Following our coverage of CTE and mTBI (mild traumatic brain injury) at the GCRI presentation last week, a small-town football team is one of the first to pilot, albeit for three days, a new concussion detection technology developed by i1Biometrics. The Middletown, NY high school tested their Impact Sensing Mouth Guard that measures hits to better assess the likelihood of cumulative blows and outright head injuries. The mouth guards recognize cheek tissue for activation, and function as a standard mouth guard plus accelerometer and gyroscope to detect the hard-to-determine rotational acceleration. Data is then transmitted wirelessly to a monitoring station (laptop) where trainers can analyze the data. The i1Biometrics system will be further tested this fall at Purdue and the University of South Carolina. Article (Times Herald Record); i1 Biometrics website.
Contact sports, long term effects and CTE
The effects of chronic traumatic encephalopathy (CTE) are likely far more widespread than the National Football League (NFL) and thousands of combat soldiers in Iraq and Afghanistan. That evidence was presented this past Monday at the German Center for Research and Innovation (GCRI) by two leading researchers in the field: Robert A. Stern, MD of Boston University and Inga Koerte, MD of the Ludwig-Maximilians-Universität München (LMU). The panel was moderated by Alan Schwarz of The New York Times, a freelance sportswriter/baseball stats expert-turned-concussion investigator/writer whose articles on sports concussions and long term effects are helping to change US sports safety. Update 10 June: video (1:38:00), event summary. (more…)
A selective look at health tech startups, toys and keeping it clean
Joan Justice, as Curator-in-Chief of HealthWorks Collective, always provides a quirky look at cool stuff in health tech. Her second round goes a bit afield of health, but what’s interesting: ClearMD (DIY provider videos for patients), Picmonic (medical student education audio-picture mnemonics), Cobalt Research (web-based Cognitive Behavior Therapy (CBT)) and Accessible Home Living (designing/remodeling for older adults/disabled needs). Health Start-Ups!: Another Round And what motivates serial healthcare entrepreneurs to be..serial? Check out her video interview with John Deutsch, current CEO of New Wave Enterprises, LLC who has been part of several EMR startups.
Ready to DIY? MIT Little Devices Laboratory is now developing MEDIkits (Medical Education Design Invention Kits) in diagnostics and therapeutics: drug delivery, diagnostics, microfluidics, prosthetics, vital signs and surgical devices. And the devices are built from–Lego parts, the internal workings of other toys with electronic parts, LEDs, and more–all to enable creative thinking in device development from a wide number of people outside traditional labs. The Little Devices Lab also has a collection of videos and press on their blog here. Can Toys Decrease the Cost of Health Care Devices? (HealthWorks Collective)
And ready to get clean? In the US, it is estimated that 100,000 people yearly die because of hospital-originating infections, largely due to poor hand hygiene. IntelligentM, a bracelet for hospital staff who are in contact with patients, reminds and checks for cleanliness. The device determines through its built-in accelerometer that hand washing and sanitizer are being used–and correctly. In communicating with RFID sensors at hygiene stations, it also reports compliance. Currently being tested at a hospital in Sarasota, Florida with two other locations shortly to adopt, and with potential uses in food service and with children. MIT Technology Review. Gizmag.
Is Silicon Valley-style thinking right for healthcare?
The always thoughtful David Shaywitz writes about coming out on the other side of the Gartner hype curve (ever so familiar to this Editor) into the ‘plateau of productivity’. He provides some anecdotal evidence from his Silicon Valley experience that you could possibly take the good parts of Hope and Hype and make them work for Health. His qualifiers lead this Editor to the following takeaways, with which Dr. Shaywitz might not necessarily agree:
- You the entrepreneur may well be thinking about changing the world with your service or device, but you might be better off focusing on solving a specific problem (or in Clayton Christensen’s terms ‘a job to be done’) and then being gratified when you do, actually, find a way to change the world and yes, you make some money for your investors. The Epic EHR started quite modestly.
- Silicon Valley observers are onto the hype cycle there– “the contrast between grandiose ambitions and disappointing delivery.” You should be too. If you’re in health tech, steer clear of the hypesters and the cocktail parties. In fact, be more like Dr. Shaywitz’s colleagues at MIT, understanding “the limitations of your work and the enormity of the unanswered questions remaining.”
- Aim for more than tweaking something existing–the incessant efficiency innovations so attractive to VCs in this ‘stuck on stupid’ economy–and “learn how to develop profoundly improved therapies, that cure – or better yet, prevent – disease and disability. ” Break out of what Dr. Christensen’s ‘broken circle.’ [TTA 9 Nov 12]
- Most startups fail, and to date there are far fewer successful exits in healthcare than in social media, which is why VCs like them ever so much more and they get the billion-dollar exits. More realistic is a modest return and a long development curve. So when seeking funding, be conservative and find alternate means.
Instead of pharmaceuticals, electroceuticals?
Electroceuticals–using electrical impulses to modulate the body’s neural circuits as an alternative to drugs–are gaining momentum, and probably a lot closer to being realized than say, genomics. According to the article, if you can map how a disease affects the neural circuitry, then ‘remapping’ through stimulating or inhibiting the malfunctioning pathways via tiny electrodes may show a way to health without biological drugs. For instance, stimulating the vagus nerve seems to reduce the production of cytokines — immune system mediators — and blocks inflammation through boosting the immune system. It has been successfully used on a preliminary basis in treating inflammatory disease with rheumatoid arthritis. Multiple research teams have experimented with additional conditions such as respiratory diseases, asthma and diabetes–and possibly neuro-psychiatric disorders like Parkinson’s and epilepsy. It’s been successful enough to date to warrant a small investment from pharma giant Glaxo Smith Kline (GSK). Wired.co.uk
Health tech growing fast in Brazil and Asia-Pacific
Brazil’s strong growth in mHealth and medical apps is detailed in three recent studies from PwC, PwC-GSMA, Research2Guidance and the New Cities Foundation. PwC is pegging mobile health apps at $46.6 million by 2015, with PwC-GSMA projecting that 43.9 million additional patients could be treated with mobile health technology in Brazil and Mexico by 2017. Research2Guidance confirms that Brazil’s an Android market, outselling iOS in the 10 most downloaded health and fitness apps by 17 times. The Geneva/Paris-based New Cities Foundation equipped doctors and nurses at a family clinic in Santa Marta, Rio de Janiero, Brazil with a $42,000 ‘backpack’ for home care, containing a GE Vscan portable ultrasound, a TuffSat pulse oximeter, an Accutrend blood monitor, an EKG machine, a blood pressure monitor, a weight scale, a digital thermometer, tape measure and stethoscope. Savings were about $200,000 per 100 patients/year. Mobihealthnews.
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”100″ /] The Gimlet Eye, having read this, just sent a message to your Editor. Could it be The Eye’s undisclosed location? Perhaps we should be… ‘Flying Down to Rio’?
In Asia-Pacific, the $55 billion APAC medical devices market–nearly 25 percent of the world market– is expected to grow over 10 percent per year over the next three years, outstripping rest-of-world growth by 4 points. Growth in China and India is especially striking, with India’s medical device growth at 16 percent per year for three years. Healthcare is improving in less developed areas, and the age 65+ population in greater developed countries is increasing as a proportion of the population as birth rates fall (in Japan, 24 percent–with Japan also the overwhelming leader in patents). While much broader than mobile health or telehealth, the overall category serves as a pointer to growth opportunities in the very near future. MD+DI Hat tip to reader George Margelis, MD via LinkedIn, who advocates Australia take a greater leadership position in developing ‘medtech’.
Avatars to help schizophrenics cope with ‘the voices’
One of the most common features of schizophrenia is the inability to control the voices that tell you what to do–at minimum annoying, but sometimes urge you to harm yourself or another. Anti-psychotic drugs do not silence them in 25 percent of cases. This approach from University College London researchers puts faces to the voices–and, by letting the patient create them, gives the patient control. With a therapist, each of the 16 patients in the study created an avatar with a computer-generated face and voice ‘matching’ the ‘voice in the head’.
In up to seven 30-minute sessions, each subject interacted with their entity’s avatar, and were encouraged to oppose its threats and orders. Not only did this allow the subjects to get comfortable with the idea of standing up to the “actual” entities themselves, but because they had taken part in creating the avatars, it helped them realize that the entities actually originated within their own mind. Additionally, each subject received an MP3 recording of their sessions, which they could listen to whenever they started hearing voices again.
Almost all participants experienced a reduction in the frequency and severity of their episodes–and three of the subjects, who had been experiencing hallucinations for 16, 13 and 3.5 years, stopped hearing voices completely. The research team just received a £1.3 million (US$1.98 million) grant from the Wellcome Trust to expand the research starting in July. Avatars help schizophrenics gain control of voices in their heads (Gizmag)
Sensory feedback adds to prosthetics and situational awareness
There have been a number of prosthetics developed in recent years that directly connect with nerves, but their drawbacks have included deterioration of the nerve-prosthetic connection over time and lack of reliability in acting like a natural limb. With over 2,000 American military personnel suffering major amputations since 2000, the US Department of Defense’s DARPA (Defense Advanced Research Projects Agency) is working to advance better nerve-connected prosthetics through the RE-NET–Reliable Neural-Interface Technology–program. DARPA uses nerve/muscle interfaces to give amputees feedback and improve control (Gizmag) For the sight-impaired, the Russian company Oriense is extending its technology that assists robots to avoid objects to a human-worn camera/sensor combination. It combines a Primesense sensor (akin to Microsoft’s Kinect camera) with Oriense’s software which scans data from the sensor and gives voice notifications about where objects are and if they are directly in your path. The prototype would not be out of place on a robot (camera on chest, computer in hand, earbud) but second generation promises to be more streamlined. From robot tech to humans: hardware to “see” the world around you (MedCityNews).
AdhereTech wins Healthcare Innovation World Cup
AdhereTech, a med reminder startup from the Summer 2012 Blueprint Health class, recently won the $50,000 Healthcare Innovation World Cup sponsored by Boehringer Ingelheim and organized by NYC-based independent healthcare research organization HITLAB (Healthcare Innovation Technology Lab). The annual competition challenges innovators in healthcare and IT to help solve global health issues; this year’s focus was diabetes prevention and management. AdhereTech is nearly to market with an M2M-connected compact bottle for pills or liquids that not only reminds, but also provides a measurement of pills/liquids remaining in the bottle [TTA 28 March]. Second place with a prize of $10,000 went to Indian company Team IITKgp which is developing a non-invasive blood glucose measurement device. Runners-up: in third place with an award of $5,000 was India’s Team SmartSense, developing a multianalyte sensing device for diabetic ketoacidosis (DKA) and Ohio’s Team EndoGoal, a mobile and web-based social rewards program for people with insulin-dependent diabetes who track daily glucose levels. All four teams had previously received $2,500 for reaching the final rounds as semi-finalists in the US and India. The awards were hosted by the German Center for Research and Innovation (GCRI). Congratulations to all. Release. Website
FDA regulation of mobile health: a study in ambiguity
The signs are not good when FDA continues to delay on issuing its draft guidance on mHealth devices (now tagged for the close of FY 2013), yet sends a notice to India’s Biosense Technologies Pvt Ltd, developer of the uChek Urine analyzer app, that it immediately needs to seek 510(k) Class II clearance. Biosense claims Class I clearance; FDA claims that it has no record. Letters fly, yet the app remains in the iPhone AppStore. How can there be a crackdown on mobile health apps, as FierceMobileHealthcare’s Greg Slabodkin projects, when developers legitimately say there’s no rules of the road? Magic 8 Ball says: ‘In The Fog’. Also Mobihealthnews.
Previously in TTA: FDA regulating medical apps–or not? The Hearings. If not FDA to regulate mHealth, then who? An ‘Office of mHealth’ a solution for FDA gridlock?
‘The new era of connected aging’
The Center for Technology and Aging’s latest white paper posits their vision on how online and mobile technologies will increasingly be used to support older adults in living independently longer and in better health, as well as assisting caregivers. Use of mobile phones, social networking and tablets have all been on a gradual growth curve, with phones well above 60 percent in the over-65 age bracket. The technology is also moving away from single-purpose devices to those that integrate with phones and tablets. The New Era of Connected Aging: A Framework for Understanding Technologies that Support Older Adults in Aging in Place
Curating consumer health apps 2.0
With Happtique apparently exiting the health app curation/vetting for consumers business [TTA 17 May], HealthTap, which has built up several doctor-related applications such as a provider directory, Q&A and referral service, is entering with AppRx. It takes a semi-crowdsourcing approach to curation, building up reviews and recommendations from its claimed 40,000 physician users which are then reviewed by a ‘medical review board’ of chosen physicians. For both doctors and patients, AppRx has its own interface for viewing the Apple and Android app stores and further breaks down types of apps into 30 categories. Prescribing is in the future. If this sounds more than a bit like Happtique’s mRx, it does–in the originally conceived version. HealthTap’s also been well-financed– $38 million by Khosla Ventures, Mayfield Fund, Mohr Davidow Ventures, Eric Schmidt and various angels. HealthTap takes on app curation, prescribing (Mobihealthnews)
iAwards winners announced today at WLSA
TripleTree’s iAwards were announced this afternoon (US) at the finale of this year’s Wireless-Life Science Alliance’s (WLSA) annual Convergence Summit. From a field of 12–AgaMatrix, AliveCor, Asthmapolis, Carenet Healthcare Services, CareTicker, Change Healthcare, Cyracom, Etransmedia, Evive Health, Healthsense, Qualcomm Life and Trice Imaging–the winners are in three areas plus one: Clinical Effectiveness —Healthsense (telecare, at long last!); Consumer Engagement–AgaMatrix (diabetes management technology); Operational Effectiveness–CyraCom (on-demand language services.) In addition, special recognition was given to Asthmapolis as the recipient of its 2013 Horizon Award, recognizing ‘their unique advancements in chronic disease management via connected health’. The annual iAwards at WLSA, sponsored by healthcare investment capital firm TripleTree, honor companies demonstrating, insight, innovation, and initiative in healthcare technology. TripleTree release.
mHIMSS Convergence Summit coverage starts with the interesting conundrum of the person who will be readmitted for his/her diabetes:
Three people who’ve been newly diagnosed with diabetes are discharged from the hospital on the same day. Who’s most likely to be re-admitted soonest? That would be the one with the worst credit rating. Someone who can’t keep track of his or her finances probably won’t be able to keep up with his post-discharge regimen.–Harry Greenspun MD of Deloitte
This Editor hears Big Data calling…After all, healthy people have more fun….Putting the “fun” back into healthcare
Plus…Live/podcasted coverage of the Convergence Summit:
- HIBC.tv (Health Information Broadcasting Consortium). You will have to search through the lengthy menu of thumbnails below for later coverage (look for WLSA) but the first group of keynotes featuring Dirk Stanley MD, Rob McCray (WLSA), Joseph Kvedar MD (Center for Connected Health) and Chris Penrose (AT&T) is here (53:34). A second 3: 20 video with Bruno Leroy (Sanofi) is here.
- mHealthZone Live on BlogTalkRadio: Ben Chodor has been continuing his radio podcasts on the mHealthZone now live from the WLSA: Day 1, Day 2 (today). All broadcasts approximately 35:00.
Appurify perhaps a solution for Misfit’s Android blues?
Appurify is a new, still in beta, service that states they are the first to fully automate the process of testing mobile apps across devices. It is competitive against two services–Perfecto Mobile and Device Anywhere–but claims the latter have manual aspects in their testing that Appurify does not. Their testing claims to be on real devices in real user conditions, with real devices hooked up to its servers so they can suss out performance on, for example, AT&T’s 3G compared to Verizon’s 4G. Appurify just received $4.5 million from Google Ventures to raise its funding kitty to $6.25 million. Perhaps they could help out Misfit with Android below? VentureBeat
Misfit Shine debut delayed, minus Android
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/05/leather-band21-1024×682.jpg” thumb_width=”150″ /]Announced to Misfit Shiners on the Saturday of the Memorial Day holiday weekend, of all times, was the further delay of their wearable tracker-sensor to mid-July from early June. The five to six week delay due to waterproofing was less aggravating to many pledgers than the dropping of Android compatibility for iOS only. To those early birds who enthusiastically pledged their money to buy 10,000 units as part of the $846,000 incredibly oversubscribed placement on Indiegogo, the squishily worded justification on their blog from founder Sonny Vu, ” iOS allows us to roll out the features we want and give you the best user experience out of the box” did not satisfy–and the date of Android’s debut was not addressed. Comments on Indiegogo are not complimentary. With not only the kickstarter funding but a healthy jolt of Series A funds ($7.6 million), it is a mystery to most why Android is not supported from the start. Refund requests are a-go-go. So Misfit is sleek, waterproof….and has to overcome bad word-of-mouth from its funders just before its official debut. And directly competitive Fitbit and Jawbone UP support Android. Crowdfund Insider, Mobihealthnews
Robots go squishy, exoskeletons do not, and here’s your drink
Gizmag profiles another soft robot, this out of University of California Berkeley with a hydrogel/graphene layer that causes it to flex when exposed to light. A natural to combine with the Harvard/Wyss/DARPA chameleon [TTA 23 Aug 12] or, according to the article, drug delivery and tissue engineering. 0:36 video demos the gel in a ‘hand’ flipping its ‘fingers’ by laser light. Soft robots could benefit from new light-controlled hydrogel
Honda, one of the many companies developing exoskeletons to assist movement, is the first to lease 100 of them to 50 hospitals in Japan for testing. After 14 years of development, it’s about time. The current model is 2.6 kg (5.7 lbs.) and according to Honda, will “improve the symmetry of the timing of each leg lifting from the ground and extending forward, and to promote a longer stride for an easier walk.” Exoskeletons have been developed on three purposes. The first is assistance to the elderly and those in rehabilitation (Honda’s, Cyberdyne’s HAL, EKSO Bionics, Argo ReWalk TTA 29 June 11). The second is industrial (Honda as well.) The third is military, to support soldiers’ strength in the field and in combat conditions (RB3D, Raytheon and Lockheed Martin; also DARPA/Harvard/Wyss TTA 27 July 12) Honda begins leasing Walking Assist Exoskeleton (Gizmag)
And after all this, wouldn’t you like a drink? Coming right up…. Cornell University’s Personal Robotics Lab adapted a Willow Garage PR-2 to serve you a beer or your favorite beverage. For a robot, anticipating human actions is a real challenge. That simple top-up of a drink can, if actions are not correctly interpreted, mean a big spill. So the Cornellians programmed the robot with 120 3D videos of people in everyday tasks, broken down into subtasks that the robot then recompiles into models of different activities, and then equipped the PR-2 with a Microsoft Kinect scanner to build up a 3D map of the objects present, so that the robot can then ‘observe’ how they might be used. It gives you pause to realize that simple everyday activities are made up of a myriad of subactions. Robby, pour me a tall one….Cornell develops beer-pouring robot that anticipates people’s actions (Gizmag again)
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