ITALIA Project Launch Event (UK)

August 12, 2013 | by

18th September 2013, The Oculus, The Gateway, Gatehouse Road, Aylesbury   10am to 5pm

Unfortunately not a Ferrari in your driveway, the ITALIA (Innovative Telehealth and Assisted Living Ideas and Applications) Project initiated by Buckinghamshire New University’s institute, the Centre of Excellence for Telehealth and Assisted Living (CETAL),  is a public/private year-long initiative to develop the telehealth applications of the future. The kickoff event will bring together companies with products, ideas or technologies, clinicians and commissioners from organizations such as Buckinghamshire Business First (BBF) and Buckinghamshire Healthcare NHS Trust. More information here (PDF download) and Bucks New University News. Admittance is free but registration on Eventbrite is requested. Our Contributing Editor Charles Lowe is scheduled to be a speaker. Hat tip to reader Stephanie Carrington of BBF.

‘Wired for health’, making case for mHealth

August 12, 2013 | by

STSI (Scripps Translational Science Institute), directed by the famous Eric Topol, MD,  is undertaking a 200-person six-month research study to determine the results of telehealth monitoring for three conditions (diabetes, heart arrhythmia and high blood pressure) coupled with an active disease management program. Half of the survey group will receive a Withings Blood Pressure Monitor, an AliveCor Heart Monitor and an iBGStar Blood Glucose Meter delivered via Qualcomm Life’s 2net Hub and Platform to a web portal or mobile device; the remainder will not but will be part of the disease management program. Subjects will be drawn from Scripps Health employees and family, which to this Editor may be stacking the deck–most employees of a health system presumably are health-conscious.  Participants also include Scripps Health, HealthComp (third-party healthcare administrator which will monitor health status), Accenture and Sanofi Diabetes. Though the release promises ‘social networks’, the only reference this Editor could find is interactivity between the person and the health care team.  Scripps press release. MedCityNews  Hat tip to former QuietCare colleague José Molina (via LinkedIn)

FDA publishes medical device interoperability standards (US)

August 8, 2013 | by | 1 Comment

While FDA is still dithering about issuing draft guidance on mHealth, it looks like medical device manufacturers can break out the champs, because FDA has now recognized 25 standards on medical device interoperability and cybersecurity. According to Bakul Patel of the Center for Devices and Radiological Health at FDA, “Making sure devices are interoperable requires the creation, validation, and recognition of standards that help manufacturers develop products that are harmonious and can “plug and play.” It’s an alphabet soup of industry standard abbreviations–IEEE, ANSI, AAMI, ISO, IEC and ASTM–and it’s purely voluntary, but various groups such as Continua and AAMI (Association for the Advancement of Medical Instrumentation) have praised this ‘first step’, and being published, it is now open for comment.

According to the Continua LinkedIn group announcement from Executive Director Chuck Parker, the 25 standards can be grouped into three categories:

  1. Risk management standards for a connected and networked environment
  2. Interoperability standards that establish nomenclature, frameworks and medical device specific communications and including system and software lifecycle processes
  3. Cyber security standards from the industrial control area most relevant to medical devices.

As the FierceHealthIT article cited, interoperability failure is a top 10 health technology hazard according to the ECRI Institute.  One can hope the new standards can be applied retroactively to current devices which are not being patched and updated because manufacturers fear running afoul of FDA clearance regulations and counter that ‘discouragement’. [TTA 8 Aug] AAMI News, Federal Register 6 August, FDA Voice (blog article by Bakul Patel)

The five-point digital health checkup meets the FBQs

August 8, 2013 | by

Checking up on some of the issues that the D3H crowd (Digital Health Hypester Horde) tends to skip merrily by, Dan Munro’s analysis hits several nails on the head and then some, with his points touching on our FBQs–the Five Big Questions*–we first outlined exactly three years ago (integration was added last year).

  1. Who has the rights to your data? You or only your doctor? (#3) And why not you?
  2. Need drastically improved standards of safety and security in devices. From those black hatted device hackers to the lack of updates by manufacturers and FDA‘s apparent discouragement–it may not be an an FBQ, but it impacts #5, data integration.
  3. Accuracy. Are these devices accurate or only ‘kinda’? How do you play off accuracy versus convenience?
  4. Privacy–what about it? Business models call for sale of ‘de-identified’ data which can be tracked back and re-identified. (#1) And what does your activity say about you-ooooo? (#3)
  5. The business model. Aside from who’s paying for the device and how much (#1, #2), #3 is still there–who’s looking at the data if you purchased the kit? And who’s liable for interpretation–and errors?

5 Point Digital Health Checkup (Forbes)

* The Five Big Questions (FBQs)–who pays, how much, who’s looking at the data, who’s actioning it, how data is integrated into patient records. 

FDA’s discouraging role in medical device security

August 8, 2013 | by

According to a Wall Street Journal report (unfortunately firewalled), hospitals are pointing a very long finger at medical device manufacturers for not updating software and leaving devices open to breaches. Yet the manufacturers readily cite FDA’s most recent guidance as prohibiting software updates and security patches without resubmitting their devices for approval–something a spokesperson for the FDA denies as long as the update is for cybersecurity only. If the draft guidance issued in June is actually finalized, it will go the distance in helping manufacturers and hospitals. Hospitals Say Device Manufacturers Resist Boosting Cybersecurity (iHealthBeat)

Big data in healthcare’s Tower of Babel: interview with Eric Topol

August 8, 2013 | by

A short interview in iHealthBeat with Eric Topol, MD, Lydon Newmann of Impact Advisors and Lee Pierce from Intermountain Healthcare shows the bright side of business intel/’big data’. All that structured and unstructured data collected on individuals can be put to good use by data warehousing and analysis–a success story is Intermountain’s reduction of induced births from 30 percent to 5 percent. Yet the wins outlined are single system. Eric Topol agrees with this Editor that “The problem that exists is they lack any ability to transfer information from one to the next. There’s no interoperability. So we have a Tower of Babel.” Audio (and a dissenting comment) here, PDF transcript here.

Microsoft Kinect now as sign language translator

August 8, 2013 | by

The versatility of Microsoft Kinect continues to astound, with uses ranging from human rehab/physical therapy to equipping robots with anticipatory powers for your drink to Ellie the Virtual Analyst. Add sign language translation to this list. The latest is Chinese sign language simultaneous translation via Kinect that will permit deaf and hearing individuals to understand each other. Sign languages are their own entity with grammar and rules that make the spoken/written language nearly foreign to the user. The system developed by Chinese Academy of Sciences’ Institute of Computing Technology and Microsoft Research Asia joins the one developed for American Sign Language last year. Wired.co.uk  Hat tip to Toni Bunting, TTA and TANN Ireland.

Digital Health Days (Sweden)

August 8, 2013 | by

21-22 August 2013, Stockholmsmässan, Stockholm, Sweden

If you prefer to cool off from summer’s heat in Stockholm, the first annual Digital Health Days is “designed to provide the perfect mix of visionary expert panels, learning workshops and demonstrations of real solutions.” It is both a conference and exhibition–and looks to be diverse based on the program (in English). Speakers include Don Jones of Qualcomm, IBM hosting a presentation on Watson and certainly a different mix of companies. Events include a health hackathon and the Digital Health B2B meeting sponsored by the Stockholm Business Region Development; pre-organized one-to-one meetings bring together partners and investors for European companies. (Registration for this only is here and free).  Website, registration

Connected Health Symposium 2013

August 7, 2013 | by

24-25 October 2013, Boston Seaport Hotel and World Trade Center

The Connected Health Symposium is celebrating its 10th Anniversary in a new venue and with the theme “Collaborations and Innovations to Engage Patients and Elevate Care.”  It will likely draw the 1,500 or so attendees it has in recent years. It is a round robin of interesting seminars (almost too much) as well as continuing with “TED-style keynotes, book signings, debates, interviews, probing panels, innovative product demos and plentiful networking opportunities”.  Based on the speaker list, what will also carry over is an emphasis on Washington policy, hospital and payer issues. Preliminary agenda is here and registration information here. Organized by Partners HealthCare Center for Connected Health.

Note: Early bird discount of $200 expires on 15 August.

New England Home Healthcare Consortium Summit 2013

August 7, 2013 | by

3-5 November 2013, Foxwoods Resort, Mashantucket, Connecticut

To meet the rapidly expanding challenges and needs of baby boomers, nationally recognized industry experts on home healthcare, aging, and emerging technology will gather for the region’s first-ever New England Home Healthcare Consortium Summit . Seven speakers will share their insights and provide solutions to prepare the industry to effectively address such critical issues as increasing cost pressures, the affects on families and friends, as well as baby boomer demands for expanded care needs, including new technologies. The agenda is here, and largely on aging and care issues although speaker Greg Wellems, CEO of Imagine! in Boulder, Colorado, an organization which serves the cognitive and developmentally disabled, will speak on the role of technology in improving support. The Monday opening keynoter, Alexis Abramson, has also been a fan of health tech since early days in 2006 (she covered this Editor’s former company with one of the earliest major media stories on QuietCare). Website, registration   Hat tip to reader Laura Abbott

First ‘Lucky Thirteen’ StartUp Health/GE program company sold

August 7, 2013 | by

Breaking News

One of the ‘Lucky Thirteen’ companies, Arpeggi, which entered the joint StartUp Health/GE Ventures program back in April [TTA 4 Apr], has been sold to another early-stage company in the genetics analytics, data management and diagnostic space, Gene by Gene. It is the first acquisition of one of the joint program companies and according to StartUp Health spokesperson Nicole Kinsey, “this is a strong sign of how well the program is is working to accelerate and scale digital health startups. This new combined company will be a major competitor to companies like 23andme and will really offer the consumer market much greater access and affordability to DNA testing and sequencing services.” The Arpeggi group and tech platform will be incorporated fully into Gene by Gene, and according to Unity Stoakes, President of StartUp Health, the latter will now enter the StartUp Health/GE Ventures program. Release (PDF)

Systems sharing data, still behaving badly

August 7, 2013 | by

A straight-shooting article in Healthcare Technology Online provides a overview of the EHR and Health Information Exchange (HIE) mess in the US. Essentially our major EHR systems (Cerner, McKesson, athenahealth, Greenway, Epic) don’t interchange data well, if at all–and the 600-odd practice EHRs were built on siloed designs, existing software and used proprietary formats, often in a rush to take advantage of Federal subsidy programs in Stage 1 Meaningful Use–as HTO’s EIC Ken Congdon stated, “electronic filing cabinets”–and heavily outsourced. Well, it’s now ‘uh-oh’ time as a key part of Stage 2 MU is interoperability. Basically we now have a set of what this Editor would term ‘paste ons’ and ‘add-ins’ to facilitate data exchange between systems that speak different languages (Editor’s emphasis):

…direct protocol (a standards-based method for allowing participants to send authenticated and secure messages via the National Health Information Network), as well as those developed by HL7 (Health Level Seven), a nonprofit global health IT standards organization, provide EHR users with the building blocks for exchanging data. Blue Button, an application developed by the VA that allows patients to download their own health records, is also being adopted and manipulated by EHR vendors and independent developers as a way for providers to exchange data between systems. Moreover, regional and state-run HIEs offer healthcare providers in several parts of the country a network they can join (and technology infrastructure they can leverage) to share health data with other HIE members.

Some systems work well–EHR and pharmacy systems seem to. However, EHR to EHR interfaces are up to the provider and are expensive. Sharing/translation does not mean that all information makes it over without getting ‘bruised’ or having to be reentered manually.  HIEs, acting as a focal point for data exchange, are also generally non-profit; the exchange platforms cost millions to develop and further millions to maintain–and buy-in is low, as the article states. Fixing The EHR Interoperability Mess (free registration may be required)

(Updated 8/7 pm for Editor Donna’s POV) This is what happens when you rush adoption and development processes that should take years in order to gain quick subsidy money, and non-healthcare entities (that is you, the US Government) encouraged this, distorting the process. The private and public waste of scarce healthcare funds is appalling, and the disruption to the healthcare system is unforgivable–especially in practices where doctors and managers in many cases have been sold a bill of goods, and they are revolting by changing EHRs, going back to paper or retiring. And the Government should look to itself first. Look no further than to the multiple failures of two branches of the US government, Veterans Affairs and Department of Defense, which have the responsibility for current and veteran members of our Armed Services. They have failed spectacularly in serving Those Who Have Served not only the integration of their two EHRs but also in updating their basic architecture [TTA 27 July ‘Pondering the Squandering’… and 3 Apr ‘Behind the Magic 8 Ball’ both review the sad details.] The belief that HIEs with limited funding will solve the interoperability problem is Magic Thinking. At least one move in this direction makes sense: the CommonWell Alliance of six EHR heavy hitters to work on ‘data liquidity’ [TTA 5 Mar announced at HIMSS], but this may be another ‘uh-oh’ and face saving.

With basic, necessary health and patient information stuck in systems and getting lost in translation, how can anyone rationally expect that personal data from telehealth devices will be integrated anytime soon, in any meaningful way? Does this mean that parallel, separate systems and platforms will continue to develop–and yet another wave of integration?  

Alere Connect gains FDA approval for MobileLink

August 7, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/topper-mobilelink1-1140×180.jpg” thumb_width=”175″ /]We had been surprised at how quiet Alere Connect, the former MedApps, has been since its acquisition a year ago. Their latest news is that their newest and quite streamlined gateway hub, Alere MobileLink, has received FDA clearance to add to its recent CE Mark certification, clearing it for introduction in both US and Europe later this year. The US announcement also indicates that it will be packaged with Alere’s INRatio 2 PT/INR Monitor as part of home patient monitoring of anticoagulant medications programs through Alere Home Monitoring. This Editor notes that anticoagulant monitoring is ‘high-value’ and for remote monitoring, fairly different. Like the earlier MedApps HealthPal, it is also ‘vendor neutral’ compatible with multiple telehealth devices for glucose meters, weight scales, blood pressure monitors and pulse oximeters. Much of the emphasis of the new Alere Connect is how it integrates tightly with Alere’s programs and Connected Health informatics, care management and accountable care solutions, which is confirmed by CEO Kent Dicks’ quote included in the release: “The Alere Connected Health platform has the ability to connect flexibly with devices and systems regardless of their manufacturer and origin. The platform captures and analyzes data with robust analytics, and then backs it up with comprehensive health management services.” No information on rollout in UK or Europe. Release.

For long-time followers of MedApps, their HealthPal wireless hub is still being supported by Alere but will not at this point be integrated with INR monitoring. Also pending FDA clearance is a home health information tablet, Alere HomeLink.

Flashback: Integration of devices with service delivery providers was a major point brought up in our discussion of the MedApps acquisition value back in January, What a telehealth device company may be worth.  “What may be a better way is that device developers joint venture themselves from the start with health or service providers. And that those already seeking financing seek provider partners.”–Editor Donna

The exploding black market in healthcare data

August 6, 2013 | by

When medical records’ black market value is estimated at an average of $50 per record–94 percent of health care organizations have had at least one breach in the past two years–and 2 million Americans were medical identity theft victims in 2011–it’s one unpleasant ‘pointer to the future.’

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/IDExperts_Infographic_v4_72-crop1.png” thumb_width=”150″ /]Data firm ID Experts studied a decade of data breaches and notes that medical data has become very attractive to professional hackers and cyber thieves. ID Experts’ full infographic.

  • First, there is so much of it with the increasing electronification of health data.
  • Second, so much of it resides on insecure or unsecured networks: smartphone, tablet, laptop.
  • Third, organizations and individuals still are only semi-conscious of fraud reality, and are negligent and sloppy when it comes to securing devices and over-reliance on the cloud without tight enterprise security. The new and underfunded health insurance ‘exchanges’ are particularly vulnerable as they, as well as other healthcare organizations, can over-rely on technology to protect data–which clever hackers can work around. Moreover, they can extract and sit on data till the trail goes cold. (Scroll down infographic to find out more). Also Ponemon Institute’s recent report in Healthcare Technology Online.

ID Experts’ study conclusions are reinforced by the California State Attorney General’s report that 55 percent of breaches “were intentional intrusions by outsiders or by unauthorized insiders” and that healthcare breaches were the third largest in reported incidents. A counter-measure may be the Medical ID Fraud Alliance, a collaboration in progress that is planned to include the Federal Trade Commission, the Secret Service and the Veterans Administration. More in Amednews.com (published by the American Medical Association)

Healthcare breaches due to criminal activity and plain error are becoming more common as well. All one has to do is bop over to Privacy Rights Clearinghouse, click on ‘MED’ for healthcare and 2013 and check the frequency to date (113) of breaches both tiny and huge. (By comparison, full year 2012 totaled 224.) Our TTA ‘Into The Breach’ Awards go to:   (more…)

Now an accelerator for aging tech

August 2, 2013 | by

Major Midwest non-profit aging services provider Ecumen and ‘innovation co-operative’ MoJo Minnesota are co-sponsoring The Age Power Tech Search, seeking young companies or subsidiaries of larger companies which have pioneered technology that improves the quality of life of older adults. To quote their announcement email, “AgePower differs from “incubators” or “accelerators” in that its focus is on transforming the future of aging and providing real-life test environments, along with access to business strategy experts in key areas necessary to fueling a successful new venture.” Advisory board includes many well-recognized leaders in aging services, thought and tech, refreshingly outside the usual Digital Health Hypester Horde (D3H). Four finalists gain a real-world test environment in Ecumen communities for six months. Both Ecumen and MoJo will take small equity stakes in the finalists as well.  Applications are due on 31 October; a 90-minute information session will take place on 13 August in Minneapolis (register here). Age Power Tech information and specs here.

Note to developers: This may be Minneapolis, but Ecumen is not only #17 on the 2012 Ziegler/LeadingAge list of US largest non-profit senior living organizations, but also a quick Google or LeadingAge search will uncover their large ‘thought leader’ role in both care and tech implementation. There’s no restriction on origination, but since MoJo’s put is developing business in MN,  if you are outside the state this Editor would expect a major factor would be a commitment to establishing a base there.

Angels to the rescue in health tech

August 2, 2013 | by

Funding ‘angels’ in the health tech space are increasingly taking on roles that go beyond investing.  Venture-Med Angels has funded 24 companies in seed and Series A rounds, generally at less than $500,000 along with larger syndications, in areas as diverse as Class 1 and 2 medical devices, including diagnostics, as well as mobile health, health IT, telehealth and remote diagnosis. A key problem is in this admission–so many companies have similar products or services. Common to accelerators, the Angels give their help to startups in pitches, achieving milestones and understanding the importance of their intellectual property. From company name to investment, Venture-Med Angels advise startups (Entrepreneurship.com’s eMed/MedCityNews)