Silicon Valley’s betting on ‘citizen doctors’, ‘citizen science’ and useful data

December 23, 2015 | by

A fascinating and slightly cynical overview of Silicon Valley’s ideological view of health tech that will fix our ‘deeply flawed healthcare system’ and what is getting funded (or not) is in next month’s San Francisco magazine. It profiles the ‘citizen doctor’ founders of vital signs ‘tricorder’ Scanadu (Sam–who’s not often mentioned–and Walter De Brouwer), bacteria tracker uBiome, ‘personal data recorder’ and experience charter We Are Curious (founded by Linda Avey, a long-departed co-founder of 23andme) and touches on the Theranos debacle. While these stories are bracing and in the instance of the De Brouwers, courageous, the notion of ‘citizen science’ (defined as direct-to-consumer health data) and its companion, Dr Eric Topol’s patient-centered/controlled medicine, has its drawbacks, viewed through the slightly gimlety ‘digital doctor’ eye of UC San Francisco’s Dr Robert Wachter. “The overarching message—not just from Theranos but from other companies struggling to get a toehold—is that, ultimately, the laws of economic gravity hold. The companies will have to produce products that add real value, either to patients or to payers. If they don’t, the market—or the regulators—won’t treat them kindly.” Flatly, there aren’t enough Quantified Selfers right now to support these companies. And Mr Market is a hard master. 23andme is back in the good graces of the FDA after a two-year scuffle and back doing direct response TV here in the US. Scanadu’s two products, Vitals (formerly Scout) and Urine are still not through the long slog of FDA clearance. The jury’s out on Theranos. And all these companies, including ‘unicorn’ Theranos, are bleeding cash and nowhere near turning a profit. ModernLuxury. Hat tip to Dr Topol via Twitter, who had a patient-centered conversation with Dr Wachter that we covered back in September.  Another recent podcast with Dr Wachter is here (Community Health Center radio).

Update: ‘Citizen science’ is nothing new, as revealed by the Science Museum (London)–it’s over 300 years old. While it entered the OED in 2014, ‘in 1715, Edmund Halley used Philosophical Transactions to ask colleagues to help him observe a total solar eclipse, prompting observers from all over the country to respond.’ Other examples are from Benjamin Robins in the same publication in 1749 on fireworks, Charles Darwin and evolution, to the present day. The difference is the flow–similar to what we now call crowdsourcing versus the individual using the data to affect their care.

 

Cornwall Council to terminate BT outsourcing deal

December 23, 2015 | by

The High Court has ruled that Cornwall Council is within its rights to terminate the multi-million pound [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/12/Cornwall-Council.png” thumb_width=”150″ /]services outsourcing contract with BT because BT “did not provide … the service it had promised to the standard it had promised”.

Cornwall Council welcomed the High Court decision yesterday saying “The judge’s decision confirms the Council’s argument that BT Cornwall had been in material breach of the contract due to their failure to carry out services to the required contractual standards and, therefore, that we were justified in reaching the decision that we were entitled to terminate the contract.

“As a result of this decision, the Council intends to give notice of the contract before Christmas but there will be no immediate change in the arrangements as notice will not take effect until January.”

BT was awarded the 10-year contract in 2013 amid much controversy as was widely reported including here on TTA. (more…)

Federal Court denies TMB application to dismiss Teladoc case

December 22, 2015 | by

Readers may have read our article in April this year “Can State medical boards legally prevent telehealth activity?”. [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/12/US-district-court-1.jpg” thumb_width=”150″ /]In that article we examined the potential impact of a case brought by the Federal Trade Commission against the North Carolina State Board of Dental Examiners. The case went all the way to the Supreme Court which determined that the State Board of Dental Examiners was not protected by immunity from anti-trust law.

Teladoc is now locked in a case with the Texas Medical Board (TMB) that is very similar to the North Carolina case and it too has gone along a similar path so far. In the latest development of this case, last week a Federal Court, the US District Court in Texas, denied the application by the TMB to dismiss a case brought by Teladoc that claims that the TMB broke anti-trust law.

What has brought Teladoc and the TMB to court in this way? (more…)

Are you a doctor interested in helping design healthy buildings?

December 21, 2015 | by

If so, there’s a professor at Reading University’s School of Construction Management and Engineering, Derek Clements-Croome, who want to meet you!

He firmly believes that those in building design need to work more with medics because they have valuable valid data about how the body and mind react in everyday environments. He is keen to learn about for example how heart rates, blood oxygenation, glucose levels and so on change when people stand and when they sit. This will help promote active working, based on real evidence that medics have. Building sickness syndrome and musculoskeletal conditions are highly relevant too. In 2013 in UK there were 131 million days off work; 60—90% of workers say they under-perform due to the poor physical environmental conditions. This costs about £100 billion per year. We could help to relieve pressure on doctors and NHS if we had healthier buildings (where we spend about 90% of our time)!

Apparently at the turn of the eighteenth century the French physician Xavier Bichat wrote a lot about the effects of poor air quality but after then the professions diverged.

Prof Croome is very keen to talk to any doctors interested and knowledgeable in these matters that would like to explore mutually beneficial collaboration. Email him at d.j.clements-croome@reading.ac.uk

Telegraph takes a quick look at CES 2016 trends, including wearables (updated)

December 19, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/12/CES-GX-p25a2_400x400.jpg” thumb_width=”150″ /]It’s hard to believe that with the end of the year, the Next Big Event for many is the Consumer Technology’s Association‘s CES 2016 in Las Vegas 6-9 January. The Telegraph notes six trends in this breezy overview of what’s going to be The Next Big Things at the show: connected cars (lots of automaker concepts including the hush-hush Faraday electric), cybersecurity (especially irking this year with healthcare taking three of the top seven-Healthcare IT News), drones (buzzing at a location near you, despite the FAA), wearables (most impacting digital health), virtual/augmented reality (with utility in rehabilitation not mentioned here), and the ever-annoying, ever-cloying Internet of Things. On wearables, the show floor has apparently tripled in size since last year, and the article highlights the Mimo baby sleep monitor and the Qardio ECG monitor. (Unfortunately this Editor missed the November New York CES preview as she was attending HIMSS Connected Health, and due to other commitments won’t be going to Vegas, Baby.) Six predictions for CES 2016: drones, cybersecurity, wearables and more (Telegraph)

Update. During CES, Parks Associates will hosting their 7th annual CONNECTIONS Summit on 6-7  January (Wednesday – Thursday). The most health tech related session is ‘Wearables: Healthcare, IoT, and Smart Home Use Cases’ on Wednesday 10:30am-11:45am, with a panel including executives from Honeywell Life Care, Care Innovations, Qualcomm, Independa, IFTTT and Lumo Body Tech, hosted by director Harry Wang of Parks whom this Editor counts as a Grizzled Pioneer, Research Division. Separate registration required. Information and full agenda here.

To our Readers: Are you attending CES? Interested in contributing some insights? Contact Editor Donna.

47% of UK adults prefer virtual visits: Aviva Health Check study

December 19, 2015 | by | 1 Comment

Insurer Aviva’s latest Health Check study headlined the following findings about UK adults’ growing preference for digital health options, including a growth in acceptance of wearable monitors:

  • 47% are willing to be diagnosed digitally instead of face-to-face with their GP
  • 67% would use wearable technology to monitor long-term medical conditions such as diabetes or heart failure–especially those who are overweight (68%) or obese (71%)
  • The majority already using healthcare technology report improved health–63% of all age groups using a physical activity monitor say it has improved their health, rising to 66% of those with a heart rate monitor
  • Three in five (60%) non-users would use a physical activity or heart rate monitor in the future, while 52% would consider using a sleep pattern monitor
  • 55% agree the NHS should provide free technology to help people play an active role in improving their health
  • Younger age groups are most open (of course) to use of monitoring. 15% of those 25-34 use a physical activity monitor (compared to 8% overall) while 9% of 25-34s use a sleep pattern monitor (vs. 4% overall)

Aviva has an interest in digital health through its recently established customer partnership with babylon‘s UK-based telemedicine app [TTA 26 May]. The study was conducted by ICM Research for Aviva UK Health in August 2015. Respondents were invited from ICM’s online panel and 2,004 interviews were conducted amongst a nationally representative sample of the UK adult population.

The full study is available here to our Readers. Aviva release.

ReWalk powered exoskeleton now covered by the VA (US)

December 19, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/12/rewalk.jpg” thumb_width=”200″ /]The advancement of robotic assistance in movement and walking took a sizable step forward (so to speak) with the Veterans Administration now covering the cost of and transition to the ReWalk powered exoskeleton on a national basis. It will be supplied to qualifying veterans with spinal cord injuries, but that qualification is a substantial hurdle in itself. According to the AP article, height and weight requirements are specific, and the paraplegic veteran has to be capable of wearing the supportive belt around the waist to keep the suit in place and carrying a backpack which holds the computer and rechargeable battery. Crutches still must be used for stability and the FDA as part of its clearance requires an assistant be nearby. It also cannot be worn for a full day, but even minimal use was proven to be beneficial; in VA pilot studies, the paraplegics who wore the ReWalk as little as four hours a week for three to five months experienced better bowel and bladder function, reduced back pain, improved sleep and less fatigue.

ReWalk has identified 45 paralyzed veterans who qualify, (more…)

2015 digital health VC funding flat, consolidations nearly double: Rock Health

December 16, 2015 | by

Rock Health published yesterday their 2015 annual Digital Health Funding report, and perhaps it is good news that 2015 activity maintained the blazing 2014 total at $4.3 bn. Still, it represents a compound annual growth (CAGR) from 2011-2015 of 30 percent.

Consumer digital health is thriving, with healthcare consumer engagement, personal health tools and tracking accounting for 23 percent of overall funding. Two of the six largest deals were won by consumer-driven genetic companies, 23andMe and Helix.

The one new record was that there were 278 deals across 248 companies, with an record-breaking average deal size of $15.6m. What continued is that the vast majority of funding deals (70 percent) were Series B and below, but C and C+ deals increased slightly.  It was also a big year for exits. M&A activity nearly doubled in volume with 180 deals and $6B in disclosed activity. Their index comprising shares of publicly traded digital health companies was off over 5 percent with two of this year’s IPOs trading lower than their opening prices.

According to the Rock Health newsletter, early-funded companies had a few zombies among them. Rock Health looked at companies up to five years ago, and found that 11 percent they classified as either dead or “zombies” (which have not raised a round in 3+ years). “Most likely to die? A disproportionate number of these zombie companies are in the care coordination, EHR, or clinical workflow space.”

The web page with a link to the full study is here. Unfortunately, the download is not free, but $99.

HealthIMPACT Southeast 22 January

December 16, 2015 | by

Biltmore Hotel, Coral Gables (Miami), Florida, 7am-6pm

Daydreaming of a post-holiday warm weather break? The HealthIMPACT events are relatively small conferences that typically cover a lot of connected health ground in a few hours. The fast paced format combines single presenters and panels into primarily 30 minute sessions (some as short as 15 minutes). Presenters are from a mix of backgrounds and come from health systems, HIT, academia and community health. This Editor has attended two events in NYC and has been impressed (and that’s not easy) with the presentations, the breaks, the attendees and the venues. Information and registration.

Other upcoming HealthIMPACT events: Southwest 24 March (Marriott Medical Center, Houston), East 17 May (Westin Times Square, NYC), West 9 June (Anaheim)

White paper identifies potential and challenges of telehealth

December 16, 2015 | by

Telehealth is a rapidly growing field that has the potential to help states leverage a shrinking and maldistributed provider workforce, increase access to services, improve population health and lower costs says a report published a few days ago. Called “Telehealth Policy Trends and Considerations”, the white paper from the National Conference of State Legislatures (NCSL) focuses on three areas: reimbursement of telehealth encounters, licensure for telehealth providers and patient privacy, safety and security.

This white paper is the result of a year’s work by a group brought together by the NCSL consisting of state legislators, legislative staff and private industry. The white paper provides options for state policymakers in these areas.

The paper also covers recent research into cost-effectiveness of telehealth, the impact of telecommunications connectivity and some specific examples of telehealth/telemedicine usage. Examples of effective use of telehealth includes the use of telehealth/telemedicine by the Veterans Health Administration. Another example cited is the telemedicine usage by the Unversity of Mississippi Center for Telehealth about which we have reported previously

The full 28-page report, is available to download here.

Report analyses published reporting of telehealth

December 13, 2015 | by

An agency of the US Department of Health and Human Services, the Agency for Health Research and Quality (AHRQ), has published, for peer review, a draft of a new report (a “technology assessment”) entitled “Telehealth: an Evidence Map for Decision making”. AHRQ, the report explains, “through its Evidence-based Practice Centers (EPCs), sponsors the development of evidence reports and technology assessments to assist public and private sector organizations in their efforts to improve the quality of health care in the United States.”

The purpose of this new technology assessment is given as creating a review of the evidence available (essentially a literature review) so as to inform decision makers. The authors had identified 1,305 citations about telehealth of which 44 had been selected for this review. Unsurprisingly, the report says ” comparatively large volume of research reported that telehealth interventions produce positive results when used for communication/counseling and monitoring and management for several chronic conditions and for psychotherapy as part of behavioral health.”

It recommends additional primary research be carried out on topics such as telehealth for triage in urgent/primary care, management of serious paediatric conditions and the integration of behavioral and physical health. Finally, it recommends that telehealth research should be integrated into evaluation of new models of care and payment so that the potential of telehealth can be assessed in organizations that are implementing these reforms. (more…)

Chubb® Care System announced

December 13, 2015 | by

Telehealth & Telecare Aware does not often find itself parroting big company press releases. However we are making an exception for Chubb which some have portrayed as the weakest of the ‘big three’ telecare equipment & service providers. It’s therefore nice to see the launch of their Chubb® Care System, announced on 11 December, described as “an enhanced assisted living solution that uses industry-leading, easy-to-use technology to protect individuals in the comfort of their home.”

The Chubb Care System is claimed to enable residents of sheltered and extra care housing to communicate quickly, clearly and securely with on-site and remote staff, as well as off-site monitoring centres.

The housing management portal included within the system is apparently accessible to estate and housing managers through a smartphone, PC or tablet. This enables them to view, add and edit resident call history, telecare and telehealth information, as well as video and speech capabilities.

One of the major benefits claimed (more…)

Next DHACA Members’ Day announced for 11th January 2016

December 9, 2015 | by

The next DHACA Members’ day will be on 11th January at the Digital Catapult Centre, 101 Euston Rd. NW1 2RA, Membership of DHACA continues to be free; members are welcome to arrive from 9.30, Proceedings will begin promptly at 10am and end at 4.30pm at the latest.

DHACA is still finalising the order of the agenda, however the following have kindly agreed to present:

Deborah El-Sayed, Head of multi-channel development for NHS 111, will talk about NIB Workstream 1.1 – Enable me to make the right health and care choices – an area of really key importance to DHACA members as this is where patients will increasingly interface with the NHS electronically. This will include a discussion when attendees can raise key issues with Deborah, and the Workstream more generally.

There will be a similar arrangement for Usama Edoo, a senior member of the Accelerated Access Review team who will (more…)

10th Anniversary Article 2: The Decade that Laid the Foundations for Connected Care?

December 9, 2015 | by

This year, on the 10th Anniversary of Telehealth and Telecare Aware, we invited industry leaders to reflect on the past ten years and, if they wish, to speculate about the next ten. We are pleased to publish the following item from Steve Sadler, who has been Chief Technology Officer for the Tunstall Group since 1996.

My reflections on the last decade describe a laying of the foundations for ‘connected care’.

The decade has seen continued and huge pressures on health, care and housing, driven by our living longer and with increasing prevalence of long-term conditions.

We have also seen major disruptions to economies worldwide, affecting their ability to continue funding traditional models of care. The resulting public sector budget constraints are daunting, pushing us to explore technology-enabled transformation of services.

At the same time we are experiencing helpful developments in technology, prompting questions as to how we can do more with IP-connectivity, health apps, internet of things, cloud and big data analytics, to help us to shape solutions that bridge the gap between our needs and our resources.

An Exciting Beginning: So what was so special about the last 10 years? (more…)

More Federal expansion of telehealth coverage proposed in Senate (US)

December 9, 2015 | by

The Telehealth Innovation and Improvement Act (Senate Bill 2343), a bipartisan bill to expand Medicare coverage of rural telehealth, was proposed last week by Senators Cory Gardner of Colorado and Gary Peters of Michigan. It would authorize Health and Human Services (HHS) to test new telehealth programs through the Center for Medicare and Medicaid Innovation. CMMI would then evaluate new telehealth models on cost, effectiveness and care improvement. Senator Gardner’s intent is to permanently expand rural telehealth. The bill has moved to the Finance committee. Another Senate bill may be proposed before the holiday break by Hawaii Senator Brian Schatz to integrate telemedicine technology into alternative payment programs including Medicaid Advantage, a service of great utility in his state where 70 percent of the population is on one island, Oahu,  and about 30 percent is scattered over four other islands. iHealthBeat, mHealthIntelligence.

Xcertia takes another pass at app certification, but will it fly? (US)

December 6, 2015 | by | 1 Comment

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/12/alp-mountains-peaks-in-winter.jpg” thumb_width=”150″ /]An app developer and a healthcare/digital health innovation lab get into the certification game. Can they fly over the treacherous peaks this time? Social Wellth made good on their promise (or threat?) to get into the app vetting business this past week through announcing a partnership with Columbia University-based HITLAB at the HITLAB Summit this week to develop a certification organization known as Xcertia. Last year, Social Wellth acquired the remains of Happtique from GNYHA Ventures [TTA 12 Dec 14]. The Xcertia principles center around privacy, security, operability and content–as Happtique’s did. The intent is to not only develop a program to certify apps based on established standards, but also form a Signature Steering Committee to ensure they maintain “their definitive set of criteria for evaluating mobile health apps.” MedCityNews, release

Possible conflict of interest. It all sounds positive, but the head of Xcertia, David Vinson, is also the CEO of Social Wellth, which despite its nonprofit-ish name makes its living by developing consumer apps and “dashboards” for insurance companies, a task grandly called (from their press release) “the curation of digital health experiences by leveraging mobile health technologies that allow for integration and aggregation of all digital assets.” Social Wellth also makes quite a bit of hay on its website about app curation for its clients. (more…)