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)

NaviGo Health: matching doctors and patients like a dating site

July 20, 2013 | by

Here in NYC, the major success envy story for eHealthy entrepreneurs has been doctor appointment-setting website ZocDoc. With multiple rounds of funding from the likes of Goldman Sachs, it’s appeared to have unassailable ‘cred’ and ownership on a national basis. Cleveland Ohio-based NaviGo Health wants to cut a small and specialized slice of this pie through using a ‘dating model’ process. (This Editor wondered “why didn’t I think of that?”) Their platform CompassMD matches newly diagnosed cancer patients with doctors, based on how both parties answer a list of questions based on communication, decision-making, treatment and personality preferences. The founders are working out of co-working space at a Shaker Heights Ohio accelerator, LaunchHouse (built in a 1950s car dealership!), and on ‘FFF’ money attempting to snag a pilot. The website’s a home page, they tweet at @navigohealth. Can a few docs out there lend them a hand on their pilot? Maybe some crowdfunding and Health 2.0 folks to the rescue? Compatability (sic) matters: NaviGo Health puts an online dating-style twist on physician searching (MedCityNews)

VA distributing iPads to Family Caregivers (US)

July 20, 2013 | by

Back in May 2012 we noted a Veterans Affairs (VA) program for 2013 that would distribute 1,000 iPads to primary caregivers of seriously wounded veterans to facilitate care delivery and data transfer. Then called ‘Clinic-In-Hand’, it is now officially debuting as the Family Caregiver Pilot for caregivers of seriously injured post-9/11 veterans already enrolled in VA’s Family Caregiver Program. The intent is now more clearly focused on reducing caregiver stress, via  pre-loaded apps to share health information, coach patients through chronic pain and PTSD and serve up tools such as reminders and a health journal. A second, the Veteran Appointment Request Web App Pilot, facilitates appointment setting via mobile or desktop PCs for a separate test group of 600 veterans and was launched at the Washington, D.C. VA Medical Center and VA Palo Alto (California) Health Care System. According to EHR Intelligence, if successful it will be rolled out to all patients at these two VA centers with a system rollout in the future–complicated by the fact that every VA center has a different scheduling system. Meanwhile, VA’s VistA and the DOD’s AHLTA still don’t talk to each other. VA integrates mHealth into daily care, gives iPads to vets (EHR Intelligence); VA Mobile Health release (for additional details go to the left hand drop-down menu). Hat tip to Contributing Editor Charles Lowe.

Apple-ologists discern ‘new’ interest in health tech and telehealth

July 20, 2013 | by

With the same obsession that Kremlinologists had during the Cold War, the Apple-ologists at 9to5Mac divine that Apple is now suddenly interested in the sensor-based fitness sector of telehealth. Recent remarks by their CEO have been examined like the mutterings of the Oracles at Delphi. Their SVP of Technologies has been spotted wearing a Nike FuelBand, just like the CEO–and by looking at his picture, he does need it! Apple Marketing folks have been examining wearables like the Jawbone UP! (naturally as competition, duh!) Far more indicative from their sources: An all-star team from semiconductors to batteries to sensors is working in secrecy on the long-awaited iWatch. Talent’s been snatched from telehealth sensor companies AccuVein (vein mapping), the recently defunct C8 MediSensors (blood monitoring), and Senseonics (embedded sensor for blood glucose).  And they are most interested in sleep tracking. iWatch’s novelty emerges as Apple taps sensor and fitness experts

Apple’s been interested all along in healthcare–and others have been interested in Apple

No surprise to TTA readers, as you’ve been tracking Apple’s and competition’s healthcare moves along with us from the start.

  • the iPad in hospitals and their preliminary tests starting in early 2011 when tablets were new and untried [TTA 8 Feb 2011]
  • Editor Steve on the Apple Smart Shoe US Patent application back in January
  • Samsung’s hype on healthcare devices and software on the new Galaxy S4–fitness tracking disruptor?
  • 5.5 million plus of health app downloads (US) from the App Store (May)
  • the development of many devices that are based on the iPhone (Misfit Shine, AliveCor‘s ECG, the Ozcan microscope and food testers only a few)
  • …though Microsoft’s Surface for healthcare back in February is likely a dud–MS just wrote off $900 million with the Surface RT, lowered its price (though only a fool with money to burn would buy it) and the Pro continues to struggle (ZDNet)

Smartwatches as the 2013-2014 tablet…and will they knock out fitness bands?

But this press focus on ‘Apple for Health’ does disguise that Apple is behind the curve, not leading it, on the watch form factor. Just like the Soviets, Apple better get a move-on or lose the race that gets serious next year. Smartwatches are fast becoming the new tablet [TTA 2 July]. One rosy industry estimate has 5 million units sold by end of 2014 (Canalys Research in Gigaom). Sony’s been there for awhile. Pebble sold 275,000 pre-orders through Kickstarter, their web store and now retail through Best Buy. This week the rumor broke among the Microsoft-ologists that they are working on an aluminum smartwatch with a 1.5-inch screen and a band out of Star Trek IV. (The comments below the TechCrunch article on the very thought of smartwatches are a good chuckle!) And undoubtedly looking over their shoulder because they’re gaining on you, contrary to Satchel Paige’s advice, are Fitbit, Jawbone and Nike, wondering if they’ll be the next Zeo.

In changing behavior, ‘wanna’ works better than ‘hafta’

July 19, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/07/carrot-cake01.jpg” thumb_width=”150″ /]The proliferation of apps, tracking programs and devices that promise to change your life through Quantifying Yourself and lead you to the New Jerusalem of fitness and health is fascinating in number and variety. Yet why do some apps and programs do their job of changing behavior–and others, equally well-intentioned, do not? It’s all about ‘wanna’ vs. ‘hafta.’  Tracking your caloric consumption quickly turns into a ‘hafta’ drag for most (MyFitnessPal), but if you plug into a lively online community (Fitocracy), make the app easy to use and the changes gradual, plus forgive a few lapses, the same activity can start feeling rewarding and ‘wanna’. It’s all about personal autonomy, reward and control. It may be carrots rather than carrot cake, but you’re doing the choosing. Must reading for those working to develop corporate wellness programs, sticky apps and engage users. Why Behavior Change Apps Fail To Change Behavior (TechCrunch) Hat tip to reader Sandeep Pulim, MD via LinkedIn.

Related: Our April discussion of employee wellness programs, Employee wellness: Carrot? Stick? Or something else?

An example of simplification helping to increase positive behavior–and perhaps outcomes–is the recent study of the Center for Connected Health’s BP Connect program. Mobile users took their blood pressure more often than the telephone hub/device users; these older users (median age 61!) found the mobile version both easier and more convenient in portability. Overall BP scores went down moderately. Connected Health Study Finds Mobile Health Improves Patient Engagement (HIT Consultant)

Google Glass through a doctor’s eyes

July 18, 2013 | by

John Halamka, MD, CTO of Beth Israel Deaconess Hospital in Boston, writes about his experience testing Glass in the clinical environment and sees five useful areas–documentation, alerts and reminders, ED dashboards supplementing or displacing tablets, decision support (Watson, anyone?) “Just as the iPad has become the chosen form factor for clinicians today, I can definitely see a day when computing devices are more integrated into the clothing or body of the clinician.”  Not the Object of Evil painted by the consumer IT gearheads and privacy advocates.  Perhaps an ideal place for this? But is this Editor the only one who finds that ‘Meaningful Use Stage 2’ compliance (assistive technology) in the #1 position a bit odd?  The Health Care Blog (Health 2.0) Hat tip to reader Bob Pyke via LinkedIn.

Is health IT funding hot and not just warm?

July 18, 2013 | by

Mercom Capital Group has also been on the trail health IT/digital health investment trends–we last looked at their 2012 report in January— and finds the opposite from the mid-year ‘warm not hot’ RockHealth digital health investment report [TTA 9 July]. They see sizzle in the $1.1 billion invested to date ($623 million in 2nd Quarter alone) in 272 deals done, versus RockHealth’s $849 million. This may all be in the definitions and the composition of companies surveyed–they had commonality on only two of the five leading deals (the leading deal for both was Proteus, the other was Watermark). Mercom is also predicting a bullish $2 billion this year which would double their 2012 market total ($200 million lower than RockHealth’s). They both see a shift from practice-focused to consumer-focused technologies–and the concentration in deals by 11 funders. Executive summary, announcement, FierceHealthIT article.

Related: A sobering article in Wired depicts the ‘series A crunch’ affecting now over-valued Silicon Valley tech startups moving from overly generous angel and private investors to hard-nosed venture capital companies. Part of the problem is, ironically, accelerators, which polish start-up founders’ presentation and business planning skills to the point where they look better than they should to angels, and perhaps get more than they should. Investors are still ‘dabbling in digital health’ (RockHealth’s POV), and that may actually be…healthy. A Fleet Street (or NY Post)-worthy lurid headline: The Screams of Crushed Startups Echo Across Silicon Valley

Funding: the concentration continues

July 15, 2013 | by

The funding concentration trend apparent in RockHealth’s latest survey [TTA 9 July] is not contradicted by latest bits of news:

  • PracticeFusion, a free physician, web-based and ad supported EMR, is rumored to be raising $60 million from what Venture Beat last week termed “a New York-based investment firm, not one of the usual (local) Silicon Valley suspects.” Now we can suppose that sources would be silent unless the deal was signed, sealed and delivered. The leaks can also be strategic ones. (PracticeFusion has also introduced PatientFusion, a PHR with added functions of booking appointments and leaving doctor feedback–which puts it squarely in ZocDoc’s increasingly challenged, but extremely well-funded territory. (We advise them to put aside a few dollars for the inevitable MMRGlobal challenge as well.) Having raised $34 million less than one year ago, the funding is clearly going to updating ‘Meaningful Use’ requirements, the patient portal and to be determined growth.
  • Chicago-based Caremerge just raised $2.1 million for its mobile apps for coordination of long term care (LTC) between providers, doctors and families. (MedCityNews)  It claims to be the first-ever integrated mobile and web solutions provider for this market. It does answer a crying, not-terribly-glamourous need in senior care, and it’s also interesting that two of the key investors are from Poland and Switzerland. But Caremerge has deep roots in GE-land: one of its founders came from GE Healthcare IT Solutions and it’s currently part of the StartUp Health/GE Healthymagination program–which accepts only companies further along in their development for their $250 million fund, and takes a generous slice of equity for advisory services rendered. [TTA 10 Jan, 7 March, 4 April]
  • Health tech accelerator Blueprint Health announced its latest class–and they are increasingly not in the earlier pattern of true startups in need of guidance to appeal to angels and VCs. Five of the ten companies already have customers, versus two in the previous class. Is this mission creep? According to an article in Gigaom, their co-founder has said that they are not deliberately looking for more ‘mature’ companies, but are nonetheless accepting them. Of course, early stage companies that have already gotten into the market have a greater chance of success and look better on the record of any accelerator program. Another trend is B2B rules. Only one of the picks is consumer focused (health coaching) and another is engaged in employee wellness rewards adopted by companies.

Are these pointers to the future, at least in the US?

  1. Nascent maturity and realism in business plans–the horizon narrowing
  2. The continued collapse of practice EHRs into a few trusted providers [Doctor backlash brewing, TTA 22 Feb]
  3. With less funding to go around, and with few companies moving from A to B to C rounds, will future investment and development go to those who have already gained traction in customers and previous investment–and somehow got to that stage with the help of angels and crowdfunding?
  4. Is it the end of the Quantified Self consumer device buzz? These investments, and the past quarter’s, are largely in the surer, more VC-acceptable water of B2B tech.

New York, New York, it’s a health tech town (Part 3/wrapup)

July 12, 2013 | by | 2 Comments

Part 3: When is a Summit only a hill? And The Pioneers overload the Conestoga Wagons.

(Disclosure: TTA was a media partner of DHS at CEWeek. We also remain a proud sponsor of and provide volunteer services for Health 2.0 NYC, the presenter of Healthcare Pioneers. Our readers should know that these relationships do not exclude this Editor from noting the thick and thin of both events, not rendered in pale pastels.)

Digital Health Summit @ CEWeek

Four floors up from a busy show floor, and after interviewing Tal Givoly, CEO and Oren Fuerst, PhD, Executive Chairman, of startup health information company Medivizor (Part 2), assistants moved attendees into the room for the start of the New York/CEWeek edition of the Digital Health Summit at 11:30 am. It opened with a fairly anodyne presentation by the Executive Director of the NYC Economic Development Corporation (NYCEDC),   (more…)