Digital agenda items: past and future

June 29, 2015 | by

There’s much to learn about future digital trends from an analysis of what’s happening in South Korea. For this, the Korea Communications Report provides fascinating reading. For example, the bar charts on page 56 (yes it is worth scrolling that far) demonstrate the huge surge in video usage towards hte end of last year as 4G became established. As Prof Mike Short (for whom I am grateful for this and other pointers in this post) commented “It may prompt some ideas about Broadband and higher speed Mobile could help in Healthcare – eg the Dr will see you now”.

Another really interesting resource is the EU’s Digital Agenda Scoreboard 2015: Strengthening the European Digital Economy and Society which enables you to explore all sorts of statistics about European life, and then visualise it in a variety of different ways. It will be a real help for those ‘scene setter’ slides at the start of a presentation. Highly recommended.

Another interesting pointer was the FT which had a major supplement on digital health (more…)

Apps, apps, apps – health, care, wellbeing: must-reads for developers

June 28, 2015 | by

Last week we covered two calls for health & care app developers: the ADASS apps event, which is looking for apps presenters, and PatientView which is looking for developers’ feedback on what they need when developing health & wellbeing apps; today we focus on medical app news.

PatientView has just released the results of their previous survey entitled “What do patients and carers need in health apps – but are not getting?” This analyses the views of 1,130 patient and carer groups worldwide. The needs and challenges raised were then discussed in a multi-stakeholder meeting held to help define concepts for new apps that address patient and carer unmet real needs. An essential read for health & care apps developers.

Staying just a little longer on statistics, the CTIA resource library has some interesting primarily US-oriented items including a recent item entitled “One in Five US Consumers Use Mobile Apps for Exercise Tracking”.

As many will be aware, this editor has argued for 18 months now in these columns (& elsewhere) for an official approval process for medical apps that includes a measure of efficacy, so they can be compared, where appropriate, with other forms of intervention such as drugs (in the case of treatment for depression, anxiety and pain relief). Workstream 1.2 of the National Information Board has now published their roadmap (disclosure: this editor is on the Advisory Board of 1.2 and two others) which describes how they plan to tackle this topic.

At the same time MIT has now announced the establishment of the Hacking Medicine Institute. This will assess whether digital health products and services really work and, if they do, help them to prove their efficacy to consumers, doctors, and insurers, possibly introducing a little competition which should speed things up nicely. (For a more detailed review of the workstreams including DHACA’s involvement, go to the DHACA website blog – you will need to become a member if you aren’t already, however it’s free).

The Australians have also just produced the MARS (Mobile App Rating Scale) for ranking medical apps. They conclude that: (more…)

Call for app presenters at the ADASS Care Apps Showcase 2015 – Monday 19 October 2015

June 24, 2015 | by

This social care-oriented event takes place at the Carriageworks Theatre, 3 Millennium Square, Leeds, West Yorkshire LS2 3AD.

This is a unique opportunity to present to key decision-makers, funders and influencers in the adult social care sector. About 200 people in one room will be waiting to be impressed by your app to help people with social care needs and their carers. These people will be in a position to recommend or directly commission such apps (and related services). The core part of the day will be a series of 5 minute pop-up pitches to the plenary audience. Delegates will then vote with their feet to hear a more detailed presentation and take part in Q&A discussion in a break-out room.

In short, it’s a unique opportunity to sell your offer and get immediate feedback from a key audience.

There are slots for just 11 presenters and there are hundreds of apps out there being deployed and developed. Therefore, there is a selection process that is fair and transparent.

‘Care apps’ included in this event fall broadly into two types:

a) Council-managed self-service applications, e.g. citizen portals to existing case management systems, e-marketplaces, online information & advice / triage, self assessment of needs & finance.
b) Consumer apps, e.g. for: sharing tasks between informal carers promoting community sharing or time-banking for people with care needs telecare for staff to use with carers / clients special user interfaces for the elderly to easily Skype, email, etc management of care finances monitoring wellbeing.

Both types of “app” might be combined with a service of some kind by you as app provider, e.g. a telephone support service.
Excluded: apps primarily designed to diagnose or monitor specific health conditions or any app that could be designated a medical device.

For full details on how to apply and the selection process are here.
All applications are to be sent to tina.gallagher@techuk.org by close of play on Tuesday 30 June.

Alternatively if you would like to attend as a delegate you can book online at the tech_UK website.

Calling all medical app developers – please help with “Guidance and Advice Most Needed by App Developers”

June 24, 2015 | by

UK-based PatientView, and its sister organisation, myhealthapps.net, in conjunction with Germany-based Research2Guidance, and the App Quality Alliance, need your answers to a survey to help inform the creation of guidelines designed to improve the quality and focus of health, wellness, and disability apps. This will be be launched at the European Health Forum Gastein in October 2015, which is attended by hundreds of health policymakers as well healthcare industry representatives.

The survey opens with a handful of short, anonymous, profiling questions. It then moves quickly on to 14 questions about issues that are absolutely key to the developers of health, wellness, and disability apps.

The survey will probably take a maximum of 20 minutes to complete. The results will be anonymised. If you would like a copy of the collated survey results (which will include the views of respondents who are other healthcare stakeholders), please indicate your interest at the end of the survey.

To enter the survey, please do click on Guidance and Advice Most Needed by App Developers.

Many thanks, in anticipation.

London Health Technology Forum & the Cleveland Health challenge

June 12, 2015 | by

The London Health Technology Forum (HTF), run by this editor, has its last event before the summer break on 17th June – Baker Botts, who have been kindly hosting our forums for a long time now will be presenting on An introduction to securing, protecting and maintaining your IPR. We’ve also news of a prize-giving event in our November meeting, and an exciting competition run by the Cleveland Clinic.

Failure to manage IPR effectively has been the cause of very many entrepreneurial failures so this free event to learn about the topic should be of real interest to very many people. Therefore, especially in view of the expertise of the presenters, it is highly recommended. There will be three presentations:

1) Starting out – a brief look at IPR relevant to new businesses

  • what IPR are you generating?
  • who creates the IP and who owns it?
  • how and where can you protect your IP?
  • how are IPR maintained?

(more…)

Nurses, China, ageing, longevity, TV, mobile data, Magna Carta, even logarithms – something for everyone!

June 5, 2015 | by

This editor has always felt that telehealth and allied technologies is a nurse’s friend, enabling them to treat more people, with less stress, in short delivering more care and driving less car. It’s therefore great to see the European Federation of Nurses so active in the mHealth event in Riga recently, and to see them making a strong case for nurse engagement in the mHealth care pathways.

However this editor could not restrain a small chuckle at presumably a wayward spellchecker resulting in the phrase “incorporating big data logarithms for clinical pathways” appearing in the Presidential Message in their June-July 2015 Update.

Staying, briefly, overseas – the UKTI and co want to take you to the Expo 2015 in Milan on 28 September to 1 October to find new export opportunities. Programme for the main day is here. Book for the whole event here. Looking further afield, there is more info about the China Healthcare & Life Sciences Roadshow 2015 taking place in London, Manchester, Belfast, Glasgow, Leeds, Cardiff between 29 June – 8 July here. For those interested in exporting to China, the roadshow will highlight the extensive work that has been done to identify and scope current opportunities in the healthcare sector there. Great stuff.

On a different tack, this editor has just been made aware that the University of Greenwich has established (more…)

Good news on telemedicine from the US…and one small potentially dark cloud

May 31, 2015 | by

According to FierceHealthIT, last week three more states – Indiana, Minnesota and Nevada – enacted telemedicine parity laws, bringing the total to 27 plus the District of Columbia, to make it that much easier to provide – and to request provision – of a telemedicine service.

  • Indiana’s requires coverage of the services under private insurance through video, audio or other media. The law prohibits a provider from having to obtain written consent for use of telemedicine.
  • Minnesota’s law says health plans must cover and reimburse for telemedicine the same way and at the same cost as in-person service. Medicaid coverage, according to the law, is limited to three telehealth services per week per beneficiary.
  • Nevada’s requires coverage and reimbursement for telehealth under private insurance and Medicaid, as well as workers compensation (the first state to include this) to the same extent and at the same price as provided in person.

Meanwhile MorningStar reports that a Federal Court ruled in favor of Teladoc, blocking as illegally limiting competition  (more…)

The health disruptors, about to be themselves disrupted

May 31, 2015 | by

FierceMedicalDevices on Friday had an article on disruption of the hearing aid business that looks like it could have slipped through a time warp from a few years back – it even mentions faxing as a part of the new process.

The disruption it transpires is separating hearing test from hearing aid provision, the results of the test being sent to a provider “via fax or email”. This it seems is likely to reduce device costs (no mention of the tests costs) from $1,000-$6,000 to some $700/pair.

However, as a Royal Society of Medicine audience heard recently, (more…)

A new MSc in Data Science for Research in Health & Biomedicine at UCL

May 27, 2015 | by

Anyone interested in pursuing an education in health informatics or data science at UCL is invited to an open evening on 25th June from 4:30pm at 222 Euston Road, London. This is billed as an informal event with an opportunity to meet staff and students and to learn more about the work of the Centre for Health Informatics and Multiprofessional Education, the UCL Institute for Health Informatics and the Farr Institute.

The occasion will be the launch event for UCL’s new MSc in Data Science for Research in Health and Biomedicine. This programme is set to equip graduates for new careers in academia, healthcare organisations, pharmaceutical companies and consultancies dealing with Big Data. UCL will be working closely with NHS, research and commercial partners to deliver an innovative and practical programme that will give students real exposure to practical research in one of the top centres for data science in health and biomedicine.

Book your place here.

Driverless cars will cut insurance costs – is there a parallel with mHealth?

May 26, 2015 | by | 1 Comment

This article in the Telegraph last week has stimulated Prof Mike Short to ask whether if driverless cars can eliminate bad driving and so reduce insurance costs, mHealth can do the same for those with either or both life assurance and health insurance.

There’s little doubt in the mHealth community that technology will cut costs, and already there are (at least a few) solid examples. The big question is, can the insurance world – both life assurers & health insurers – be convinced? We know in the UK for example that BUPA is working hard on mHealth solutions, and that Aviva has tied up with Babylon (who recently won the recent AXA ‘Most Innovative Provider’ award)…and doubtless there is much more too. Obviously the situation is much further ahead in countries such as the US where health insurance is the norm.

Mike suggests that we run an insurance led event to look at techniques of prevention as well as cure/care. This could have an interesting policy dimension if the health insurers were willing to think about new measurement policies and indicate where they wish to go with data driven policies – eHealth as an opener for new policies and forms of funding? As he says, apps/wearables/connectivity are just enablers to this wider story, for which the insurance systems and their objectives need to be understood too.

DHACA is happy to participate, broker or organise such an event – we’d really welcome view from readers though first – would you be interested in taking an active part in what might just change the face of health insurance in the UK, and promote mHealth at the same time?

An important intervention on mHealth from the EU Data Protection Supervisor

May 25, 2015 | by

At the end of last week, the EU Data Protection Supervisor (EDPS) published an excellent document entitled Mobile Health – Reconciling technological innovation with data protection. To quote the press release:

Failure to deploy data protection safeguards will result in a critical loss of individual trust, leading to fewer opportunities for public authorities and businesses, hampering the development of the health market. To foster confidence, future policies need to encourage more accountability of service providers and their associates; place respect for the choices of individuals at their core; end the indiscriminate collection of personal information and any possible discriminatory profiling; encourage privacy by design and privacy settings by default; and enhance the security of the technologies used.

The document itself contains much of interest. To this editor, who has heard many people poo-poo the importance of wellbeing data, it was good to see:

Lifestyle and well-being data will, in general, be considered health data, when they are processed in a medical context (e.g. the app is used upon advice of a patient’s doctor) or where information regarding an individual’s health may reasonably be inferred from the data (in itself, or combined with other information), especially when the purpose of the application is to monitor the health or well-being of the individual (whether in a medical context or otherwise). (Page 5)

As someone who gets concerned at turning people off sharing their health data, it was nice to see the recognition that: (more…)

National UK Telehealthcare Awareness, KFC & Wayra – three recent items

May 25, 2015 | by

On June 3rd, UK Telehealthcare is holding their first National Telehealthcare Awareness day with events all over the country – follow the link to see what’s happening close to you!

This editor was alerted by a poster from the recently rehoused CUHTec who are supporting the  Mascot event at Merton. Other events that particularly caught this reviewer’s eye were at Welbeing/West Sussex, NEAT (remember when the N used to stand for LB Newham – now it’s Norwich) and Cair.

Next, who can resist a heading that reads KFC Tray Typer keyboard is finger clickin’ good. It turns out that KFC have created a wipe-clean tray mat that doubles as a Bluetoothed keyboard so you can continue typing without gumming up your mobile device with grease whilst enjoying their delectable fare.  Sadly these were only available in Germany, and then only for a set of new KFC openings. The plan apparently was that the mat was durable enough to get wiped down and re-used however (more…)

More evidence of confusion among clinicians over medical apps (UK) + MAUDE

May 25, 2015 | by

A paper just published in the Annals of Medicine & Surgery entitled A UK perspective on smartphone use amongst doctors within the surgical profession also sheds some interesting light on the use of mobile apps by surgeons.

Given the recent advice to members by the RCP against the use of apps that are medical devices though not CE certified, the following finding is of especial interest, as it is widely considered that many clinical calculators meet the EU legal definition of a medical device:

…when looking specifically at senior doctors, the most common type of app utilised was clinical calculators followed by reference guides/handbooks and then drug reference guides.

The paper also confirms findings by this editor and others that clinicians are confused by the wide range of apps available and lack guidance on the effectiveness & efficacy of individual apps.

The majority of participants did not have any relevant suggestions for app development, which may suggest that there is an uncertainty over the catalogue available. Given concerns voiced in both our study and the work of others questioning the reliability of available resources, a possible solution would be the creation of a UK based app directory to outline availability with verification of performance and validity. However given the complexity of this regulation, peer review specific to the UK may have to suffice.

A short & interesting read that very much supports the need for a reference source for clinician-facing apps, and an objective measure of the benefits they deliver: recommended.

Whilst writing, Prof Mike Short has also drawn my attention to a related, very short, article entitled To Be or not to Be a Medical Device: Is the Regulatory Framework a Safety Rope or a Fetter? which thankfully concludes that:

Certainly, adhering to the standards listed <in the article> massively increase administrative overhead in research and development, extend the “time to market” and causes increased costs. However, this is the price to pay for success to reach the goal: Impact on patient care. Therefore, the answer to the question in the title of this article is: Software can be a medical device and from this point of view, we have to accept administrative overheads – and the regulatory framework can be a useful guide-line.

Perhaps more interestingly though it includes reference to the FDA’s ‘Manufacturer and User Facility Device Experience (MAUDE) which records product problems (obviously in the US), including those for medical software. Wouldn’t it be great if the EU had such a database for medical apps?

After a long absence, a What the Blue Blazes award…or is that two?

May 16, 2015 | by | 1 Comment

blue-blazesThough recently threatened, the Telehealth & Telecare Aware What the Blue Blazes award has not been presented for some while, so it was kind of PC Magazine to draw our attention to an AT&T Innovation Day special of a Connected Car Seat that texts the car’s owners if it detects a child has been left in the car when the car temperature exceeds a pre-set level. When this editor’s two daughters were babies, leaving a dog in a car on a hot day was considered unacceptable, let alone a child, so to introduce a facility that may notify car owners of children at risk of overheating would seem to be the ultimate in irresponsible encouragement (most text messaging services of course guarantee neither delivery, nor maximum elapsed time to delivery, even if a parent happens to have their phone handy, & it’s switched on, & not on silent).

Now if the car was to persist in blowing its horn if it detected a car owner trying to leave a baby alone still strapped in the car on a warm day, or automatically phoned the police to report an overheating child left alone in a car, that might make more sense. (In Europe, the latter option – calling the police – couldn’t be simpler, as an add-on to eCall, the new automatic car emergency service being introduced across Member States in the next two years.)

Meanwhile in Jordan, a woman recovering from a caesarian section operation on April 24th, troubled by persistent vibrations in her womb (more…)

A collation of recent items received – something for everyone

May 11, 2015 | by

Thanks to Professor Mike Short, Mike Clark and Dr Nicholas Robinson, the following are items that have been drawn to the attention of this editor, plus a few he spotted himself:

We begin with a post from Dr Richard Windsor, aka Radio Free Mobile, a person whose opinions I greatly respect, arguing that Fitbit has chosen the perfect moment to float.

Next is an invitation to a Healthcare App – Peer to Peer Session at Swansea University on 20th May at The Institute of Life Science 2 – attendance is free, booking is here. Hours are stated  as 10.45 am – 12.00pm (ie noon).

Then we have a gentle reminder for the Royal Society of Medicine’s event on the 4th June entitled “Should patients manage their own care records?” As the RSM is a charity, our charges for a whole day of excellent speakers are a tiny fraction of what a commercial event would charge, and there’s no hustling.

After that we have the latest Morgan Stanley North American Insight, summarised as saying (more…)

The Future of Medicine – Technology & the Role of the Doctor in 2025 – a brief summary

May 10, 2015 | by

The following is a brief summary of a joint Royal Society of Medicine/Institute of Engineering & Technology event held at the Academy of Medical Sciences on 6th May. The event was organised, extremely professionally, by the IET events team. The last ticket was sold half an hour before the start, so it was a genuine sell-out.

The speakers for the event were jointly chosen by this editor and by Prof Bill Nailon, who leads the Radiotherapy Physics, Image Analysis and Cancer Informatics Group at the Department of Oncology Physics, Edinburgh and is also a practising radiological consultant. As more of those invited by Prof Nailon were available than those invited by this editor, the day naturally ended up with a strong focus on advances in the many aspects of radiology as applied to imaging & treating cancer, as a surrogate for the wider examination of how medicine is changing.

The event began with a talk by Prof Ian Kunkler, Consultant Clinical Oncologist & Professor in Clinical Oncology at the Edinburgh Cancer research Centre. Prof Kunkler began by evidencing his statement that radiotherapy delivers a 50% reduction in breast cancer reappearance, compared with surgery alone. He stressed the importance of careful targeting of tumours with radiotherapy – not an easy task, especially if the patient is unavoidably moving (eg breathing) – Cyberknife enables much more precise targeting of tumours as it compensates for such movement. Apparently studies have shown that 55% of cancer patients will require radiotherapy at some point in their illness.

This was followed by Prof Joachim Gross, Chair of Systems Neuroscience, Acting Director of the Centre for Cognitive Neuroimaging & Wellcome Trust Senior Investigator, University of Glasgow, talking about magnetoencephalopathy (MEG), which enables excellent spatial & temporal resolution of the brain. However it currently uses superconducting magnets that in turn require liquid helium, so is very expensive to run. He then showed an atomic magnetometer which apparently is developing fast and will be a much cheaper alternative to MEG – he expects people will be able to wear sensors embedded in a cap soon. He then went on to show truly excellent graphics on decoding brain signals with incredible precision; he explained that the 2025 challenge is understanding how the different brain areas interact. Finally he described neurostimulation, using an alternating magnetic field with the same frequency as brain waves to change behaviour; whence the emergence of neuromodulation as a new therapy. Both exciting, and just a little scary.

Dr David Clifton, Lecturer, Dept of Engineering Science & Computational Informatics Group, University of Oxford, followed with a talk on real-time patient monitoring. He began by explaining the challenges that clinicians face with this wall of patient data coming towards them: only “big data in healthcare” enables all the data generated by patients to be analysed to identify the early warning signals that are so important to minimise death and maximise recovery. (more…)