How To Design Killer Apps for Healthy Living (KA4HL)

July 31, 2013 | by

21 August 2013, 6-9:30pm, John Jay College, New York, NY

This evening meeting sponsored by the 3,000+ member Health 2.0 NYC concentrates on the impact of smartphone apps and their use in health tracking. 95% of all downloaded apps are never used more than once. This event explores what factors make a behavior-changing app effective in helping people to be healthier, and what makes an app ‘viral’. Two KA4HL Rock Stars will discuss app design and then up to 10 apps will present and be judged on points. Applications are still open. Watch this spot for further information on presenters and format. Further information is on Meetup (registration on Meetup and for the group is required for access) but final registration and information will be in a week or so on Eventbrite. Health 2.0 NYC events average about 100-125 attendees and you can always expect a lively presentation, bountiful networking plus drinks and snacks.

Editor’s note: TTA is a media sponsor of and Editor Donna is a co-organizer/event producer/social media chair/bottlewasher for Health 2.0 NYC.

Contact lenses for measuring eye pressure

July 31, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/07/1-s2.0-S1471489212001993-gr3.jpg” thumb_width=”200″ /]Swiss company Sensimed Triggerfish (a most un-Swiss name!) has developed a soft contact lens for long-term (up to 24 hours) active measurement of intra-ocular pressure, a key indicator of glaucoma. Within the lens are small gauges and a transmitter which sends an output signal to a larger antenna affixed to a bandage worn around the eye. This antenna is then cable-connected to a recorder. From the recorder, the data is downloaded to the practitioner’s computer via Bluetooth. In ‘restricted commercial stage’  in CE-mark countries; submitted for 510(k) review to FDA but not yet approved in the US. Short article in ApplySci Discoveries; remarkably detailed MedGadget interview with Sensimed’s Chief Medical Officer Dr. René Goedkoop; Acta Ophthalmologica abstract.  Website. Hat tip to our Contributing Editor and TANN Ireland Editor Toni Bunting. 

Disturbing program on assisted living (US)

July 30, 2013 | by

The other (and darker) side of how many live out the last years of their lives and the poor (but expensive) quality of care will be televised tonight in the US. PBS’ Frontline will air what is termed in Forbes a ‘powerful exposé’, Life and Death in Assisted Living, premiering Tuesday 30 July at 10 pm Eastern Time. It focuses on major problems in assisted living housing, especially at market leader Emeritus. For our many readers who cannot view PBS, the ProPublica investigative journalism group who worked on this series is also publishing a series online with the same title over the next few days and as a Kindle e-book. One case taken up is a woman with advanced dementia and chronic medical conditions who would have been previously in a nursing home or skilled nursing facility (SNF). Your Editor noted that assisted living was developed as an alternative (see next article) to nursing homes in the late 1980s, ironically by the founder of Emeritus who is no longer with the company.

LeadingAge, the association representing US non-profit aging services providers (AL, SNF, home care) and the US branch of IAHSA, has wisely prepared a heads-up for members and press talking points differentiating themselves from for-profit operators like Emeritus, starting with “The Not-for-Profit Difference: Unlike for-profit communities, the leadership at our organization does not “push to fill facilities and maximize revenues.” We are not driven by bottom lines.” On point advice on talking to the press here including a communications lifeline from the association.

‘Green Houses’: a better model for senior living (US)

July 30, 2013 | by

“Let’s abolish the nursing home”–Dr. Bill Thomas

In the US, the ‘Green House Project’ model has made tremendous progress in developing homes for older adults as an alternative to nursing homes. A ‘design for living’ for 10-12 residents, a Green House is a home-like model built from the ground up with private rooms, bathrooms and community living. Currently 260 homes are open or under development across 32 states. From their website, the intent is for “Those who live in, work in, and care about a Green House [home] share the duty to foster the emergence of late-life development within the daily life they create together.” The care ratio is also much higher; care teams are organized on self-managed work teams to care for the mostly high acuity residents (including dementia). Yet costs, according to NPR, are about the same as the median for nursing homes nationally (many residents are on Medicaid) and in quality of life, it respects residents habits, privacy with the outcome that it supports residents longer in a level of independence.

The Green House concept came from the work of Bill Thomas MD, a geriatrician who also developed the Eden Alternative and frequently writes on ChangingAging.org. The news is the backing of the Green House Project by the prestigious and well-funded Robert Wood Johnson Foundation and NCB Capital Partners. The Project provides the model and guidance to independent organizations for organization, implementation and certification of these homes. MedCityNews was wowed by it (Wall Street Journal link does not work, however). See the video from RWJF on what they saw as ‘a catalyst for significant social change’.  Green House Project website   RWJF page on their support of this ‘force multiplier’.

What if you added non-intrusive health tech to these homes? The opportunities could be as varied as the ELSI Smart Floors and alert system for safety (Charles)…fitness bracelets/wearables to monitor basic vitals and ADL/activity (Jawbone, Misfit, AFrame)…biosensor ‘tattoos’ (Toni). Tablet/PC based socialization/brain stimulation (GeriJoy, GrandCare, It’s Never 2 Late). Could this humane environment move to a higher level with a touch of tech?

[This video is no longer available on this site but may be findable via an internet search]

Apple’s ‘tarnished luster’, Round 2

July 29, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/07/headeriwatchfinal.jpg” thumb_width=”200″ /]Today’s disclosure provides Apple-ologists with a major ‘what does this mean’ field day. The exec on the right no longer is on the executive team of the man on the left. On the right, Bob Mansfield, former SVP Technologies; on the left, CEO Tim Cook. AllThingsD last night (US Pacific Time) reported and confirmed that the early Sunday removal of Mr. Mansfield from the website, uncovered by the appropriately named MacRumors, meant precisely that. The ‘special projects’ assignment is usually a face-saver until the contract runs out.

We’ve gleaned some trouble in AppleLand on the odd reiteration of their eHealthy moves but slow progress on the iWatch [TTA 20 July]. It turns out that Mr. Mansfield had already announced his retirement from Apple in last year, but after some internal controversy was persuaded to return in October 2012 with a major title and compensation as head of Technologies until 2014. In this Editor’s experience, these lurebacks never turn out well even when beaucoup bucks are in the mix. We will leave it to the Apple-ologists to figure out the permutations and emanations.

Related: Will this add to the tarnish on the former Appleshine as Dave Logan had it just last week? [TTA 26 July]

Photo credit: 9to5Mac

Nurses using social media for health tech collaboration

July 29, 2013 | by

Interesting article and longish (26:04) video on how nurses are using Google Hangout for collaboration, especially on using technology as part of their practice and getting involved in tech development. The four onscreen are located in Canada, Australia and Hawaii. The author is herself an RN and health care advisor for the US Strategic Perspective Institute, a think tank whose main job is advocating ‘saving jobs’, a Sisyphean task if there ever was one. (Don’t bother to look at the healthcare blog–the last entry there was 2010.)  This is from ZDNet. Nurses use Google Hangouts to collaborate on technology

Pondering the squandering of taxpayer money on IT projects (US)

July 27, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]The Gimlet Eye has been in Observation Mode this week. But this handful of Dust-In-Eye necessitates a Benny Goodman-style Ray on another US governmental ‘fail’. When it comes to IT, the government admits…

Agencies Have Spent Billions on Failed and Poorly Performing Investments

Exhibit #1: FierceHealthIT summarizes five big ones out of a 51-page Government Accountability Office (GAO) report focusing on the inefficiency of agency IT initiatives–just in healthcare.

  1. Veterans Affairs (VA) VistA EHR system transitioning to a new architecture: terminated October 2010 at a cost of $1.9 billion
  2. VA-Department of Defense (DOD) iEHR integration: as previously written about, it collapsed under its own weight for another $1 billion [TTA 8 March]

  3. DoD-VA’s Federal Health Care Center (FHCC). Opened in 2010 as a joint facility under a single authority line, but somehow none of the IT capabilities were up and running when the doors opened. ‘Jake, it’s ChiTown.’ Only $122 million.

  4. DoD’s own EHR, AHLTA (no VistA–that’s VA’s) still doesn’t work right; speed, usability and availability all problematic. A mere $2 billion over 13 years.
  5. VA’s outpatient system is 25 years old. Modernization failed after $127 million over 9 years before the plug was pulled in September 2009

You’ll need Iron Eyes to slog through the detail, but it is a remarkable and damning document. PDF (link)

but…there’s more. Excruciating, hair-hurting, and would be amusing if not so painfully, and expensively, inept. Malware Removal Gone Wild at Commerce… (more…)

A question for our readers: what does it take for health tech to cross borders well?

July 26, 2013 | by | 1 Comment

In considering the culture gap surrounding Telefónica’s stumble down the pit with O2–and other projects they had that didn’t cross borders well–this Editor thought it worthwhile to ask our readers, particularly our new ones, to kick off a conversation in Comments about this observation. There seem to be national barriers in health tech. Why?

What are the factors that enable health tech companies to cross borders and be successful?

This is not a comprehensive survey by any means, but in your Editor’s experience, it appears that most health tech innovation by smaller companies stays in the country of design. When it is purchased by a multi-national organization, cautiousness takes hold. Much of the liveliness of PERS market leader Lifeline has dimmed since Philips acquired it about 2008, (more…)

Apple’s tarnished luster predicted, interestingly

July 26, 2013 | by

At the point where doctors and their children use iPhones routinely, iPad is the elite tablet and Apple’s balance sheet is deep in cash, University of Southern California business professor and management consultant Dave Logan is warning that the magic is waning. He uses a bit of communication analysis called ‘wordmapping’ that he’s developed to parse the remarks of Apple’s management, notably CEO Tim Cook, and concludes that Apple is losing its way. There is no longer a revolutionary-in-residence imagining something from nothing…none on the horizon, either. Apple-ologists have been tap dancing around this for awhile, but the protracted development of the Apple smartwatch is pinging all sorts of alarms, despite the flurry of activity in and around health ‘n’ fitness [TTA 20 July] We’ve been to this movie before when Blackberry was a must-have and dubbed ‘Crackberry.’ A rather cheeky headline that’s made a few AppleFans upset. Why Apple is a dead company walking (CBS MoneyWatch)

Related: Want to try wordmapping for yourself as a tool for ‘instant rapport’? Mr. Logan dishes on the fascinating pointers here.

Qualcomm Life, Palomar Health pair up to check out Glass-wear

July 26, 2013 | by

The pairing up of Qualcomm Life and California health system Palomar Health in Glassomics is certainly a novel move. It’s termed an ‘incubator’ to explore wearable computing in medicine, but it is more like a test bed for the partners. Heading it are two recognized health tech honchos–Don Jones, VP of Qualcomm Life and Orlando Portale, Palomar’s Chief Innovation Officer. Innovation and development is not new for Palomar and Portale–they trialled AirStrip, Mr. Portale’s mobile platform for it (eventually sold to them), and were key in the three-year ramp-up of Sotera Wireless’ Visi Mobile patient vital sign monitor [TTA 23 Aug 12]. Much has been made of the Glass connection and testing its healthcare chops, but their mission is not limited to ‘glassware’ (and not for your weekend drinks party, either.) It’s also a home to test out Qualcomm’s 2net connection platform and Healthy Circles Care Orchestration tools and services. Glassomics website. Gigaom article

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/07/specs.jpg” thumb_width=”170″ /]And for your weekend drinks party, here’s a cooler, lighter and less geeky take on Glass: GlassUp. It reports incoming e-mails, text messages, tweets, Facebook updates and other messages. Italian design for Augmented Reality (the new cool term for the category) of course. Yours for $299-399 on crowdfunder Indiegogo, where they are less than halfway to their goal with 11 days left (better hustle!). The Indiegogo video here.

Pressure-sensitive electronic ‘skin’

July 26, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/07/skin-monitor-130513.jpg” thumb_width=”175″ /]A thin pressure sensor under development by a team at Stanford University has the potential to impact robotics, health tech devices, smartwatches and prosthetics. A transistor made of a flexible polymer semiconductor is actually more sensitive than skin, detecting temperature, pressure and humidity, and works even when curved. At a pulse point, it not only detected pulse but also “a second, weaker wave of blood being bounced back from the extremities, and a third wave that can provide a measurement of the stiffness of the artery. Stiff arteries can be a sign of damage from diabetes, or cholesterol buildup.” LiveScience. Published in Nature Communications in May and somehow winding up in the NY Post this week.

Related:

  • the TakkTile sensor developed at Harvard which is also centered on a digital barometer [TTA 23 April].
  • another pressure-sensitive thin skin from researchers Martin Kaltenbrunner and Takao Someya at the University of Tokyo, oddly attractive on its own. Engadget

The doctor’s dilemma: I hate my EHR, but is it worth the ‘rip and replace’? (US)

July 26, 2013 | by | 1 Comment
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/07/doctor_pulling_hair.jpg” thumb_width=”150″ /]Will this doctor be able to replace his hair? Confirming EHR misery for doctors, this article in Healthcare Technology Online gives more details on the Black Book Rankings’ 2013 State of the Ambulatory EHR Market report that we presented back in February when early findings were released. Out of their 17,000 users from solo practitioners to 100+ doctor practices, 31 percent of respondents were dissatisfied enough with their EHR to consider making a change with 18% seeking to change systems within the next year. Poor usability led the reasons why. But there’s 84 percent plus queasiness about vendor viability, reasonable when there are 600+ vendors and a number have already gone out of business leaving their practices stranded. The basics aren’t enough–must-haves are support for mobile devices (80 percent), data sharing and integration (83 percent)  and patient portal (58 percent). And it has to be Web-based/SaaS  based (70 percent). One detail: confirmation of the anecdotal ‘we jumped too fast to get the Meaningful Use money’.  #EHRbacklash, indeed. 

Harvard Business School + Harvard Medical School = Forum on Healthcare Innovation

July 26, 2013 | by

Definitely for your weekend perusal, the report issued earlier this month from the first collaboration between HBS and HMS, the Forum on Healthcare Innovation, is derived from the five-panel, two-day conference, ‘Healing Ourselves: Addressing Healthcare’s Innovation Challenge’, held last November at HBS. It centered on ‘Five Imperatives’ :

1. Making Value The Central Objective
2. Promoting Novel Approaches to Process Improvement
3. Making Consumerism Really Work
4. Decentralizing Approaches to Problem Solving
5. Integrating New Approaches Into Established Organizations

Dan Munro’s Forbes article is an excellent summary of a 26 page report. Additional content and videos are available on the Forum’s website. The one certainly worth watching is Clayton Christensen’s as moderator of Panel 4 – Improving the Patient Experience (link) which focused on decentralizing care–pushing care out to consumers via clinics and decentralizing the innovation process. (The Innovator’s Prescription discusses this at length.) What is notable from the initial reading is that no one is discussing ‘technology’, HIT or mobile health specifically or as a panacea–but it is shadowing everything : effectively using patient data, the quality of that data, and ways patients can use information to guide their choices. This doesn’t seem like a single shot effort, so we’ll be watching for Round 2.

Cambridge Wireless Healthcare Special Interest Group

July 24, 2013 | by

Queens College, Fitzpatrick Hall, Silver Street, Cambridge.  Thursday 26th September 2013

The Cambridge Wireless Healthcare Special Interest Group (SIG) in association with IET, Cambridge Biomedical Campus and EAHSN present  ‘Management of long term, chronic conditions – Technology innovation in patient pathways’.

This half-day topical event will highlight the challenges and opportunities technological innovations present to the health service now and in the future. It will follow the patient pathway; from initial contact with an NHS member of staff (such as their GP), through to referral, primary treatment and support from social care services. Speakers will address the issues surrounding the remote monitoring of carers and how that maps onto the technical world with a focus on clinical improvement and patient support, safety and confidentiality.Confirmed speakers: Keith Swinburne of Papworth Hospital, Dr Afzal Chaudhry of CUH, Dr Andrew Grace of University of Cambridge, Dr Rachel Morris of University of Cambridge School of Clinical Medicine and Charles Lowe of The Royal Society of Medicine.

To find out more information and register, please visit their website. Agenda. Registration.

Editor’s note: our Contributing Editor Charles Lowe will be the kickoff speaker.

Health tech funding reshapes, diversifies

July 22, 2013 | by

In thinking how funding for health tech startups has changed since this Editor’s early days (2006) when VCs had a lock on the Letter Series (A, B, C) and your real goal was to ‘please, Lord, won’t you find me a strategic investor?’ (are there any of those left?), some more pointers to the future, both in EU and US:

Withings, known for its pioneering Bluetooth scale circa 2009, and more recently other Bluetooth monitors, nimbly moves to wearables with a fitness tracker about the size of a USB drive and priced at an affordable $99. It also has raised $30 million led by Bpifrance with $15 million, with participation from Idinvest Partners, 360 Capital Partners, and Ventech. (Most of us have forgotten that Withings is a French company.) A French challenge to Fitbit, Nike, Jawbone and a whole raft of smartwatches coming 2013-2014 including Sony, Pebble and Apple? VentureBeat

Angel funding diversifies geographically. No longer do the coasts have a lock on the action. Silicon Valley has had some problems [TTA 18 July], Silicon Alley (NY) is still finding its way and Boston/Cambridge is, well, Boston/Cambridge. We recently covered angel groups in Ohio (LaunchHouse), Texas (Wildcatters) and Arizona (SeedSpot). Now Delaware joins the list with FP Angels. And where are most of the companies? According to the Halo Report, in the US Southwest. Angel investing groups show love for the Southwest and healthcare in Q1 (MedCityNews)

And the rise of crowdfunding. As mentioned previously, angels and ‘FFF’ funding has been supplemented and market tested by crowdfunders such as Kickstarter, IndieGogo, MedStartr and Health Tech Hatch. Two kitchen-table entrepreneurs can market test their idea almost immediately. The problem is failure to deliver on time, on budget and as promised, as witnessed by the overwhelmingly successful Misfit Shine. The math of Hardware+Crowdfunding=Success has more than a few caveats in the formula. The hardware revolution will be crowdfunded (VentureBeat)

And a little-noticed change in Securities & Exchange Commission (SEC) regulations lifted the ban on ‘General Solicitation’ which according to this Forbes article will allow entrepreneurs seeking funding to cast a net beyond their network of ‘pre-existing relationships’–but they have to be accredited investors. It makes the reach to non-accredited investor interest just a little bit closer–for good or ill. The SEC’s Removal of General Solicitation Changes Everything

For our readers, health tech appears ‘siloed’ by region and country. What does it take to move beyond borders?:

  • If your startup is based in the UK or EU, have you thought about reaching out to US funding through a US base?
  • If you’ve considered and rejected it, why? (Health tech
  • Why are we not seeing more activity by UK/EU companies in the US (or Americas) markets?
  • What do you perceive as the differences between developing health tech ex US–and translating it to the US market?
  • Has anyone had experience extending in non-US/UK/EU markets?

News ‘shorts’ for shorts weather

July 22, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/07/00114031.gif” thumb_width=”150″ /]It’s summer on both sides of the Atlantic–and shorts were spotted at the British Open! Thus a ‘short’ roundup of three items of interest–but this is after you read Charles Lowe’s superb Soapbox on bidding the WSD farewell, and TANN England’s Chrys Meewella’s latest on rural telemedicine.

An update on the US Department of Defense’s and Veterans Affairs’ efforts to combat PTSD. “Every VA facility is now required to provide evidence-based treatments for PTSD, including prolonged exposure” (PE). PE asks the patient in session to revisit, in their minds, the traumatic event. A study published in JAMA Psychiatry in July examined treatment by relatively novice therapists using PE with over 1,900 patients for PTSD and depression, and found that PE was effective in reducing both comparable to previous trials, plus “The proportion of patients screening positive for PTSD on the PTSD Checklist decreased from 87.6% to 46.2%.” The Reuters Health article reprinted in MedCityNews is an overview; link to JAMA abstract is here (subscription or library access required for full content.) TTA related: PE smartphone app coach 6 Aug 12.

Adding teddy bears to wearables, from Croatia…IDerma has developed Teddy the Guardian, a stuffed bear that according to a PSFK report records a child’s heart rate, body temperature, blood pressure and oxygen saturation, then sends the data to the parent’s smartphone. All the child does is to put their finger on Teddy’s paw or the paw on their forehead. According to the article, the sensors are CE/FDA approved, but reading this over, the system is not FDA approved nor is it in production. Note the IDerma engagement with Croatia’s bid for entry in the EU and the young entrepreneurs behind it. Hat tip to Toni Bunting, our new Contributing Editor and TANN Ireland editor.

Pointer to the future. Webnapperon form factors PCs into everyday objects. This Belgian based company reimagines a simplified PC as everyday, familiar objects on a side table–a picture frame is the screen, a doily interacts with the computer and through its RFID reader, reads a tagged item from family and friends that looks conventional, but has an RFID chip that delivers additional content  Apparently very little capability beyond this from the article but but perhaps serviceable for the oldest–and a pointer to the future in accessorizing objects with RFID chips. Springwise.com, and another hat tip to Toni Bunting. Website (in French)