Mapping assisted living and integrated care & support work in the UK

February 14, 2014 | by

We don’t normally draw readers’ attention these days to items of news unless we have a comment to make, as Twitter, and most notably Mike Clark’s excellent & timely tweets (@clarkmike), fulfils that role well.

However the Assisted Living Capability Map is just so good it perhaps merits an extra mention to readers. Click on any region on the map and it will give you details of all assisted living activities in that region known to the HealthTech and Medicines KTN.

The same is true of the Integrated Care & Support exchange (ICASE) map with shows integrated care & support pioneers, initiatives & case study exemplars. It is not, sadly, designed with the 10% of men who struggle with red/green colour blindness in mind, although that’s a small criticism of an excellent piece of work.

One more step in changing the patient:doctor relationship

February 12, 2014 | by

We have written extensively in recent months about how technology is changing the way patients are using doctors, yet some, notably the RCGP in their vision of GP practice in 2022, seem unprepared, or unwilling to accept this. Well if more evidence of the coming change were needed, AliveCor’s announcement that it now has FDA approval for sales of its (iOS & Android) smartphone-enabled heart monitor direct to the public will perhaps provide some.

In particular, the announcement includes a service – available in the US only at present – called AliveInsights, that will (more…)

Legrand “joint venture” with Neat

February 9, 2014 | by

A press release on Legrand’s website and (in Spanish) on Neat’s website, both just published, confirm the forming of a joint venture between the two.  This of course is the Legrand that took over Tynetec last year and Intervox in 2011, making it, they claim, now the  “second-largest player in the promising assisted living market.”

Neat’s products, distributed through Possum, have been finding favour across the UK because of their attractive prices. How, one wonders will the tie-up with Tynetec’s organisation now work, and will Possum now lose this attractive distribution arrangement, particularly in the major rollout in Cornwall where Neat are preferred suppliers?

All comments, anonymous or otherwise, will be gratefully received.

Finally, just to be clear, there is no connection between Neat, the Spanish supplier of assisted living equipment and Newham’s NeAT programme  (which originally stood for Newham Advanced Telecare and it so happens at one time I managed).

A mine of app data – free!

February 9, 2014 | by

Vision Mobile has just produced their 6th annual survey of the apps market, entitled “Developer Economics: Ecosystem wars drawing to a close” which is stuffed full of useful information on trends in app development, and is free.

There is so much in there that it is invidious to pick out a few quotes to whet your appetite, however needs must, so here are some, from the introduction:

“Six years on, the mobile ecosystem wars are drawing to a close with Android and iOS capturing over 94% of smartphone sales in Q4 2013. Android continues to dominate Developer Mindshare with 71% of developers that target mobile platforms, developing for Android.” (more…)

Are you the SME that has developed the best eHealth solution in the past year? (EU)

February 3, 2014 | by

If so, be sure to register for this great competition quick, as the closing date for registration is February 6th.

The competition’s objective is to support business success of EU SMEs by giving them visibility together with marketing opportunities to attract customers, partners and external capital. There are two separate categories, each with their own three prizes: those will turnover of under €500k and those with turnover over €500k.

Good luck!

Three takes on adopting new technology

February 2, 2014 | by

Last week saw three very contrasting reports on technology adoption by care workers.  The first, by NESTA, was a fascinating read entitled Which doctors take up promising new ideas? New insights from open data. Unsurprisingly for those of us who have attempted to peddle new technology to GP practices, the key findings are that larger practices are more likely to be early adopters, and that early adopting practices tend to influence those close to them, resulting in islands of early adoption. (The first is not an inviolate rule I found – sure larger practices can specialise so can focus more on innovation, however a larger workforce can also mean a greater probability of a technophobe with a bee in their bonnet about a pet project that the technology is drawing funds from.)

The report is a great example of big data in action (more…)

Terminology: do we need another contribution?

January 28, 2014 | by | 1 Comment

Although I suspect most readers have now got used to the variability in definitions in our field, to the point where it has, thankfully, dropped from being the regular debating point it used to be on TTA (eg here, here and here), valiant souls occasionally pop up to continue seeking to impose uniformity. The most recent is this paper from the European Connected Health Alliance and Wragge & Co, which has an excellent justification for its publication:

In our legal opinion, a more important distinction with these definitions is whether the products and/or services involved are regulated by telecommunication and technology laws and/or health laws. To answer these legal issues comprehensively you need clear legal definitions which do not exist either in the UK or on a pan European (EU) basis.

…which seems a very good point that I suspect many of us had missed. (Perhaps more important for many readers, I guess standardisation would make it easier for recruiters to find the best people to invite for interview from LinkedIn, too, now that that database has become the recognised database for professionals in many fields).

It is certainly a good collation of views on many of the terms we often use. There is much good stuff in here too (more…)

The future of doctors

January 23, 2014 | by

The Economist this week has an important leader and report on the future of work that has key implications for technology adoption by clinicians.  It is well worth reading in full. For those who cannot, the very basic issue raised is that technology is again replacing labour with capital. In the past this has always resulted in higher value jobs being created. This time though, there are many suggesting that it might just be different: some people will run out of road.

The Economist article does not go into the detail of many individual professions, however the description of the types of work most suited to this next wave of automation does cover much of the field of medicine (as, coincidentally I argued recently in my predictions for 2014). A particularly relevant section in the article is:

The machines are not just cleverer, they also have access to far more data. The combination of big data and smart machines will take over some occupations wholesale;

…which supports my contention:

And just think too, what correlations a single system overseeing the treatment of tens of thousands of people, with access to regular vital signs and other information on progress for each one of them, might be able to spot to enable it to improve patient care, that elude the best of GPs treating far fewer. Doubtless increasing genomic analysis & knowledge will enhance this too. –

So how should doctors react? Clearly one view, which seems still to be the minority approach (and that Telehealth & Telecare Aware is really all about trying to encourage) is to use existing technology, like telehealth and mHealth, to improve healthcare and reduce its cost. Automation is expensive so investors will look for those professions where the expected returns are highest; with this approach, the greatest benefits from automation will lie in other professions, so the greatest impact of automation on the medical profession will be delayed.

The alternative, which still seems to be the majority view, is to argue for the continuation of current practice and ignore the benefits of technology (and ignore the evidence that demographic changes will mean that the ratio of careworkers to those requiring care will render the current system infeasible anyway). That way will keep the cost of care relatively high and promote a crisis in the delivery of healthcare relatively soon, making early profound medical automation particularly attractive.

Of the two, from a patient point of view, earlier rapid automation looks superficially attractive although the chaos of rapid change will likely create many challenges that make it less attractive – let’s hope that the leaders in the medical profession, and those who appoint them, read the Economist this week and recognise the benefits to them (as well as to patients) of early technology adoption.

Certifying medical apps (contd.)

January 21, 2014 | by

No sooner had I given my keyboard the final tap to publish the conclusions of my work yesterday on medical apps than the first item hit my inbox that suggest that certification is a flawed proposition.

The suggestion of this iMedicalApps article is that the Happtique saga has shown certification to be impossible. Instead it is suggested that people make up their own minds based on peer review on sites (you’ve guessed it) such as theirs, and a greater understanding of apps.  The key paragraph for me is (more…)

Driving up medical app usage in the UK – part III: conclusions

January 20, 2014 | by

This series of posts covers some work I have been doing over the past three months: attempting to answer the question of how best to improve the perception by clinicians and patients of the efficacy of health-related apps. This work has been done for the i-Focus project, part of the Technology Strategy Board’s dallas programme.

Part I briefly summarised the EU regulations covering health-related apps. The point was made that any health-related app must comply with data protection and consumer protection requirements, irrespective of whether the risk level is sufficient for it to be classified as a ‘medical device’. Where an app is classified as a ‘medical device’ it also has to be classified so that the appropriate adjudication work can be determined for it to receive a CE mark (Class I, lowest risk, requires least investigation; Class III, highest risk, requires greatest investigation).

Part II summarised the principal findings from discussions with a very wide range of potential stakeholders, from patients to consultants, and from individual app developers to chief executives of app curation companies.  The key findings were:

  • There is currently little academically-endorsed evidence of medical app efficacy, though much anecdotal evidence;
  • There are too many bogus apps around;
  • There are safety worries – for example where clinicians are using unregulated apps to manage medication dosage;
  • The process for obtaining certification is unclear;
  • Some app developers are ignoring data privacy legislation;
  • The business model for achieving sales via the NHS is not well understood.

In addition, a theme running through both posts is that there is an international dimension to this issue, with some countries, notably the US, well advanced in certain aspects.

From these findings, four key conclusions emerge: (more…)

Royal Society of Medicine events that should appeal

January 17, 2014 | by

This year the RSM kicks off with Recent developments in digital health on 27th February, in association with the Royal Academy of Engineering. This event aims to update attendees on all the latest advances in the field of digital health that will affect care delivery. Perhaps the highlight of the day will be the demonstration of a smartphone that, on its own, can measure a person’s systolic and diastolic blood pressures, pulse, blood oxygen saturation, respiration and temperature – as this is a facility that will appear on the next generation of smartphones, the discussion on how app developers and the medical profession will respond will be particularly interesting. In addition there will be presentations by leading thinkers in the field on topics like big data, mHealth, medical apps, point-of-care-testing, genomic technology, evidence gathering and NHS England’s digital priorities.

Another event, that sold out early last year, is our medical apps day, this year on 10th April, entitled  (more…)

2013 fitness tracker sales…and a personal experience

January 16, 2014 | by

As someone who has been wearing a Jawbone UP for some five months, I was interested to read that Mobihealthnews reports on a (pay-walled) survey that shows Fitbit, Jawbone and Nike as sharing 97% of the activity tracker market in 2013 present, the split being 68%, 19% & 10%, respectively (the rest 3%).

At the same time that news agency, along with others, reports on the rash apparently created by the recently-introduced Fitbit Force on some people. Closer to home, I have had cause to scrutinise (more…)

ATA seeks comment on draft ‘telemedicine’ guidelines

January 16, 2014 | by

Most readers will be aware of the TSA Telecare & Telehealth Integrated Code of Practice which has developed over time from the TSA’s original telecare code, and many will be aware of the recent arrival of the Telehealth Services Code of  Practice for Europe (TeleSCoPE).  Now the ATA in the US has produced revised draft telemedicine core guidelines for comment that provides an interesting comparison with these two.

Before I go further, a word on definitions. The definition of ‘telehealth’ in TeleSCoPE includes telecare so it covers the same areas as the TSA code. This ATA draft does not cover telecare, and includes telehealth into the definition of ‘telemedicine’. However by also explicitly covering clinician to patient communications where the patient is attending a location away from their home and where care is provided professionally, it also covers a wider range of services than the normal UK understanding that telehealth is primarily aimed at the patient in their own home, or, via their mobile device, their own private setting. The comparison across the codes is not therefore exact.

The TSA code is of course accessible to members and those seeking accreditation only. Those who have read the many sections of it will be aware that (more…)

Telecare – time to lose the last “e”?

January 12, 2014 | by | 1 Comment

Many years ago when I co-founded eForum to promote what was then called “eGovernment”, it was common for smart speakers to begin their conference presentations by saying that it’d soon be plain “government”, which indeed it has been now for many years; around the world, government sector workers have embraced technology to offer huge improvements in quality of service to citizens at reduced cost. Sadly health services have proved far more resistant to the beneficial use of technology, so eHealth & mHealth seem likely to take rather longer to lose their prefixes, in spite of pleas from the VA. If any support for this view was needed, the telehealth news from the flat earth society of a recent survey of GPs (more…)

Driving up medical app usage in the UK – part II

January 8, 2014 | by

Introduction

This series of posts covers some work I have been doing over the past three months: attempting to answer the question of how best to improve the perception by clinicians and patients of the efficacy of health-related apps. This work has been done for the i-Focus project, part of the Technology Strategy Board’s dallas programme.

Part I attempted to summarise the EU regulations covering health-related apps. The point was made that any health-related app must comply with data protection and consumer protection requirements, irrespective of whether the risk level is sufficient for it to be classified as a ‘medical device’. Where an app is classified as a ‘medical device’ it also has to be classified so that the appropriate adjudication work can be determined for it to receive a CE mark (Class I, lowest risk, requires least investigation; Class III, highest risk, requires greatest investigation).

This post summarises the principal findings from discussions with a very wide range of potential stakeholders, (more…)