Tenders closing quickly: Cornwall/Isles of Scilly, Blackpool

June 13, 2017 | by

Susanne Woodman of BRE, our Eye on Tenders, had sent these earlier but your Editor was at fault in being tardy in reviewing them. But there’s still time!

  • Cornwall/Isles of Scilly: The University of Plymouth and E-health Productivity & Innovation Cornwall & Isles of Scilly (EPIC) are seeking to engage specialist support for the Social Care Sector and Care Homes across Cornwall and the Isles of Scilly to develop their awareness and capability to adopt emerging ehealth products and services. This is closing Wed 14 June so go to the Plymouth website for more information. Gov.UK Contracts Finder
  • Blackpool Council: They are inviting “suitably experienced care organisations to participate in an exploratory exercise to help the Council better understand the market position with regards to supporting individuals with a learning disability and/or autism to live independently through use of assistive technology.” This closes Monday June 19. Tenders Electronic Daily (TED), Due North website

76% of health systems to adopt consumer telemedicine by 2018: Teladoc survey

June 13, 2017 | by

We normally don’t feature corporate or sponsored surveys, but are making an exception here as it demonstrates two trends: that hospital systems can’t fight consumer telehealth** anymore, and that the future mix of usage is starting to change. Teladoc’s/Becker’s Healthcare Hospital & Health Systems 2016 Consumer Telehealth Benchmark Survey projects that by 2018, 76 percent of health systems will adopt consumer telehealth (vs. site-to-site), double from 2016, and that most who have it will be expanding offerings. As a benchmark survey, it tracks services offered or plan to offer, organizational priorities, and goals.

An interesting part is how the mix of services under telehealth is evolving. Presently, the top three among current users are urgent care, primary care, and psychiatry/mental health. For new users, their priorities are ED/urgent care (45 percent), readmission prevention (42 percent), primary care, including internal medicine and pediatrics (42 percent), chronic condition management (41 percent). Nearly one in five (18 percent) plan to include cardiology services.

As implemented by health systems, telehealth has run into problems that were totally predictable and will provoke the ‘Duh?’ response from our Readers. From the report:

  1. They didn’t measure patient or physician satisfaction with their telehealth programs, even though improving patient satisfaction is a leading motivator for offering telehealth services.
  2. Gaining physician buy-in was cited by 78 percent of respondents, and rated as the #1 lesson learned
  3. The second most important? The importance of aligning telehealth initiatives with organizational goals (75 percent). (more…)

The Nightingale-H2020 project for wireless acute care (UK/EU)

June 12, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/06/nightingale.jpg” thumb_width=”150″ /]Susanne Woodman of BRE, our Eye on Tenders, is following the Nightingale-H2020 project for acute care–and if you are in the wireless or wearable remote monitoring business, you should be too. It is a pre-commercial procurement project (PCP) that invites the European healthcare industry to develop wireless solutions for patient in-hospital and home monitoring. Deriving from the European Commission’s Horizon 2020 grant, the process started last year with a €5 million award and in the spring had two Open Market Consultation meetings. Q&As from these meetings were recently released. The official tender will be released this November on the EU website Tenders Electronic Daily (TED). For more information, consult the Nightingale PCP website and their useful PDF on the process. @Nightingale_EU

Behave, Robot! DARPA researchers teaching them some manners.

June 9, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/Overrun-by-Robots1-183×108.jpg” thumb_width=”150″ /]Weekend Reading While AI is hotly debated and the Drudge Report features daily the eeriest pictures of humanoid robots, the hard work on determining social norms and programming them into robots continues. DARPA-funded researchers at Brown and Tufts Universities are, in their words, working “to understand and formalize human normative systems and how they guide human behavior, so that we can set guidelines for how to design next-generation AI machines that are able to help and interact effectively with humans,” said Reza Ghanadan, DARPA program manager. ‘Normal’ people determine ‘norm violations’ quickly (they must not live in NYC), so to prevent robots from crashing into walls or behaving towards humans in an unethical manner (see Isaac Asimov’s Three Laws of Robotics), the higher levels of robots will eventually have the capacity to learn, represent, activate, and apply a large number of norms to situational behavior. Armed with Science

This directly relates to self-driving cars, which are supposed to solve all sorts of problems from road rage to traffic jams. It turns out that they cannot live up to the breathless hype of Elon Musk, Google, and their ilk, even taking the longer term. Sequencing on roadways? We don’t have the high-accuracy GPS like the Galileo system yet. Rerouting? Eminently hackable and spoofable as WAZE has been. Does it see obstacles, traffic signals, and people clearly? Can it make split-second decisions? Can it anticipate the behavior of other drivers? Can it cope with mechanical failure? No more so, and often less, at present than humans. And self-drivers will be a bonanza for trial lawyers, as added to the list will be car companies and dealers to insurers and owners. While it will give mobility to the older, vision impaired, and disabled, it could also be used to restrict freedom of movement. Why not simply incorporate many of these assistive features into cars, as some have been already? An intelligent analysis–and read the comments (click by comments at bottom to open). Problems and Pitfalls in Self-Driving Cars (American Thinker)

GreatCall’s acquisition: a big vote for older adult-centered healthcare tech

June 9, 2017 | by

This midweek’s Big News has been the acquisition of the mobile phone/PERS company GreatCall by Chicago private equity firm GTCR. Cost of the acquisition is not disclosed. GTCR stated that they expect to make capital investments to GreatCall to fund future acquisitions and internal growth. GreatCall has over 800,000 subscribers in the US, generates about $250 million in profitable revenue annually, and employs about 1,000 people mainly in the San Diego area and Nevada. According to press sources, senior management led by CEO David Inns will remain in place and run the company independently. 

Our US Readers know of GreatCall’s long-standing (since 2006), bullseye-targeted appeal to older adults who desire a simple mobile flip phone, the Jitterbug, but has moved along with the age group to a simple smartphone with built-in health and safety apps. Along the way, GreatCall also developed and integrated the 5Star mPERS services on those phones, served by their own 24/7 emergency call center and developed an mPERS with fall detection. Their own acquisitions included the remnants of the Lively telecare home monitoring system in 2015 [TTA 5 Dec 15], adding the Lively Wearable mPERS/fitness tracker to their line; and senior community telecare service Healthsense last December. The original Lively home system and safety watch are sold in the UK (website) but apparently not the Jitterbug. In the UK and EU, the Jitterbug line would be competitive with established providers such as Doro.

What’s different here? GTCR is not a flashy, Silicon Valley PE investing in hot, young startups or a traditional senior health investor like Ziegler. Its portfolio is diversified into distinctly non-cocktail-chatter companies in financial services and technology; technology, media and telecommunications (including an outdoor ad company!); and growth businesses. It has real money, investing over $12 billion in 200 companies since 1980, and strategically prefers leadership companies. Their healthcare businesses have primarily been in life sciences, specialty pharma, dermatology, specialty services such as healthcare in correctional institutions, and device sterilization. Recent acquisitions have been San Diego-based XIFIN, a provider of cloud-based software to diagnostic service providers, RevSpring in billing and communications, and data analytics firm Cedar Gate Technologies. It also has partnered with newly formed medical device companies.

GreatCall crosses over into GTCR’s telecommunications sweet spot, but the older adult market and direct-to-consumer sell are different for them. Because it is unique in their portfolio, this Editor believes that GTCR sees ‘gold’ in the ‘silver’ market. Larry Fey, one of their managing directors, cited its growth and also GreatCall’s recent moves into senior communities with their products. GTCR also has expertise in the security alarm monitoring sector, which along with pharma clinical trials can bolster better utilization and broaden the utilization of GreatCall’s call centers.

However, this Editor would caution that the US senior community market has been having difficult times of late with overbuilding, declining occupancy, resident/labor turnover, and rising expenses–as well as recent coverage of security lapses and resident abuse. Telecare systems like Healthsense are major capital expenses, but the flip side is that communities can use technology to improve care, resident safety, and to differentiate themselves. To make the most of their Healthsense acquisition, GreatCall needs to bring innovation to the V1.0 monitoring/safety/care model that Healthsense is in its current state, and make the case for that innovation in cost/financials, usability and reliability. San Diego Union-Tribune, Mobihealthnews

Tech that assists those with speech impairments, telemedicine for mapping public health

June 8, 2017 | by

This year’s trend to develop technologies that solve specific but important problems, such as improving navigation for the visually impaired, [TTA 8 June] continues:

  • Voice-controlled assistance systems are becoming commonplace, from improved interactive voice response (IVR) to Siri, Echo, and Alexa. Their limitation is that their recognition systems understand only standard, not impaired or even heavily accented speech. For those with the latter, a Tel Aviv-based startup called Voiceitt has developed Talkitt, an app that learns an individual’s speech based on basic, everyday spoken (or typed input) phrases and after a training period, converts them into normal audio speech or text messages on a tablet or smartphone. This aids with everyday life as well as devices like Echo and Alexa. Voiceitt is out of the Dreamit Health accelerator and was just seed funded with $2 million. This Editor notes from the TechCrunch article that it’s described as ‘the thin edge of the wedge’ and ‘a market with need’. It will be introduced this year to health systems and schools to assist those with speech impairments due to health conditions. Hat tip to Editor Emeritus Steve Hards
  • Diagnosing degenerative diseases such as diabetic retinopathy, which is preventable but if untreated eventually blinds the patient, is doubly difficult when the patient is in a rural, economically disadvantaged, predominantly minority, and medically underserved area of the US. Ophthalmologist Seema Garg has been on a quest since 2009 to have this recognized as a public health threat. The North Carolina Diabetic Retinopathy Telemedicine Network out of University of North Carolina-Chapel Hill, headed by Dr. Garg, collaborated with five NC clinics to recruit patients with diabetes. Her team then trained primary care staff to take digital retinal photographs transmitted over a secure network to be examined for symptoms. The public health study used Geographic Information Systems (GIS)-mapping for patient accessibility to ophthalmologists, demographics, and risk factors such as higher A1C levels, minority race, older age, kidney disease, and stroke. JAMA Ophthalmology, Futurity  Hat tip to Toni Bunting of TASK Ltd. (and former TTA Ireland editor)

Wearable haptic/Braille guidance system for the visually impaired

June 8, 2017 | by

MIT researchers from their CSAIL (Computer Science and Artificial Intelligence Laboratory) unit have developed a system that is designed to aid the visually impaired in accurately navigating a room, with or without the assistance of a cane. It consists of a 3-D camera worn on the abdomen, a belt that has vibrational (haptic) motors, and an electronically controlled Braille interface worn on the side of the belt. The camera is worn on the chest as the optimum and least interfering body location. The pictures taken are analyzed by algorithms that quickly identify surfaces and their orientations from the planes in the photo, including whether or not a chair is unoccupied. The belt sends different frequency, intensity, and duration tactile vibrations to the wearer to help identify nearness to obstacles or to find a chair. The Braille interface also confirms the object and location through key initials (‘c’ for chair, ‘t’ for table) and directional arrows. According to the MIT study, “In tests, the chair-finding system reduced subjects’ contacts with objects other than the chairs they sought by 80 percent, and the navigation system reduced the number of cane collisions with people loitering around a hallway by 86 percent.” MIT News, Mashable, ‘Wearable Blind Navigation’ paper Hat tip to Toni Bunting of TASK Ltd.

 

VA says goodbye to VistA, hello to Cerner for new EHR–and possible impacts (updated)

June 7, 2017 | by

The new sheriff just turned the town upside down. Veterans Affairs’ new Secretary, Dr. David J. Shulkin, as expected moved quickly on the VA’s EHR modernization before the July 1 deadline, and moved to the same vendor that the Department of Defense (DoD) chose in 2015 for the Military Health System, Cerner. VA will adapt MHS GENESIS, based on Cerner Millenium. The rationale is seamless interoperability both with DoD and with private sector community providers and vendors, which base their services on commercial EHRs. The goal is to have one record for a service member through his or her lifetime and to eliminate the transition gap after discharge or retirement. (Transition gaps are also repeated when reservists or National Guard are called up for active duty then returned to their former status.) Another priority for VA is preventing the high rate of suicide among vulnerable veterans.

Updates: VA confirmed that Epic and Leidos will keep the development of the online medical appointment scheduling program, awarded in 2015 and currently in pilot, to be completed in 18 months. The contract is worth $624 million over five years. Wisconsin State Journal  The House Appropriations subcommittee on Veterans Affairs likes the Cerner EHR change. The Senate Veterans Affairs Committee is meeting Wednesday to discuss the VA budget sans the EHR transition. The EHR numbers are expected to be sooner rather than later. POLITICO Morning eHealth 

Dr. Shulkin is well acquainted with the extreme need for a modernized, interoperable system serving the Veterans Health Administration (VHA), having been on the US Senate Hot Grill for some years as Undersecretary of Health for VA. The foundation for the move from homegrown VistA to Cerner was laid last year during the prior Administration through an August RFI for a COTS (commercial off the shelf) EHR [TTA 12 Aug 16] and in later hearings. “Software development is not a core competency of VA” and it has been obvious in system breakdowns like scheduling, maintaining cybersecurity and the complex interoperability between two different systems. To move to Cerner immediately without a competition, which took DoD over two years, Dr. Shulkin used his authority to sign a “Determination and Findings” (D&F) which provides for a public health exception to the bidding process. The value of the Cerner contract will not be determined for several months.

For those sentimental about VistA, he acknowledged the pioneering role of the EHR back in the 1970s, but that calls for modernization started in 2000 with seven ‘blue ribbon’ commissions and innumerable Congressional hearings since. He understated the cost in the failed efforts on interoperability with DoD’s own AHLTA system, VA’s own effort at a new architecture, and modernizing the outpatient system. This Editor tallied these three alone at $3 billion in GAO’s reckoning [‘Pondering the Squandering’, TTA 27 July 13]. 

It is still going to take years to implement–no quick fixes in something this massive, despite the urgency.

  • Both MHS and VA will be running two systems at once for years (more…)

Tunstall Americas has a new president/CEO (updated)

June 5, 2017 | by | 1 Comment
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”175″ /]Updated Softly, softly. Rumors of a change at the top of Tunstall Americas were confirmed by the appearance in late May of Oscar Meyer as president/CEO on the leadership page of their website. This Editor was tipped earlier that Casey Pittock’s name had disappeared from the page at some point prior to mid-May. Inquiries at that time to their UK press contact were not returned. As of June 6, there is still is no formal press release announcing the change on PRWeb, their usual release site, or posted on the website.

The leadership page gives the barest bones of Mr. Meyer’s background: most recently North America Commercial Operations team for Invacare Corporation, a DME company primarily in the long-term care market, with most of his career at J&J. His LinkedIn page also adds in an adjunct professorship at Xavier University, a brief VP stint at Gambro (acquired by Baxter 2013) and Snow Creations, LLC, giving his location as Ohio. Tunstall Healthcare Group CEO Gordon Sutherland also is a veteran of Invacare (as head of EMEA) and Gambro.

Our Readers will recall the sudden change at Tunstall Americas three years ago when Mr. Pittock was ‘unveiled’ at the Medical Alert Monitoring Association meeting by then Tunstall Group CEO Paul Stobart, replacing Bradley Waugh [TTA 14 Mar 14]. Mr. Pittock was still listed on the Tunstall Group website as CEO North America through May 26, but as of this writing (June 6) the leadership roster has been updated with Mr. Meyer’s picture and brief bio. 

This Editor hopes that Mr. Meyer makes headway in the complex and crowded US PERS and safety market. Tunstall acquired in 2011 one of the most successful PERS/monitoring businesses here, AMAC, but failed to build substantially on their established business. One of the last appearances of Mr. Pittock in the press was in February for the Ripple Network Technologies personal safety device, where Tunstall Americas was providing the 24/7 emergency monitoring [TTA 1 Feb]. A great idea, but by March 3, Ripple had canceled its Kickstarter fundraising and their last Twitter post was March 21, indicating the company has gone dark or out of business. It is another example of how difficult it is to make headway here in the Americas. Is it acquire another company–or go home?

Texas gets its telemedicine on: governor signs off on full direct-to-consumer access

May 31, 2017 | by

The telemedicine stars at night–and day–are big and bright, deep in the heart of Texas. Over the weekend, Governor Greg Abbott signed into law Senate Bill 1107 which ended the requirement that a physician-patient relationship had to be established offline before a telemedicine visit could take place. MedCityNews  The Texas House earlier this month passed House Bill 2697 permitting direct-to-consumer virtual doctor visits, followed by the concurrent bill SB 1107 in the Senate. JD Supra (Jones Day), Modern Healthcare

The new legislation allows for previously prohibited initial care via telemedicine (versus in person), asynchronous “store-and-forward” typically used for data and images or other such audiovisual technology so long as it complies with rules that ensure safety and quality. The bill’s terms were negotiated between the Texas Medical Association, the Texas eHealth Alliance, and Teladoc. It also effectively ends the long-running, six-year standoff between Teladoc and the Texas State Medical Board, and the shutout of other providers such as American Well.

Both rivals cheered the good news on, which was timed beautifully for Teladoc’s 1st Quarter earnings call on May 9, adding to record-high visits, plus healthy revenue and membership increases. While it has many internationally known medical centers, Texas is a huge state and is notoriously short of primary care physicians, with 71.4 primary care physicians per 100,000 people and 46th among all the states for primary care physicians per capita.

There is one aspect of the bill that ensures further legal challenge, which is the language prohibiting the use of telemedicine to prescribe abortion-inducing medication as it does in 20 other states. Mobihealthnews. Further background in March article

Add hospital-acquired infections to your list, Google Ventures!

May 31, 2017 | by

Google Ventures’ Hot 7 [TTA 23 May] should be a Hot 8. Three recent articles have reminded this Editor that we are no further along in controlling nosocomial, or hospital-acquired, infections–and they are getting worse. They annually kill 75,000 US patients in hospitals and 375,000 patients in nursing homes. Those who get it and survive take months to fully recover, if they can.

  • They keep multiplying. The US’ Eye on Infection, Betsy McCaughey, former NY State lieutenant governor, brings to attention a new one called Candida aureus, a fungus which kills 60 percent of patients it infects. It’s been detected in New York (15 hospitals so far), New Jersey, Illinois, Massachusetts, and Illinois. It is carried on surfaces, sink drains, uniforms, clothing, skin, and devices, the last usually fatal to the patient. Patients can also be carriers.
  • The spread of CRE (carbapenem-resistant bacteria) could be the future of Candida aureus. In 1999, it was first detected at Downstate Medical Center in NYC. By 2008 it reached 22 states and is now a nationwide threat.
  • MRSA and MSSA are widespread, waxing and waning in outbreaks.

The problem has escalated to the point where Mark Sklansky, M.D., a professor of pediatrics at the David Geffen School of Medicine at UCLA, has launched a pilot to ban handshakes in two UCLA neonatal intensive care units–and it’s being debated on whether it’s effective or just consciousness raising.

Ms McCaughey attributes this to lack of action by CDC, despite Congress, in staying with outdated guidelines for how to clean patients’ rooms, ignoring the potential of automatic room disinfection to save lives. CDC underestimates the impact through bad sampling. Hospitals under-report deaths from infection. State authorities are no better in their inaction.

A solution far more aggressive than banning handshakes is screen-and-clean. Israel’s drastically reduced CRE by 70 percent in one year from its 2007 outbreak. Even babies are screened. Automatic room disinfection is not a panacea, but architects have been tackling this in designs for future hospital rooms for years. The most recent concept this Editor saw was at last November’s NYeC Digital Health Conference.

GV, where art thou? FierceHealthcare, Creators.com, NY Post

Warby Parker’s home eye testing app, executive hire

May 31, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/05/warby-parker-prescription-check.jpg” thumb_width=”150″ /]An app for a home eye test–but is it wise? Warby Parker, the well-known online eyewear company, is testing an app that enables an eye test at home. Currently ‘Prescription Check’ is being tested on Warby Parker customers between the ages of 18 and 40 in California, Florida, New York, and Virginia. Initially, Warby Parker uses the information to confirm that the existing prescription is still correct; updated prescriptions are in the future.

Without brick-and-mortar locations, the company is obviously using this to retain current customers and gather in new ones, away from local optician stores–the market that Smart Vision Labs is courting with its optician-administered, ophthalmologist-reviewed five-minute vision exam to lure in one-stop-shopping-seeking millennials [TTA 11 Apr] for both glasses and checking contact lenses. Both companies recommend a professional eye exam at least every two to three years.

Unlike Smart Vision Labs, Warby Parker is already being opposed by the American Optometric Association (AOA) which disdains DIY eye exams. South Carolina also recently passed legislation banning smartphone-based eye exams. Prescription Check is also similar to Opternative, which charges $40-60 for an online exam including contact lenses. Healthcare Dive, TechCrunch, Mobihealthnews

Warby Parker’s seriousness on eye testing is underlined by their announcement of David Rose as their new VP of Computer Vision. Mr Rose was the founder of the Vitality GlowCaps bottle-top med reminder, purchased by what is now NantHealth in 2011. He was also one of the first digital health entrepreneurs this Editor met at her first Connected Health Symposium in 2009, where he showed the GlowCap 1.0 to all who would listen! Mobihealthnews 

DNA ‘Snapshot’ facial modeling–and predicting future Alzheimer’s risk

May 31, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/05/SNPSHT-Example-1-1024×972.jpg” thumb_width=”150″ /]It sounds like something from an episode of ‘Law & Order’ (US or UK), but extracting facial appearance and ancestry from a forensic DNA sample isn’t fiction anymore. Parabon NanoLabs was funded by the Defense Threat Reduction Agency (DTRA) to develop Snapshot originally to dismantle improvised explosive device networks in Iraq and Afghanistan. The methodology was then transferred to DNA analysis. Parabon uses data mining and advanced machine learning to predict how the single nucleotide polymorphisms of the genome will make someone appear. This appearance profiling includes eye color, skin color, hair color, face morphology, and detailed biogeographic ancestry (see left above). The forensic art alone can age up or down the subject, adding or subtracting glasses and facial hair. These factors have successfully focused investigations for over 80 law enforcement agencies. According to Armed with Science, Parabon is now transferring the technology to predict an individual’s lifetime risk of Alzheimer’s–certainly a revolutionary use in healthcare technology.

HealthIMPACT East Monday 5 June (NYC)

May 31, 2017 | by

HealthIMPACT East
Monday, 5 June, Union League Club, New York, NY

The HealthIMPACT series of mainly single-day events on health tech/HIT’s effect on healthcare now covers several major cities in the US. What this Editor likes about them is that they compress a great deal of information in a single day, with well-presented, relaxed panel discussions with top executives and figures in the industry. They are also held in interesting venues like the Union League Club in NYC. HealthIMPACT East is co-produced with NODE Health. This fifth annual meeting will focus on evidence-based digital health, healthcare innovations, cybersecurity, and how to achieve value-based care. Speakers are from academic and provider organizations like Yale University, Jefferson Health, Mount Sinai, Northwell Health, PCHAlliance, New York-Presbyterian, NJIT, and Partnership Fund for NYC, Panels are being hosted this year by former colleagues from Health 2.0 NYC Megan Antonelli of Purpose Events and “The Healthcare IT Guy” Shahid Shah. It’s not too late to register for this full day, including breakfast, lunch, and cocktail reception, here. TTA is a media partner for HealthIMPACT East.

‘We carry on’ this Memorial Day

May 26, 2017 | by

As our Readers and Editors make our getaways for this holiday weekend (on Monday, in the UK the Spring Bank Holiday, in the US Memorial Day), it cannot help be on our minds the terrorist bombing this week killing concertgoers in Manchester and the extreme likelihood of further terror attacks. NHS trauma centers are already on highest alert specifically for this weekend, and there are reports that there may be another or even more devices in the hands of terrorists, ready for further slaughter, based on the remains of the home bomb factory. Here in New York, it is also Fleet Week, where many of our Navy’s and Coast Guard’s ships, along with sailors and Marines, visit the city. There are multiple, well-publicized events all over the metropolitan area. Evidence of increased security is everywhere.

On this US Memorial Day, where we remember and honor our fallen soldiers, sailors, airmen, Marines, Coast Guard, Merchant Marine and civilians in military service, we also include in our thoughts and prayers the innocent Manchester children and adults killed for simply enjoying themselves at a concert. We also remember that there are 18 adults and 14 children still in hospital, and that NHS emergency and trauma staff, under extreme pressure, performed magnificently.

Hundreds, perhaps thousands, of lives are forever changed. What really hits the heart, more so than at Bataclan, are that most of the dead and survivors, are children and adults waiting to take them home. Innocent lives snapped out in a few seconds. Holes in the heart that will never close.

What also hit the heart was Roy Lilley’s Friday newsletter, which says it better and more than this Editor can express. We carry on because we have to, until we can do better. We are pleased to link to it here.

CBO finds as budget neutral telehealth in Senate CHRONIC Care Act

May 26, 2017 | by | 1 Comment

Sneaking under the holiday week wire, when Congress high-tails it for home, the Congressional Budget Office (CBO) reviewed the telemedicine and telehealth provisions in the US Senate’s pending CHRONIC Care Act and found last week that they do not increase or decrease Medicare spending overall. Formally S.870 – Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017–and sponsored by Sen. Orrin Hatch of Utah, this means that this bill developed by the Senate Finance Committee’s bipartisan Chronic Care Working Group has passed a key spending acceptability test, and is another step further towards passage. CHRONIC removes many of the qualifiers that Medicare hedged around telehealth and telemedicine, with most restricting reimbursement to rural areas. There are four areas where the Act removes barriers:

  1. Nationwide coverage for Telestroke
  2. Home remote patient monitoring for Dialysis Therapy
  3. Enhanced telehealth coverage for ACOs–this expands the provisions in the Next Generation ACO program to ACOs participating in the Medicare Shared Savings Program (MSSP) Stages II, III and the few left in Pioneer, so that telehealth will be reimbursed regardless of geographic location and in the home.
  4. Increased flexibility for telehealth coverage under Medicare Advantage plans

There’s a long way to go, but this is an important step forward to an equal playing field for telehealth services. National Law Review’s summary