As what is being termed a ‘historic blizzard’ descends upon Editor Donna’s city….a blizzard of news:

Nearly $15 million round for Sotera Wireless: Dr. Eric Topol-approved (on NBC Rock Center) Sotera Wireless, with the wrist-worn VisiMobile doctor monitor capable of tracking blood pressure, respiration etc. for multiple hospital patients, raised $14.8 million in its latest round from a combination of eight investors, including Qualcomm Life, Delphi Ventures and Safeguard Scientifics. Gigaom……Outbound IVR partially successful in identifying adverse drug reactions. A Canadian study published in JAMA Internal Medicine tested outbound automated interactive voice response (IVR) at 3 and 17 days after prescriptions were issued to check on adverse drug reactions with 629 patients at family health practices in Quebec. The automated calls identified 46% of adverse drug reactions, with the most frequent events being non-compliance after three days (but 2/3 of patients did not comply) and new adverse symptoms after 17. iHealthBeat, HealthLeadersMedia……EHRs ‘underwhelming’ in pediatric practices. Only 19% met basic EHR definitions, with only 6% ‘fully functional’. Reasons why: EHR systems don’t typically have weight-based medication dosing features, automatic growth chart plotters, immunization tracking and catch-up immunization calculations. No wonder. Study published in Pediatrics with researchers from Seattle Children’s Hospital, East Carolina University and the American Academy of Pediatrics. HealthcareITNews…..Finally some news from Brasil. Telefónica Digital announced Monday (4 Feb) the acquisition of a controlling stake in Axismed, a chronic care management and eHealth provider which currently monitors about 180,000 patients. According to TechCrunch, this is Telefónica’s first eHealth investment…..Teledental? A group of 11 California health care organizations are participating in a program to increase access to dental care for an estimated 2,000 children from low-income households, the disabled and older adults. Exams will be performed at schools, residences and nursing homes by hygienists and assistants; results will be transmitted by imaging equipment and online dental record systems to dentists for review and action. iHealthBeat

Some positive telehealth results from Italy. A meta-analysis of data from 23 home-based blood pressure telehealth (HBPT) monitoring studies demonstrated the effectiveness of using HBPT to improve BP control in hypertensive patients versus office-only monitoring. For the HBPT group, overall costs were higher and more medications were prescribed, but medical cost-only comparisons were similar as was risk of adverse events. Quality of life measurements were better. The analysis was performed by researchers from the Italian Institute of Telemedicine (IIT) in Varese with the collaboration of the Department of Cardiology, IRCCS Ospedale, San Luca, Istituto Auxologico Italiano and Department of Clinical Medicine and Prevention, University of Milano. Clinical usefulness and cost effectiveness of home blood pressure telemonitoring: meta-analysis of randomized controlled studies (Journal of Hypertension, March 2013; abstract only, subscription/access required)

Update 8 February: For a copy of the study, please email lead researcher Stefano Omboni of the IIT.

This 36:52 video of Dr. Bernard A. Harris, Jr., CEO of Vesalius Ventures, past president of the American Telemedicine Association and former astronaut who conducted the first telemedicine consult from space, discusses Vesalius’ investments in telehealth companies (secure communications, disease management), plus what they look for in companies and management (an A-level team with a B-level technology is better than a C-level team with an A-level technology). Nirav Desai has also usefully put in time markers against topics covered. HandsOnTelehealth

A two-year (2010-12) study published in Health Affairs of 40,000 online consults via Minnesota-based integrated delivery system/insurer HealthPartners found that they reduced billing by an average of $88.03 per case (average cost: $40) and saved about 2.5 hours per patient. Patients were seen through the system’s 24/7 Virtuwell online clinic for 40 different primary care conditions, with the three most frequent being sinusitis, urinary tract infections and conjunctivitis. However, Virtuwell does not use video practitioner-patient consults, instead walking patients through an online automated interview about symptoms, medical history, allergies and medications. Then a nurse practitioner reviews each patient’s information and sends a treatment plan in a secure message, a process taking about 30 minutes. A phone call with the nurse is optional. Other results: no real increase in visits, and an episode resolution (no face-to-face visit) rate equivalent to ‘minute clinics’ at 89% to 95%. This sounds like an attractive template and option for concierge medicine, IPAs, ACOs and insurers, but needs to work around cross-state regulations. Neil Versel in Information Week, iHealthBeat, link to study abstract (Health Affairs)

New to Editor Donna is healthcare technology accelerator Healthbox. Perhaps uniquely, they are based in US and UK–Boston, Chicago and London–with partners in all three cities; a partial list is (US) Blue Cross Blue Shield Massachusetts, Express Scripts, Ascension Health (US largest Catholic health system), California HealthCare Foundation, Walgreens and (UK) Bayer, Bupa, Guy’s and St. Thomas’ Charity, and Serco Health. In its first year, Healthbox has fostered 27 companies to refine their offerings and gain market traction including investment (portfolio companies). According to Healthbox spokesperson Abbie Ginther, the highlights of what participants receive in the 16 week program is:

• $50,000 in seed capital
• Strategic guidance and mentorship from leading industry experts as well as business veterans
• Participation in Innovation Day, an event bringing together hundreds of investors, healthcare leaders and entrepreneurs to hear from the companies and how they are bringing innovative solutions to healthcare needs
• Collaborative, open workspace for companies to use for the duration of the program

They are currently accepting applications for its 2013 programs starting with their second Boston program starting in March. Application deadline is very tight here (10 February), but applicants for London/Europe (start date TBD in spring) can register on the same link. Applications. 

The Gimlet Eye and Editor Donna were just chatting about organizing the tidal wave of email we receive every day, when over the transom floated startup Tictrac (a takeoff on TicTac breath mints?), a ‘lifestyle monitor’ that will organize All That Data for the Determined Quant. It synchs with over 45 services, including Fitbit, Facebook, Runkeeper and Withings, to not only aggregate and correlate data (e.g. to high email use) but also manage goals such as losing weight. Not only that, it will connect the dedicated quant to outside sources such as coaches (who undoubtedly will pay per connection.) But will it organize email, mitigating our (unmeasured but very real) stress? This Startup Measures How Much Stress Email Gives You, And Helps You Reduce It (Business Insider)

The Commonwealth Fund, a foundation that supports health care research and makes grants to support practices and policy, has just published a compilation of three telehealth case studies from the Veterans Health Administration (VHA), Partners HealthCare/Center for Connected Health and Centura Health at Home dating back to 2004. These concentrated on reducing preventable rehospitalizations and used various aspects of telehealth/remote patient monitoring (RPM). The VHA’s was the most comprehensive (with best results in depression and mental health), Partners focused on cardiac and Centura on congestive heart failure, pulmonary and diabetes. While Commonwealth’s main point is the lessons to be learned (disruption of the status quo, the changes in processes and the time to scale), this early data is interestingly not well known–and should be. Overview, compilation PDF (note the overview has links to the full individual case studies)

This is either the most outrageous example of ‘NIH’ (not invented here), willful ignorance or sheer howling incompetence by the Indian Government in the face of frequent personal assaults often leading to death. The Wall Street Journal India just revealed, in the blandest possible terms, that the Indian Government’s ‘department of electronic innovations’ will be working on plans to develop a prototype wristwatch by mid-year that can, when the wearer pushes the panic button 1) send a text message to police and family members, 2) has a GPS to send location and 3) shoots 30 minutes of video–for US$20-$50. As our readers will remember, an attack on a young couple in central Delhi in December, and her subsequent death from beating and rape, made international headlines in December, initiated mass protests and revealed police incompetence in fighting and prosecuting crime.

Needless to say that what immediately came to Editor Donna’s mind was that there are already several devices on the market that do precisely that for the alert functions; the two top-of-minds were Aerotel’s GeoSkeeper and Lok8U’s Freedom but this Editor is sure our readers can identify others. All the state-run telecom, ITI, need do is adopt or license the technology and market it at a low affordable price perhaps subsidized by said Government. Cheaper, better, faster.

A panic button will not save the vulnerable from attack. Any device may be ineffective in a remote area, where the police are distant or not responsive and if the wristwatch is torn off. Encouraging women to take courses in situational awareness and personal self-defense–including the proper use of self-defense weaponry such as tasers, pepper spray (Mace) or even low-load pistols–would be a lot more effective as a first line. Better policing and law enforcement would also be strong deterrents. This ‘watch’ idea is a decent tool and a backup especially for those who cannot carry said defense, and better than nothing in discouraging assaults. And video is not needed–so after the fact, hardly a deterrent and perhaps even a further incentive for a criminal to badly maim or kill a victim.

So why is the Indian Government taking its sweet time in developing, then providing, an alert and video wristwatch to mitigate crime, when ‘off the shelf’ alert versions are readily available? Is it merely a bone thrown to the protestors? Certainly those who have been victims, or are close to someone who has been, will grimace consuming this serving of oatmeal. A Wrist-Worn Answer to Sexual Attack? (Wall Street Journal IndiaRealTime) A hat tip to Toni Bunting, TANN Ireland.

Update 4 Feb: Here’s a combination that in a right-side world might seize the imagination of the Indian Government: pepper spray, blinding light, quick photo that is then sent via Android smartphone to authorities. Stop/divert attack, get evidence and send to the police. Devised by three students from Cornell University for their ‘Design for Microcontrollers’ course, it may be far from finished work but even starting at this point, the turnaround to a workable, inexpensive defense/notification tool might be far shorter than the magic watch, and do more. Article (The Next Web) and the students’ project PDF. Another tip o’ hat to Toni Bunting.

InMedica (IMS Research) drops another shoeful of data in its latest publication ‘Analysis of Demand Dynamics’ [TA 4 Jan] by predicting a global rise to 1.8 million patients annually by 2017, up from 308,000 patients in 2012 remotely monitored by their providers. The majority of currently monitored patients have congestive heart failure (CHF) followed by chronic obstructive pulmonary disease (COPD), but by 2017 InMedica projects that COPD will be surpassed by diabetes. InMedica release

Related: A large N (8,000) study finally on telemedicine virtual visits published by JAMA Internal Medicine compares the quality of patient care between ‘e-visits’ and in-person visits. Patients had sinus infections and urinary tract infections and were surveyed between January 2010 and May 2011. For both patient groups, 7% or less returned for another consultation within three weeks. This suggests that both forms of visits have the same quality–and the e-visit cost 21% less. JAMA 14 January. Institute for HealthCare Consumerism (also InMedica)

Korean ‘nurse droid’ being tested in nursing homes. The KIRO-M5, which resembles a pint-size (3′) version of R2D2, can wake up residents, announce meals, schedule daily exercise–and can sniff the air to alert an aide or nurse when an elderly patient needs a diaper change. The KIRO also sterilizes and deodorizes the air, and totes supplies. Developed by the Korea Institute of Robot and Convergence. Korean nurse bot sniffs the air to detect soiled diapers (GizMag)

A polymer patch delivers vaccine. Designed by MIT, a dermal patch with microneedles slow-releases vaccine DNA rather than viruses or proteins, to allow the body to build immunity. Could this open up fresh horizons on drug delivery? And with a wafer-thin transmitter, can monitor it? Polymer patches could replace needles and enable more effective DNA vaccines (GizMag)

And finally the most amazing–a prosthesis mostly out of a 3D printer. A five-year-old boy, Liam, now has a workable hand with moveable fingers made using a Replicator 2 3D printer. The fingers are attached to a brace worn over the hand, and controlled via cables and return bungees. The designers who collaborated long distance from Washington state and South Africa, have also released the design into public domain. Inexpensive home-brewed prostheses created using 3D printers (GizMag)

Once the favorite of doctors and health professionals, now completely overwhelmed by Apple, the BlackBerry 10 is widely seen as the last chance for the now eponymous company. Coming in predictive word lookup touchscreen (Z10) and keyboard (Q10) versions (addressing the accuracy problem of touchscreens, not good in healthcare data entry), the BB10 also offers a dual-mode between work and personal information–very appealing to healthcare CIOs–with supposedly fast switching between the two. Despite design and handling raves from tough customers such as ZDNet (with the usual grousing about apps), the forecast is cloudy at best; BB’s enterprise base here in the US as of Q4 2012 dropped to a distant 6%–third–behind iPhone and Android OS phones. Curiously, the UK will be first to get the BB 10 in the touchscreen version only, which hints at a slow or ‘debugging’ rollout; March for the US. From the healthcare side, Mobihealthnews. From the tech side, ZDNet: Beautiful phone playing serious catch-up; It’s all in the name