Care Innovations gets into the behavior change training business

October 28, 2016 | by | 3 Comments

An under-the-radar move by Intel-owned Care Innovations, which markets the Health Harmony telehealth and the QuietCare behavioral telemonitoring systems, is their entrance in the behavior change training business.

Care Innovations developed an accredited (CE eligible) training course for nurses to effect behavior change in patient beyond what may be a limited telehealth engagement. According to their release, the training will help them with coaching patients to increase their engagement with their health and identifying areas for improvement, along with the appropriate technology.

The three-hour course work, designed primarily for telehealth nurses but open to all, has three key learning sections:

  1. Six steps to take to achieve behavior change in healthcare
  2. Learning four coaching skills: crafting open-ended questions, sharing words of affirmation, demonstrating reflective listening and crafting summary statements
  3. Discussing the most common challenges associated with acting as the coach, which are avoidance, ambivalence, resistance and compliance.

There are three sessions before the end of the year, priced at a relatively modest below $300 rate, with group discounts. Information is on their website here.

It’s an interesting move in that the training seemingly is not exclusive to CI clients, although this Editor would expect that 1) it would fit best with CI’s system and 2) is a way of cultivating prospective clients in an academic, value-added way.

For CI, it is another association with the ‘intersection of behavior change and technology’ (more…)

The Theranos Story, ch. 22: the human cost of lab error (updated)

October 26, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/11/upside-down-duck.jpg” thumb_width=”150″ /]Save this one for the coffee or lunch break. What is the cost of a lab error on the human psyche? It can be mildly upsetting to you and your doctor, warning of a developing condition and some changes have to be made–or make for a very bad day/week/months. It can be falsely reassuring or simply confusing.

We know that in April, Theranos flunked a CMS review, and in May voided all test results from its proprietary Edison devices from 2014 and 2015, as well as some other tests it ran on conventional machines. The results were not only off, but way off, according to the WSJ. “Notes from the CMS inspection show that 834 out of 2,890 quality-control checks run on the Edison in October 2014, or 29%, exceeded the company’s threshold of two standard deviations from its average result. Standard deviation is a statistical measurement of variation. In addition, 80% of the 834 quality-control checks that raised a red flag under Theranos’s internal standards were more than three standard deviations from its average result, the inspection notes show.”

They also failed to notify patients for weeks or months, and often not until forced to. At least 10 lawsuits have been filed in Arizona and California. Some of the human stories of Theranos’ improbable lab results, which included tens of thousands of patients, with the cost of retesting, repeated doctor visits and agonizing suspense :

  • After five widely different Theranos blood coagulation tests in six weeks, a retired marketer living in Arizona and his doctor so distrusted the results that the latter recommended that he stop taking warfarin and switch to a milder medication. This patient found out only last Friday that Theranos had corrected a September 2015 test showing his blood taking more than six times longer than normal to clot. The other four tests showed the warfarin wasn’t thinning his blood enough. Contradictory results confusing both doctor and patient on treatment.
  • A thyroid cancer survivor got thyroxine results (T4) from three tests conducted in October 2014. The extremely high results could have indicated hyperthyroidism at the least, or a more serious condition. The results–false after retesting failed to confirm.
  • A breast cancer survivor had extremely high levels of estradiol, which could have been produced by a rare adrenal tumor that can secrete estradiol or an elevated risk of breast-cancer recurrence. Again, false results but found only after retesting.

The comments under the article are worth the long scroll. (They are running 98 percent in favor of Holmes for Prison 2017. Also there are a few shots at Walgreens’ role in legitimatizing Theranos by putting their centers in store; this embarrassing part of the story isn’t over, in this Editor’s opinion.) What is evident–fraud perpetrated on patients and doctors–and anyone who invested. David Boies, their legal supremo and board member, is gonna have a full docket between this and the various legal actions taken by the Alphabet Agencies.

Agony, Alarm and Anger for People Hurt by Theranos’s Botched Blood Tests. If the WSJ is paywalled, search under the headline text.

See here for the agony of TTA’s 21 previous Theranos chapters. We hope that John Carreyrou and the WSJ investigative team, which we’d assume includes Mr Weaver, this article’s author, are awarded the Pulitzer Prize.

MedStartr Momentum 2016–28-29 November (NYC)

October 26, 2016 | by

28-29 November 28
Gerald Lynch Theater (John Jay College-Lincoln Center), 524 West 59th Street, New York, NY

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/11/MedStartr_red_grey_sm.jpg” thumb_width=”150″ /]MedStartr Momentum is a conference with two full days focused on finding, partnering, piloting, and investing in the best new ideas in healthcare. With 9 Momentum talks, 7 discussion panels, 5 pitch contests with over $500,000 in prizes, and performances that will inspire, MedMo16 promises to be among the best events of the year for everyone involved in healthcare innovation. Speakers include John Nosta, Ben Chodor and from Northwell Health, Memorial Sloan-Kettering, NYU, Mount Sinai and Mad*Pow. It is also the kickoff for the MedStartr Venture Fund which adds to the crowdfunding impact of MedStartr–now up to 94 health projects. Find out more and register on the Momentum website. TTA is a supporter of MedStartr and Editor Donna is a MedMo16 event host. Hat tip to Alex Fair of MedMo16 and MedStartr.

The King’s Fund Digital Health Congress 2017–call for showcase projects (updated)

October 26, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/10/Kings-fund-call.jpg” thumb_width=”300″ /]Despite the colorful (and falling) leaves of autumn, The King’s Fund is looking forward to the Digital Health Congress on 11–12 Jul 2017. What’s up? First, they are looking for innovative digital health projects to feature. Contact Caroline at c.viac@kingsfund.org.uk for more information. The deadline to submit is Friday 9 December.

The 2017 Congress will focus on progress and improvements in:

1. enabling citizens to take an active role in their health and care
2. improving data sharing and interoperability across the health and social care economy
3. demonstrating the benefits and improving productivity
4. using technology and data to improve user experience and quality of care.

Editor Charles was, of course, first out of the gate earlier this month, and has informative guidelines on this here.

The King’s Fund’s event page is here; the Digital Health Congress fact sheet is here including information on sponsoring or exhibiting. To make the event more accessible, there are new reduced rates for groups and students, plus bursary spots available for patients and carers.  Hat tip to KF’s Claire Taylor for the information and the update. TTA will be a media partner of the Digital Health Congress 2017. Updates on Twitter @kfdigital17

Who’s getting what!

October 26, 2016 | by

Denny Hatch, the master direct mail copywriter and creative thinker, for decades had a private direct mail marketing newsletter called ‘Who’s Mailing What!’ This came to mind with some very big funding rounds in the past few weeks:

  • Omada Health’s Series C $48 million raise in September to boost validation, enhance its Prevention program and expand to state Medicaid for low-income patients. Current clients include Humana and Costco. Forbes attributed the size of the round to Omada’s approach in tying participant outcomes to over 50 percent of its compensation. MedCityNews.
  • Propeller Health‘s Series C of $21.5 million. This is a sensor on asthma meds such as inhalers that connects to an app. With 45 programs and clients like Dignity Health and Molina Healthcare, Propeller has been growing intensively since this Editor last saw them at the 2014 NYeC Digital Health Conference. Their total funding is now $45 million. TechCrunch.
    • And now that we mention it–don’t forget that TTA Readers receive a 10% registration discount on this year’s conference 6-7 December–use code TTA when registering. Click on the advert in the right sidebar to enter registration or view their event website.
  • Spain’s biotech sector got a boost when Ysios BioFund II Innvierte exceeded the initial fund target of €100 million (US$110 million), closing at €126.4 million (US$140 million). It recruited existing investors and multiple Spanish and European economic interest groups. With their Biofund I, Ysios has €191.4 million (US$220 million) in assets under management. MedCityNews
  • iRhythm closed its IPO on Tuesday with an over-allotment. Shares from last Thursday’s offering of 6.3 million shares at $17 on NASDAQ initially soared 65 percent to $28 before closing at $26.05. iRhythm’s Zio service is a cardiac monitor patch and long-term monitoring to determine whether a patient has an arrhythmia or atrial fibrillation. WSJ, Reuters
  • And before you have that AFib, if you are living in California, Heal can provide you with an in-person doctor house call from your smartphone for $99, which may be covered by a participating insurer. Series A round of $26.9 million. VentureBeat

‘Deconstructing the telehealth industry’ (Ziegler report, US)

October 26, 2016 | by

A recently published white paper from Ziegler, a specialty healthcare investment bank, that actually does what it says –deconstruct the US telehealth (and telemedicine) industry. It also constructs a framework of ‘who does what’. Good graphic and text (but not infographic, mercifully) detail on the shareholders, barriers, tailwinds and future state, plus financial/acquisition participants and a compact growth history. Article here on Benzinga, or go directly to Ziegler to download.

Friday’s cyberattack is a shot-over-bow for healthcare (updated)

October 25, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/03/26ED4A2300000578-3011302-_Computers_are_going_to_take_over_from_humans_no_question_he_add-a-28_1427302222202.jpg” thumb_width=”150″ /]Friday’s multiple distributed denial-of-service (DDoS) attacks on Dyn, the domain name system provider for hundreds of major websites, also hit close to home. Both Athenahealth and Allscripts went down briefly during the attack period. Athenahealth reported that only their patient-facing website was affected, not their EHRs, according to Modern Healthcare. However, a security expert from CynergisTek, CEO Mac McMillan, said that Athenahealth EHRs were affected, albeit only a few–all small hospitals.

A researcher/spokesman from Dyn had hours before the attack presented a talk on DDoS attacks at a meeting of the North American Network Operators Group (NANOG)

The culprit is a bit of malware called Mirai that targets IoT–Internet of Things–devices. It also took down the (Brian)KrebsOnSecurity.com blog which had been working with Dyn on information around DDoS attacks and some of those promoting ‘cures’. According to Krebs, the malware first looks through millions of poorly secured internet-connected devices (those innocent looking DVRs, smart home devices and even security devices that look out on your front door) and servers, then pounces via using botnets to convert a huge number of them to send tsunamis of traffic to the target to crash it. According to the Krebs website, it’s also entwined with extortion–read, ransomware demands. (Click ‘read more’ for additional analysis on the attack)

Here we have another warning for healthcare, if ransomware wasn’t enough. According to MH, “even for those hospitals with so-called “legacy” EHRs that run on the hospital’s own computers, an average of about 30 percent of their information technology infrastructure is hosted (more…)

An assistive robotic glove for those with hand disabilities

October 22, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/10/exo-glove-giphy-5.gif” thumb_width=”200″ /] There are many people who have lost hand mobility due to injury, stroke and other neurological conditions. Exoskeletons are a great idea, but for a small area far too bulky. At Seoul National University, research director Kyujin Cho and a group of SNU Biorobotics Lab students, working with disabled people, have developed the Exo-Glove Poly, a soft wearable robot ‘glove’ that is capable of grasping objects. Three soft, tactile fingers fit over the wearer’s thumb, index finger and middle finger, with a tendon-like routing system of wires connected to a motor which opens and closes the hand. It is waterproof, washable and reasonable looking. According to the article in AtlasoftheFuture.org, this assistive technology is scheduled for commercialization in late 2017. Exo-Glove Poly website. Hat tip to contributor Sarianne Gruber via LinkedIn.

Weapons in the Perpetual Battle of Stalingrad that is diabetes management

October 22, 2016 | by

A major area for both medicine and for healthcare technology is managing diabetes–Type 1, Type 2 and also pre-diabetes, which is the term used to describe those who are on the path to Type 2 diabetes. Type 1 diabetics, because they have had it for years, usually since youth, have one battle and are fighting that Perpetual Battle of Stalingrad. As this Editor has noted previously, technological tools such as closed-loop systems that combine glucose sensors with insulin pumps take much of the constant monitoring load off the Type 1 person. [TTA 20 Aug, 5 Oct]

But the panel at MedCityNews’ ENGAGE touched on a point that rankles most pre-diabetics and Type 2 diabetics–the lack of empathy both healthcare and most people they know, including family, have for their chronic condition. Many feel personal shame. And digital health ‘solutions’ (a tired term, let’s retire it!–Ed. Donna) either drown the patient in data or send out, as Frank Westermann of Austria’s mySugr said, a lot of negative messaging. Adam Brickman of Omada Health, whose ‘Prevent’ programs are mainly through payers and employers, noted it was a real challenge to get people to change their lifestyle, but also change their state of mind. Their model includes peer support and health coaching, specifically to include that empathy. Home support also makes all ther difference between those who successfully manage their condition and those who don’t, according to Susan Guzman of the Behavioral Diabetes Institute. The approach is certainly not one-size-fits-all.  MedCityNews  In September, Omada received a sizable approval on its approach via a Series C round of $48 million. Current clients include Humana and Costco. Forbes attributes the size of the round to Omada’s approach in tying participant outcomes to over 50 percent of its compensation.

 

Connected Health Symposium to merge with PCHAlliance conference

October 21, 2016 | by

One of the earliest conferences in healthcare tech, the Connected Health Symposium organized annually in Boston by Partners HealthCare, is merging with the Personal Connected Health Alliance (PCHAlliance)‘s Connected Health Conference to stage one conference in 2017. Joseph C. Kvedar, MD,  who is VP Connected Health at Partners HealthCare, will be a senior advisor to PCHAlliance, a featured speaker at this year’s PCHA CHC in December and will be the Program Chair for the newly combined event. To this Editor, it’s a logical move as when both of these conferences were pioneering nearly a decade ago, there were few venues beyond the traditional (and boring) Big Health meetings. Now there are multiple meetings, large and small, expensive and popularly priced, every month in many cities. In the release there is no information on when and where the joint event will be. The Symposium was in October and the 2016 PCHA CHC will be 11-14 December at the Gaylord National Harbor near Washington DC. TTA is a media partner of the PCHA CHC for the 8th year, starting in 2009 when it was the brand new mHealth Summit.

Cerner’s takeoff delayed on DOD’s new EHR, MHS Genesis

October 20, 2016 | by

The new $4.3 billion US Department of Defense EHR, jointly developed by Cerner and Leidos, has taken another delay from the aggressive rollout schedule set in April.  The original test start date was 6 December at the Fairchild Air Force Base hospital in Spokane, Washington (state) and the Oak Harbor Naval Hospital on Washington’s Whidbey Island. Back in early September, it was reported that it would be delayed by at least a few months for technical reasons (Federal News Radio and Healthcare IT News). The rara avis in the latter is a mention of major dental supplier Henry Schein–along with Accenture, they were part of the award, but very much a junior partner in providing the dental EHR. (Leidos release)

The latest update on the start of MHS Genesis is February 2017 for Fairchild AFB and June for Oak Harbor. Healthcare IT News

Population health is everywhere (US)

October 20, 2016 | by

Last week, CMS published the ominously dubbed Final Rule on MACRA (the Medicare Access and CHIP Reauthorization Act of 2015) which utterly changes how physicians are compensated by Medicare and the various monetary incentives they have in quality and patient-centered care. This Editor is not going to get into interpretation of 2,300+ pages, but her belief is that this will not be effective in 2017 as designed, as literally it is over-complex and not understood by those who implement patient care. The dizzying models include Merit-Based Incentive Payment System (MIPS) and for the daring, the Advanced Alternative Payment Model (APM). All great business for the 100 or so ‘value-based consultants’ ready to help those expensively organized ACOs which thought they’d be rich from Meaningful Use. Oh, and what about the patient and their well-being in the meantime?? Healthcare Dive, Healthcare IT News and here  Don’t hunt for CMS’ fact sheet–it’s here. Don’t look for much about telemedicine and remote monitoring, which apparently was included in the law but not in the Final Rule for MIPS but is a part of the Advanced APM. Congress may act to expand Medicare’s payment policy on telehealth, but don’t hold your breath for it happening this year. POLITICO Morning eHealth 19 Oct

But population health and the data analytics that’s needed to get a handle on both large-scale patient health trends to allocate care where it is needed, and the financial metrics that organizations need, is hot. Verily Life Sciences (Alphabet-Google’s ever versatile healthcare tech arm) is allying itself with 3M Health Information Systems. (This Editor bets that you never thought that the Post-It Notes company was in health information!) According to the article, 3M’s part has to do with its business in coding, classification and risk-stratification methodologies. Verily will bring to the party data analytics, algorithms and software development. Healthcare IT News

This Editor also noted IHS Markit’s analysis of MACRA mixed with a bit from ATA’s Fall Forum. One insight: And now CMS plans to tie 90 percent of traditional Medicare fee-for-service payments to value-based payments in 2018. A lagninappe: “MACRA will help telemedicine to simply become another modality within healthcare delivery.” The wrapup is quite illuminating.

As identified during a recent consumer survey conducted by IHS Markit on digital health trends in the US, patients are interested now more than ever in sharing their healthcare data, and provider communication is at a low: (more…)

The Theranos Story, ch. 21: the denouement of tears, fears and lawsuits

October 12, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/11/upside-down-duck.jpg” thumb_width=”150″ /]Finally, Theranos sinks its labs, Wellness Centers…and 340 employees. Since founder/CEO/controlling shareholder Elizabeth Holmes has been banned by CMS from running any labs for the next two years, shutting ’em down makes total sense in terms of saving her job. (Of course, if you are one of those fired employees in Arizona, California or Pennsylvania, it doesn’t. But hey, you may be worth more than Ms Holmes!) What she’s betting what is left of the company on is the miniLab, which hasn’t exactly come heartily out of the gate. It was Gimlet Eyed at the AACC annual meeting in Philadelphia, then shortly thereafter she withdrew from FDA review a Zika test using the miniLab due to lack of a patient-safety protocol approved by an institutional review board. (Tsk, tsk–Ed.)

Now the news of a lawsuit by a major investor will, in its process, reveal more of the Bubble That Was Theranos and possibly put the banana peel under the pivot. Investors sank over $800 million into the company, and one of them, Partner Fund Management, wants its $96 million back like Lee Marvin as Walker in Point Blank. According to the Wall Street Journal, which originally wielded the needle, the charges are that they and other funds were lured in by fraudulent claims and various misrepresentations of the Edison technology and its effectiveness–in other words, that they had labs and tests that actually worked. The SEC continues to investigate, including subpoenaing Partner and possibly other investors.  ABC News, Wall Street Journal (search on title ‘Major Investor Sues Theranos’ if you hit the paywall), Gizmodo 30 Aug, 11 Oct (a wonderfully Gimlety take by Eve Peyser), and a series of acid flashbacks in Forbes

See here for the 20 previous TTA chapters.

Artificial intelligence with IBM Watson, robotics pondered on 60 Minutes

October 12, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/06/robottoy-1.jpg” thumb_width=”150″ /]This Sunday, the long-running TV magazine show 60 Minutes (CBS) had a long Charlie Rose-led segment on artificial intelligence. It concentrated mainly on the good with a little bit of ugly thrown in. The longest part of it was on IBM Watson massively crunching and applying oncology and genomics to diagnosis. In a study of 1,000 cancer patients reviewed by the University of North Carolina at Chapel Hill’s molecular tumor board, while 99 percent of the doctor diagnoses were confirmed by Watson as accurate, Watson found ‘something new’ in 30 percent. As a tool, it is still considered to be in adolescence. Watson and data analytics technology has been a $15 billion investment for IBM, which can afford it, but by licensing it and through various partnerships, IBM has been starting to recoup it. The ‘children of Watson’ are also starting to grow. Over at Carnegie Mellon, robotics is king and Google Glass is reading visual data to give clues on speeding up reaction time. At Imperial College, Maja Pantic is taking the early steps into artificial emotional intelligence with a huge database of facial expressions and interpretations. In Hong Kong, Hanson Robotics is developing humanoid robots, and that may be part of the ‘ugly’ along with the fears that AI may outsmart humans in the not-so-distant future. 60 Minutes video and transcript

Speaking of recouping, IBM Watson Health‘s latest partnership is with Siemens Healthineers to develop population health technology and services to help providers operate in value-based care. Neil Versel at MedCityNews looks at that as well as 60 Minutes. Added bonus: a few chuckles about the rebranded Siemens Healthcare’s Disney-lite rebranding.

Telehealth in China: the largest market of them all?

October 12, 2016 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/10/HC_Bulletin_F14_bigdata_china_feature.jpg” thumb_width=”250″ /]Is China ready for telehealth, and the needed investment? It turns out that according to this article, the market does strongly resemble Western, Latin America and APAC countries in its needs and aging, dispersed population. The numbers (left) say yes. The market divides into three for the writer:

  1. A supplement to the public community care system, which has motivated most of the interest the Chinese government has in telehealth to care for millions (defined in the article as patient-doctor video consults, but doesn’t appear to exclude remote patient vital signs monitoring) as well as EHRs, scheduling, online access to diagnostic test results, and e-prescribing.
  2. Rural health care, not as unique as the writer seems to believe. Virtual consults and telehealth are used, and paid for, by CMS in US rural areas and on Native American reservations by the Indian Health Service. We also wrote about it in Brazil [TTA 27 Feb].
  3. Second opinions by Western physicians desired by high net worth individuals and upper middle class families. Again, not that unusual as this resembles the health tourism practiced by the affluent in Latin America and the adoption of video consults. This is denoted as the narrowest and chanciest of the three markets.

Chinese patients in (1) and (2), for the most part, would see any of these as an improvement. Their experience is that they get little time with a physician, don’t have a personal relationship with one or more doctors, and don’t expect much of a personal relationship with their doctor. So telehealth and RPM would be huge upgrades for China.  From Healthintelasia. Illustration from Analysis Group

Tunstall Americas adopts belle

October 12, 2016 | by

We haven’t heard much from Tunstall Healthcare in the past two months, but Tunstall Americas has announced that the belle PERS unit has been added to the US line of products which now . The belle is on the AT&T GSM cellular network for two-way voice communication with their 24/7 call center and GPS location technology. The pendant has a rechargeable battery that can last up to 30 days on a single charge, and can be either worn or carried in pocket or purse. Also new in the line is the Tunstall flood detector which signals the call center through the Vi+ and CEL.  Release, Tunstall Americas website.