said.
Lenders are expecting the company to give a new profit forecast today for the 12 months to September 2014, according to the people. The company didn’t comment on earnings targets or leverage in its statement.
AND: Its 350 million pounds ($590 million) of loans dropped to as little as 77 pence on the pound, according to broker quotes, from 99 pence in September. (Ed. note: these loans are publicly traded and a lowered value is highly significant as to the debt quality.)
The outcome of the meeting is not yet known.
As our readers know, private equity firm Charterhouse Capital Partners LLP acquired Tunstall Group in 2008 from Bridgepoint Capital for £514 million (US$ 1 billion), funded in part with over £242 million in debt and with Bridgepoint and management retaining small shares (FT.com). The September 2013 refinancing was for £350 million ($590 million). This paints a picture of a highly leveraged company beholden to many beyond its owners and its contractors in local authorities and housing associations. Tunstall and Charterhouse also received negative publicity when the Guardian did an exposé on their use of the (wholly legal) ‘Quoted Eurobond Exemption’, where they pay loan interest at high rates to their parent companies through a mechanism via the Channel Islands Stock Exchange.
Management changes over the past six months have also rocked the top layers of the company. (more…)
More telehealth for the bassinet set
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/12/3019806-poster-1280-sprouting.jpg” thumb_width=”160″ /][grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/product_sock-Owlet.png” thumb_width=”160″ /][grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/0ca96884.MimoKimono.png” thumb_width=”160″ /][grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/Sensible-baby.jpg” thumb_width=”160″ /]Industry talk is that wearables are no longer the hottest things on the hype curve because of smartwatches and smartphones getting even smarter, but one area is the exception: baby wearables. MedCityNews has an overview of four, three of which we’ve noted since late 2012: Sproutling, Owlet, Rest Devices’ Mimo Turtle (which fastens into Kimono, a/k/a the ‘onesie’) and (new to us) Sensible Baby SmartOne. All have some combination of heart rate, skin temperature, movement/sleep position monitoring from sensors into a smartphone app. Form factors: Sproutling and Owlet are anklets, Mimo Turtle’s monitor fits into a designated secure pocket in the lower (baby’s) left of the onesie, Sensible Baby goes into a pocket or attaches to clothing so it’s likely more suitable up to toddler age. Last December’s FastCompanyDesign article on Sproutling targeted its debut for this summer [TTA 10 Dec 13], but there’s no trace of a website so it’s still in development. Owlet’s been in market since fall 2013 [TTA 27 Aug 13] as has Mimo Turtle which is now sold through major retailer Babies ‘R’ Us. Sensible Baby is still inviting beta testers and pre-orders at $99, projecting $149 when on sale later this year. There’s also no reassurance on the site that the SmartOne can be safely chewed — and of greater concern, its size appears to be small enough to swallow. With pricing between $150 and $300, they are at the Velocity of Cute as ‘ooh-ahh’ gifts for those baby showers which are coming up on many calendars and for your favorite Quantified Self Moms. (Just hold the obsessive smartphone checking.)
Also: Investor/engineering lab Lemnos Labs’ blog posting on Sproutling’s development from application/prototype to a scalable production model will be interesting especially if you are being challenged in the hardware development process.
Previously in TTA: Wearables on the hype cycle: a ‘Fitbit for babies’, Owlet baby monitor sock exceeds funding goal (But Huggies Tweet Pee seems to have stayed in Brasil…), Owlet baby monitor sock moving to market, Cute sensor fashions now for baby.
Sleep monitor for telecare in epilepsy, abnormal night activity
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/SAMI-Camera.jpg” thumb_width=”140″ /][grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/SAMI-image05-300×169.png” thumb_width=”175″ /]
A truly underserved area is monitoring children who have epileptic seizures or other conditions at night. There’s danger to the child and loss of sleep or inability to detect by the parent or guardian. Sleep/activity monitors, baby monitors and movement sensors haven’t been adequate nor accurate. The Epilepsy Foundation (EF) in the US has developed SAMi, a monitoring system consisting of an camera (left) with built-in infra-red LED illumination connecting to an iPhone, iPad or iPod app. At night or designated sleep times, it alerts only for prolonged movement typical of a seizure or other suspect night activity, activating the phone with both audio and video. The movements are also recorded and logged for date/time/duration. It is not inexpensive: the SAMi camera alone is $399 and $949 for the fully configured kit with a iPod plus Wi-Fi router. The new Indiegogo campaign is to raise $90,000 for the next gen camera and to purchase units for charitable distribution to families. Also Medgadget. (A search here on ‘epilepsy’ will confirm the lack of attention to–and the need for–epilepsy monitoring)
‘Brain Games’ on preventing, diagnosing sub-concussive brain trauma
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
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
[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)
[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
[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
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’
[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
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
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
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!]
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