https://telecareaware.com/

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]TripleTree, a VC that funds many iHealthy companies, casts a hopeful eye (certainly not a Gimlet Eye) at the consumer-driven growth of health tech and finds the steam generated by the Quantified Selfers and Fitness Addicts, stoked by the Healthcare Digerati who are not Going Surfing USA, is cooling fast and flatly. The Big Bucks are betting on ‘nudging’ (or as Aunt Lillian put it, ‘nooodging’) those diabetics, overweight couch potatoes, smokers and consumers of 72-ounce sodas, those naughty 20 percenters who spend an estimated 80 percent of US healthcare money, towards the New Jerusalem of Healthy Lifestyles and Big Savings. Of course, as the writer points out, payers and pharmas are still gathering data and documenting that increasing physical activity or sensoring med reminders, despite their Quantum of Cool, actually gets everyone to this destination and not another. One increasingly popular Road to Perdition is to introduce the refractory to the Carrot und Stick Gauntlet located at the corner of Tech, Privacy and Cost [TTA 21 March.] But the intensely blinking Big Yellow Light is that the Diabetic Experience [TTA 5 April] points out that ‘nooodging’ people to do something they don’t wanna and has uncertain, variable outcomes is not necessarily Their Road to Damascus. Personal Fitness, Chronic Condition Management and Connected Health

While The Eye takes The Road to the Beach in a 1946 Buick Super woody, Editor Donna notes the listing at the end of the article of the dozen finalists for the iAward to be announced 30 May, including AliveCor, Healthsense (a telecare system!) and Qualcomm Life.

Now a virtual therapist

“Ellie” the Virtual Analyst has it right down to the ‘uh-huhs’ in responding to her patients, but she really excels at taking the measure of body language. According to the NPR interview with University of Southern California’s (USC) Institute for Creative Technologies’ lead developers, psychologist Albert “Skip” Rizzo and computer scientist Louis-Philippe Morency, “Ellie tracks and analyzes around 60 different features — various body and facial movements, and different aspects of the voice. The theory of all this is that a detailed analysis of those movements and vocal features can give us new insights into people who are struggling with emotional issues. The body, face and voice express things that words sometimes obscure.” Movement is tracked by Microsoft Kinect, voice by a microphone. This is the flip side of their original telementalhealth research from last year with simulations of virtual patients for training psychiatric residents [TTA 14 Aug] and PTSD assessment [TTA 28 Oct 11]. Like both of these, this was originally commissioned by the US Department of Defense for PTSD diagnosis, so Ellie provides a report at the end of each session. Your Editor also thinks there’s commercialization potential in the growing category of ‘couch apps’. [TTA 11 May] If Your Shrink Is A Bot, How Do You Respond?

Scanadu Scout emerging for crowdfunding

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/05/scout1.png” thumb_width=”150″ /]The Scanadu Scout [TTA 30 Nov 12], so widely touted as a ‘medical tricorder’ going for the Qualcomm Tricorder XPRIZE, listed on Indiegogo’s crowdfunding platform yesterday, and is already 3x oversubscribed at $311,000 with 29 days to go. Scanadu connects to your smartphone via Bluetooth LE and from a forehead readng calculates temperature, respiratory rate, blood oxygen, heartrate, blood pressure and stress. However it has no FDA nor CE approval, thus is being ‘quantified’ as a research tool not a vital signs monitor, so you too can be a Scout. $199 now is the entry price but multiple package deals are still available, but you’ll have to wait till March 2014 at the earliest. Complete with glowing videos. Indiegogo, Wired UK.

News Flash: The Gimlet Eye just texted Editor Donna with a better name; the Scanadu Nirvana, for the altered state the hordes of Quantified Selfers (QSers) are undoubtedly in.

(Holiday) Weekend reading: McKinsey’s guide to 12 disruptive technologies

The McKinsey & Company consultants have compiled two lengthy PDFs (one long executive summary and a very long full study), plus a podcast by one of their researchers, on what they see are 12 core disruptors which will be familiar to most of our readers. None are labeled ‘healthcare’ but seven of the 12 fit right into any tech in the field: mobile internet, the ‘internet of things’, advanced robotics, automation of knowledge work, cloud computing, next-gen genomics and 3D printing. Disruptive technologies: Advances that will transform life, business, and the global economy (downloads in article)

A model for health tech accelerators, made in NY

NY Digital Health Accelerator Is a Model to Emulate: Startup’s Perspective (Forbes)

‘Digital health accelerators’ are popping up like spring flowers, but what is the ‘secret sauce’? New York Digital Health Accelerator’s (NYDHA) program may have found the recipe. Dave Chase, CEO of Avado, takes a go at it from what a program like this means to an early-stage (or startup) company. Key points:

23 leading providers were the selection committee–customers, a/k/a ‘who pays’–and they mentored and met extensively with their assigned company
Funding and the equity ‘take’ were the most attractive of any accelerator: according to Chase, “providing the most funding per company of any accelerator ($300,000 or more[Ed.note: versus a more typical $20,000]) — roughly 5-15x more than other accelerators while taking significantly less equity.”
It was actively co-managed by The Partnership Fund for NY and NYeC (NY eHealth Collaborative) whose senior staff sourced conference/exposure opportunities and connections with Federal and state healthcare leaders
NY is clearly backing this with a goal of reinventing healthcare

Previously in TTA: Healthcare IT–New York’s Next Big Thing [14 May] highlighting the Partnership Fund for NY and the NYDHA program.

Australasian Telehealth Society national strategy white paper (AUS)

The Australasian Telehealth Society has issued a five-year (2013-2018) white paper that outlines how Australia can transition toward a National Telehealth Strategy which would improve the delivery of health care. Australia, not unlike the US but with less population, has extremes of population gathered in dense urban and regional areas, then scattered in distant, sparsely populated rural or remote areas. The idea is to improve access and quality, with essential elements being a national broadband strategy and current healthcare resources. Importantly, the Society’s defines ‘telehealth’ at the outset broadly as “enabling health care services and related processes delivered over distance, using information and communication technologies” including telecare, telehealth and telemedicine. The paper was initiated during the roundtable discussion session at their Global Telehealth 2012 Conference held in Sydney on 26-28 November 2012. Authored by Colin Carati and reader George Margelis (hat tip once again). Society link and download PDF

Robots in older adult care: a debate

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/05/20disrupt-pic2-tmagArticle.jpg” thumb_width=”150″ /]An article in The New York Times ‘Bits’ tech blog has raised debate on the appropriate role of robots in care for older adults. Illustrated by a picture of two PARO robots being recharged (a strange sight indeed) and a lead about the movie ‘Robot & Frank’ [TTA 23 Aug 12], it discusses the ethics of robots (and robotic pets) in care for the elderly versus humans which continues in the comments. One position is that it is not ethical to entrust your aging loved one’s care to a machine, and that human care is always preferable even if not high quality, because we all need human interaction. The other is that the same loved one might very well prefer having a robot efficiently assist them versus a human helper who talks down to them, doesn’t listen, is incompetent, unable or dishonest. The older person may very well interact with a robot better and demonstrate more directive control. A middle position is that robots for assistive care and robotic pets are quite acceptable as an adjunct to human support. After all, we do tend to anthropomorphize objects, not only cars (ask this Editor about Big Blue, Homer, The Bug and the Cherry Bomb) but also in studies robotic pets such as Sony’s now defunct AIBO. It is also the theory behind the virtual pet-in-a-tablet GeriJoy. And who hasn’t ‘talked’ to their balky PC or printer? Certainly Frank demonstrated ‘greater independence’ when he enlisted his pal Robot in a little heist! Disruptions: Helper Robots Are Steered, Tentatively, to Care for the Aging

Medical apps largely missing medical expertise: study

A recent Ohio State University study, presented at the American Academy of Pain Medicine (AAPM) conference in April, analyzed 222 pain-related smartphone apps available for Android, iPhone and Blackberry devices. Their findings:

One third had no input from a health care professional
Professional input could not be determined for an additional one third
27 percent of the apps had obvious input from an MD or DO
8 percent had input from a non-physician health care professional

The OSU study in 2012 was modeled after a UK study in 2011 that examined 111 pain-related apps, with similar findings. As our readers know, in the US Happtique had taken on the role of a health app certifier through its Health App Certification Program (HACP), and presumably despite their internal changes that certifying process will continue and information will be accessible to the public. The FDA is still debating (and debating) app approval processes (along with the FCC, HHS…) while approving a few [TTA 22 Mar]. AAPM has also expressed interest in ‘gatekeeping’ for pain management apps. American Medical News/Amednews.com Hat tip to reader George Margelis of Australia

FDA goes a bit easier on digital pill classification (US)

Good news for digital pill developers such as Proteus and Carnegie-Mellon’s digestible devices [TTA 15 April]. In FDA’s final order issued 16 May in the Federal Register, ‘ingestible event markers’ (IEM) are now classified as a Class II medical device, which does not require the premarket approval and the longer approval cycle that new devices (‘de novo’) under Class III must have. According to The Hill’s’ regulation blog ‘RegWatch’, “FDA granted the device class 2 status shortly after its approval in 2012, but the legal order sets a permanent standard for the technology.” Proteus’ FDA approval for their IEM was granted in July 2012 [TTA 2 Aug 12] and this now formalizes subsequent IEM classification. iHealthBeat

Management, direction changes at app certifier Happtique

May 17, 2013 | by Donna Cusano

When an entrepreneurial venture, nurtured by a large parent, ‘goes sideways.’

Management and directional changes at Happtique, a subsidiary of the Greater NY Hospital Association (GNYHA), have rocked the still rather insular, and small scale, New York health tech world. Background talk has been in the air for some months. Reading through the exclusive report from Brian Dolan at Mobihealthnews, followed by GNYHA Ventures’ statement, plus your Editor in NYC, several shoes have officially dropped.

Well-known co-founder Ben Chodor is no longer CEO, but according to GNYHA remains with the company as co-founder, focused on strategic growth as well as an outside evangelist of sorts. He will continue to host the mHealthZone on BlogTalkRadio and will be at the WLSA Convergence Summit on 29-30 May. Also already departed is Chodor’s leadership team. (more…)

Google Glass ‘hacked’ for hospital facial recognition

Your Editor hid this one from The Gimlet Eye, but according to VentureBeat, Google Glass has been successfully ‘hacked’ for what may be a significant–and useful–medical app. MedRefGlass uses facial recognition to permit doctors to pull up patient files, and also to create patient folders by voice, take photos, and add voice notes–all hands-free. The development team has posted more here at NeatoCode Techniques on Tumblr. New Google Glass hack gives doctors the power of face recognition. Watch the video demo (04:44).

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

The Friday robo-alert: Five ways robots are invading hospitals

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/05/ri-man.png” thumb_width=”150″ /]Having watched the delightful ‘Forbidden Planet’ (1956) on Turner Classic Movies last night, marking the debut of the robot paragon Robby the Robot, this overview of hospital robotics from VentureBeat is on point. No Robbies here (despite our picture, this article does not cover robots that lift or design dresses with options of diamonds, emeralds or star sapphires) but does highlight:

Germ and infection reduction (the ultraviolet Xenex)
Remote consult robots (iRobot’s RP-VITA, now FDA approved)
Prosthetics (BioOM prosthetic ankle)
Surgical robots
Therapeutic robots for the elderly (PARO, which is a ‘1.0’)

Previously in TTA: RP-VITA’s FDA approval and profile; prosthetic advances, surgical microgripping robots and BriteSeed’s SafeSnips; the debate on the $6,000 PARO; better and more affordable robots and aids for older adults such as GeriJoy (virtual pet) and Clevermind (stimulation); and the vast area of humanoid robots such as Roboy, Hector and Kompaï. (Or just search ‘robots’ in TTA for our wealth of coverage.)

Telehealth Soapbox: Negotiating a Vendor’s Limitation of Liability Clause

This is the third of an occasional series on US law and intellectual property (IP) as it affects software and systems used in health technology. This article is a ‘how to’ on achieving a more equitable liability arrangement between a company and a vendor. A standard clause a vendor uses to protect their company from liability can cause a great deal of trouble and financial heartache for a contracting company when ‘things go sideways’. Correspondingly, if you are a vendor or partner, this enables you to anticipate issues a skilled negotiator on the other side of the table will present.

Mark Grossman, JD, has nearly 30 years’ experience in business law and began focusing his practice on technology over 20 years ago. He is an attorney with Tannenbaum Helpern Syracuse & Hirschtritt in New York City and has for ten years been listed in Best Lawyers in America. Mr. Grossman has been Special Counsel for the X-Prize Foundation and SME (subject matter expert) for Florida’s Internet Task Force. More information on Mr. Grossman here.

When clients come to me to consider suing because of a tech deal that has gone bad, the single worst lawsuit killer is often the “standard” limitation of liability clause found in a vendor’s form agreement. It never ceases to amaze me how people don’t pay attention to these clauses as they blithely sign-off on a one-sided agreement. It’s just one little clause and yet it can cause so much damage.

Here’s an example of the type of provision that you’ll see in tech agreements:

“The liability of vendor to customer for any reason and upon any cause of action related to the performance of the work under this agreement whether in tort or in contract or otherwise shall be limited to the amount paid by the customer to the vendor pursuant to this agreement.”

Yes it’s heavily slanted in favor of the vendor—it’s the vendor’s form. I draft them just as one sided when I’m representing a vendor so that I protect MY client. As I always say, he who drafts sets the agenda. (more…)

Six technologies for aging in place: a review

Analyst and trendspotter Laurie Orlov in Aging in Place Technology Watch reviews six new monitoring and assistive technologies designed to improve safety and independence for older adults in the home environment: for organizations, the Center for Technology and Aging (CTA)’s mHealth Toolkit [TTA 28 Sept 12]; Earl, a free voice driven iPhone & iPad newsreader app; the Lively telecare system [TTA 19 April]; the ConnectMyFolks iPad app for simple news, email, text, photos and videos; BugMe! Stickies for jotting reminder notes by ElectricPocket; and Unfrazzle to assist caregivers in task tracking and connectedness with other caregivers.

Plus: If you are looking for an underserved market in health systems and tech, it is certainly centers, facilities and individuals in dementia care. It has the paradox of being a growth market, highly profitable for senior housing–and largely bereft of care programs that do more than the minimum to help preserve the faculties of the person with dementia. This recent article by Laurie Orlov discusses a different approach linked to the Montessori Method being used at a dementia support center in Toronto. It adapts the widely used teaching method for children pioneered in 1907 to slow decline in brain function and behavior, at different stages. (Globe & Mail article)

Toward a better understanding of US care models