Phobic? There’s an app for that.

[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

[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)

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

[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)

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’

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?

‘Sticky sensor’ research at USAF Research Lab

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/04/Biosensors.jpg” thumb_width=”150″ /]Sticky biosensor patches are seemingly all the rage in wearables, but in very preliminary stages. The US Department of Defense (DOD) research labs are no exception. Here’s one from the USAF Research Lab that is intriguing because of its less-than-chunky profile (pictured) compared to the University of Illinois research prototypes [TTA 10 April]. The concept is basically to measure biometrics through vital sign measurement and body chemicals through perspiration (a/k/a sweat) that would be sent to a (hold the fanfare) smartphone. It’s advanced enough to be beta tested on runners in the September Air Force Marathon. The key researcher, Josh Hagen PhD., also notes it’s being developed not only for military use, but also for commercialization.  Armed With Science

WLSA announces global adoption theme for Convergence Summit

The Wireless Life Science Alliance’s Ninth Annual Convergence Summit, 14-16 May at beautiful San Diego’s Omni Hotel, will be themed around greater global adoption of technology-enabled healthcare. This marks a change from the technology-heavy early days (your Editors have been covering since at least 2010) to worldwide institutional adoption (too slow), outcomes (public health still deteriorating) and consumer engagement (limited). The Wednesday sessions are for members only, the following two days are general sessions and exhibits. Featured speakers include Jeff Arnold, founder of WebMD and now CEO of Sharecare; Dr. Leroy Hood of the Institute for Systems Biology; Ralph Simon, CEO of Mobilium Global Limited which is active in Africa; from the UK, Dale Athey, PhD, CEO & Founder of OJ-Bio Ltd. Another feature of the Summit is the announcement of the TripleTree iAwards for Connected Health winners. Twelve finalists were announced earlier this month. More information and registration.

Another alliance to promote connected health

The formation of the Personal Connected Health Alliance (PCHA) by the Continua Health Alliance, mHealth Summit and HIMSS solidifies what has been a close working relationship into what will “represent the consumer voice in personal connected health.” With the three organizations having worked together for some years particularly in relation to the mHealth Summit, the PCHA will now be the Summit’s formal presenter with Continua, HIMSS and the Foundation for the NIH as partners. Clint McClellan, Qualcomm’s Senior Director of Business Development and Continua’s board chair, is the acting chair and the PCHA will be located in Arlington, Virginia. According to Rich Scarfo, Vice President of the PCHA and the developer of the mHealth Summit,“The Personal Connected Health Alliance, in cooperation with the mHealth Summit and Continua, will continue driving the industry forward by generating a new knowledge base around the personal connected health space, providing a strong and united voice on policy, regulatory issues and government relations, and advancing education and awareness for the widespread adoption of personal connected health technologies.” Continua, after a few uncertain years while it shifted from a sole mission of interoperability standards and certification to combining that with advocating personal telehealth, now enjoys a membership of roughly 200 companies and has largely shed its ‘subsidiary of Intel’ reputation. The mHealth Summit has undergone its own shifts from a focus on governmental and NGO wireless health to a much wider scope (and major expansion) courtesy of HIMSS. Certainly PCHA’s activities will bear watching with this tripartite backing. Release on HIT Consultant (hat tip to publisher Fred Pennic), mHealthNews, YouTube video

One can only speculate on PCHA’s mission overlap with another DC advocacy group, the Alliance for Connected Care. The latter, a thinly veiled lobbying group [TTA 13 Feb], has been strangely quiet, with the news section of its glossy website not updated since early March. (Lobbying is best done quietly?)

Redesigning PERS artistically in Glasgow: the winners

Following up on our 28 March story of Chubb Community Care sponsoring a competition at the Glasgow School of Arts to redesign the traditional telecare medical alarm (PERS), the five winning entrants and teams were announced today (23 April). They are:

Element: Craig Meakin, Kayleigh Nelson, Eilidh Gibson and Ramsay Black
Pebbl: Gordon Ritchie, Francesca Stephens, Jordan Smith, Erin Wallace and Heather Walker
Bodyguard: Steven McCauley, Harry Hutton, Kim Stendahl, Matias Rinne and Andrew Robertson
Lumeo: Nadia Bassiri, Robert Turner, Harry Opoku Agyeman, Helen Campbell and Jonathan Thomson
Suit: Michael Tougher, Hannah Kirkbride, Euan Spalding and Tristan Stoner

The winning teams will share a £2,500 cash prize, and their designs were publicly presented at Municipal Buildings in Forres, Moray in the north of Scotland. The Glasgow Arts teams worked with Moray residents who currently use PERS and their carers to determine design and functionality factors. According to the release, Chubb is using the designs to complement the work of its own engineering teams, and thus at this point the concepts are still under wraps. We hope these concepts gain wider exposure. Release link to come.

Getting ‘Better’ with a personal health assistant

Is Better going to where better healthcare should be?

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/04/pha.jpg” thumb_width=”150″ /]Making its formal debut last week was Better, an iPhone app (Android to come) developed in conjunction with and backed by the Mayo Clinic. The aim of Better is to deliver information and care no matter where people are located. The analogy co-founder/CEO Geoff Clapp uses is ‘AAA (RAC or AA=UK) for healthcare’ but it seems to be a bit more developed than emergency tows and TripTiks. In its free version, it provides complete access to Mayo Clinic educational content tailored to the user’s interests and provides access to a personal health record (PHR) for the family. In the $49/month premium version, Mayo provides 24/7 national access to a personal health assistant available by phone and video. The PHAs can coordinate your and your family’s providers, help navigate your insurance and billing and coordinate follow up care. If needed, the PHA can connect the user with a Mayo Clinic nurse who can explain symptoms, potential causes and recommend next steps. The paid version also provides a symptom checker, built with algorithms and using the Mayo database.

According to Mr Clapp (interviewed in Mobihealthnews), Better is ‘early’ and trying to define a market. He is encouraged by remarks such as “I’m not sure I totally get it and not sure the world is ready for this” which is similar to what he heard when co-founding Health Hero (now Bosch Health Buddy) in 1998 (among the most Grizzled of Grizzled Pioneers). Also in this interview, he cites a focus on underserved disease groups such as Crohn’s Disease and cystic fibrosis where help is not generally available; eventually they will also move toward telemedicine. Since the sale. he has been mentoring companies at Rock Health. Better has raised $5 million to date between Mayo and Social+Capital Partnership and is located in Palo Alto, California. It’s an interesting spin on concierge medicine–can it be considered ‘concierge healthcare for the masses?’ Given the pedigree and the partners, we expect to hear bigger, better things from Better in the next few months. Also MedCityNews,  the PSFK Labs blog and FastCompany. Video (YouTube)  Hat tips to Bob Pyke, Editor Toni Bunting

Data breaches may cost healthcare organizations $5.6 bn annually: Ponemon (US)

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/10/keep-calm-and-enter-at-own-risk-3.png” thumb_width=”150″ /]The PHI threat is within for HIT staff and CIOs, with no end in sight: Ponemon Institute and IS Decisions

The Ponemon Institute’s fourth annual benchmark report on patient privacy and data security was released last week and with a few exceptions, the news is worse than last year. Eight highlights in the study of 91 responding organizations (Ponemon admits results are skewed to larger sized respondents) for 2013 are:

  1. The average cost of data breaches in the study group was approximately $2 million over a two-year period. Extrapolated to the over 5,700 hospitals in the US, the annual cost is $5.6 billion, down from $7 billion in 2012.
  2. The number of data breaches decreased slightly. 38 percent report more than five in the 2013 report compared to 45 percent in 2012. The number of organizations reporting at least one data breach in the past two years was 90 percent versus 94 percent in 2012.
  3. Healthcare organizations improve ability to control data breach costs. The economic impact of data breaches for the healthcare organizations represented in this study over the past two years is $2.0 million–but it is 17 percent (nearly $400,000) less than 2012.
  4. ACA increases risk to patient privacy and information security. No surprises here for readers with insecure exchange of information between healthcare providers and government (75 percent ), patient data on insecure databases (65 percent) and patient registration on insecure websites (63 percent) leading the way. (more…)

An architect’s POV on transforming rural health

‘Wellness districts’ and restructuring beyond walls and payments

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/04/Butler-County-Elting-bldg.jpg” thumb_width=”175″ /]Healthcare building architect Doug Elting cannot be accused of thinking small. The Transformation of Rural Health starts with reimagining healthcare facilities serving rural areas into facilitators of population health: “…the  local healthcare center as the source of health and vitality….focus(ing) on the provision of services that will maintain health, enhance public participation and redefine the scope of care.” (Not difficult imagining when you see an attractive wellness/rehab center like Butler County Health Care Center in Nebraska, left.) Like Clayton Christensen, Mr Elting envisions decentralized care that incorporates telehealth, care coordination, PHRs, fitness and social support. He then moves to an organizing principle called Wellness Districts:

Rural community, county and critical access hospitals will become components of Wellness Districts composed of Life Enhancement Centers coupled with physicians and physicians groups. These Life Enhancement Centers (LEC) are flexible and agile facilities containing a variety of services meeting the needs of the population. The LECs could contain: patient-centered medical home physicians’ offices, wellness and rehabilitation centers, specialty clinics, diagnostic centers, wound care centers, nutrition and cooking classes, outpatient treatment centers and urgent care facilities. LECs may include related services including dental offices, eye care specialists and retail functions including: durable medical equipment, opticians, retail pharmacies, food services etc. (more…)

A ‘before the alarm’ approach to the soundtrack of ICU data

ICUs–and indeed, any acute care setting–have a soundtrack of boops and beeps that accompany regular telemetry of data from multiple devices. Alarms which indicate emergencies shatter the rhythm, eventually inducing ‘alarm fatigue’. What if ICUs could get a step or two ahead and use the torrent of data to predict a downturn in a patient’s condition and warn clinicians before that alarm goes off? That is the idea behind the system being developed at Boston Children’s Hospital with a local data analytics startup, Etiometry.  The latter’s Risk Analytics model is designed to transform data into clinically actionable information and to predict decompensation–a worsening or emergency status for the patient. For the cardiac intensive unit at BCH, the Stability Index pops up on the vital signs screen. “Doctors choose different parameters to measure, then the Etiometry system renders its risk assessment on a simple numerical scale, with 0 being most stable and 4 the least.” Not the first innovation for Boston Children’s either; with another software provider, they developed a single view of vital signs interface dubbed T3.  Boston Globe, FierceMobileHealthcare

Nike FuelBand out of gas

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/04/FuelBand.jpeg” thumb_width=”175″ /]In what is the first of the major players in fitness bands and wearables exiting the category, CNet reported last Friday that Nike is winding up its hardware business with the layoff last Thursday of nearly 80 percent of its Digital Sport staff. Previously, Nike had canceled a new version of the FuelBand due for release later this year, but they will continue sales and support for the present iteration which only works with Apple. Their focus is now on fitness and athletic software, which can plug into smartphones and other companies’ devices at far less cost and greater profit than the hotly competitive band business. Much of the speculation surrounds their strong Apple connection; Tim Cook, Apple CEO, sits on the Nike board. This maneuver could benefit them both greatly when Apple finally gets into the smartwatch biz. Perhaps two world-class brands could better sort out what to do with the data, which is another sore point according to PC Magazine’s take on it. Further reasonable discussion on this courtesy of Gigaom. Hat tip on the last to David E. Albert, MD via Twitter @DrDave01.  (Nike photo)

Why healthcare doesn’t encrypt: correct, incorrect assumptions

As our readers know, we’ve preached the Gospel of Data Security for quite awhile, to the point where even The Gimlet’s Eyes have crossed. Based on this smart analysis in Healthcare IT News (done by an outsider to healthcare), there are real reasons why HIT leaders are reluctant to implement encryption and security that would be SOP for other types of organizations. Mr. Schuman sorts the ‘drag the feet’ factors:

  1. Outdated but still widely believed: Encryption makes information less accessible across a broad network, increasing retrieve and review time. There is increased, not decreased, pressure to increase access, including by practices and patients, as part of  Meaningful Use (US).
  2. Encryption as a barrier: Providers see encryption as increasing time, decreasing  usability of systems, making workarounds more difficult.
  3. Encryption not permitted: Equipment designed with a specific hardware/software configuration block security add-ins. The logic is that any add-ins, even for security, could and do compromise performance. They thus violate manufacturers’ warranties and leave hospitals/practices open to legal action if equipment does not perform as intended.
  4. It’s complicated and pricey: Encrypting proliferating devices multiplicity of devices and systems takes manpower–it’s not only not there, but also expensive. Good intentions, but little money, is there.

The solution may lie in encrypting data between applications, not in the hardware/software itself. Hat tip to reader ‘Klondike Playboy’ John Boden.