Summertime, and the health data breaches are easy….

August 10, 2016 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/02/Hackermania.jpg” thumb_width=”150″ /]Cybersecurity is the word, not the bird, from South Korea (see here) to the US.  The week opened with an unusual healthcare plan supplier breach: 3.3 million payer records held by a card issuer, Newkirk Products of Albany, NY. The company issues ID cards for several Blue Cross and Blue Shield plans and provides management services to other commercial payers. Ironically, it was discovered five days after their $410 million acquisition by Broadridge Financial Solutions of Lake Success, Long Island. On July 6, Newkirk discovered ‘unauthorized access’ to a server with records containing the member’s name, mailing address, type of plan, member and group ID number, names of dependents enrolled in the plan, primary care provider, and in some cases, date of birth, premium invoice information and Medicaid ID number. “No health plans’ systems were accessed or affected in any way” according to the release. MedCityNews, Newkirk release on notice

Another supplier breach affected another estimated 3.7 million patients at Arizona’s Banner Health. This one was a bit closer to home, hacking computer systems used in payment processing on debit and credit cards used at their food and beverage outlets in four states between June 23 and July 7.  A week later, the hackers gained unauthorized access to systems containing patient information, health plan member and beneficiary information, as well as information about physician and healthcare providers. MedCityNews, Banner Health release

But what’s secret anymore about your health data anyway? It’s all those apps that are sending data via your Apple Watch and your Fitbit which aren’t necessarily covered by HIPAA or secure. (more…)

Tunstall Americas’ Vi+ offers free temperature monitoring

August 10, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /]Last week Tunstall Americas emerged from a long period of quiet with their introduction of Tunstall’s Vi+ telecare home unit [TTA 3 Aug]. We noted that Vi+ included an integral ambient temperature sensor which could alert their response center on extremes in home temperature and that the release highlighted it. This week, we learned the reason why, as on Tuesday they announced marketing that capability as free Temperature Extremes monitoring for subscribers of their medical alert monitoring service. When the ambient temperature sensor is activated, their call center will be alerted when the room temperature rises above 89°F or falls below 50°F. The subscriber and registered contacts are then notified so that the person can be checked and the situation corrected. Tunstall release (PRWeb)

South Korea’s ambivalence towards telemedicine

August 10, 2016 | by

The surprising reasons why. 5.8 million South Koreans aren’t exactly tech-phobic, enjoying a nationally swift internet backbone and high personal smartphone penetration. The home of the two leading smartphone makers is pioneering mobile-first retailing and a national IoT network. South Korea (SK) also has the need–an aging population living in rural areas. Yet South Korea bans doctor-patient virtual visits in their Medical Act, and expects major demonstrations by doctors and activists when it comes up for a vote later this year in their National Assembly. Telemedicine and also telehealth/RPM may happen eventually, backed by powerhouses like SK Telecom, Samsung and LG, but will have to take into consideration some unique circumstances:

  • Cyberattacks from North Korea, which have already hit a Seoul university hospital’s software security contractor and demonstrated their system’s HIT vulnerabilities
  • The government’s glitch-ridden telemedicine pilot program with serious problems in data management, encryption and weak passwords
  • The fear that only the rich will be able to afford it–and in SK’s split system, the fear that funding may be withdrawn from the extensive network of community clinics instead of benefiting them

Medical professionals, including the 100,000 doctors in the KMA who successfully blocked telemedicine in 2014 and haven’t participated in the pilot program, are calling for “a slower, more collaborative plan of attack that establishes safety protocols and smart regulatory oversight.”  Quartz

NHS Liverpool seeks telehealth provider

August 9, 2016 | by

NHS Liverpool Clinical Commissioning Group (NHS LCCG) is soliciting a telehealth (remote patient monitoring) technology for a three-year contract. The first step for the telehealth provider is to submit a Pre-Qualification Questionnaire (PQQ) document by 5 September. If invited, providers will tender for the provision of telehealth technology services. The contract is valued at £2.4 – £14.4 million (including VAT), to start 3 April 2017 and extendable for two years after the initial three. The clinical portion–patient recruitment/assessment, back-end clinical monitoring and clinical support elements– is part of LCCG’s NHS Community Health Services provision and will be separately bid. For complete information, see the listing on the new Gov.UK Contracts Finder. Hat tip to Suzanne Woodman.

Broadband and health in USA

August 5, 2016 | by

The Federal Communications Commission (FCC) has been investigating [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/08/C2H-BroadbandMap_Gaps-America.png” thumb_width=”150″ /]the relationship between broadband and health in the US through their Connect2Health Task Force and this week it has released an online tool “Mapping Broadband Health in America”.
It is an interactive map that allows users to visualise, overlay and analyse broadband and health data at the national, state and county levels.

This tool allows easy access to existing health and broadband access data to anyone who wants to look at the possible influence of broadband access on health over a period of time or to identify gaps which may provide opportunities to develop or expand online health services.

The interactive tool allows the user change the broadband availability measure (by say proportion of coverage or download speed for example) and select a health measure such as say obesity rate or preventable hospitalisation days and shows where the selected broadband measure is satisfied, where the selected health measure is satisfied and where both are satisfied. The types of health measures are currently limited but if users find the tool useful and feedback to the FCC there may well be further expansion.

Have a play with the map here.

The Theranos Story, ch. 18: Is the ‘miniLab’ the Real Edison, or The Great Oz 1.0?

August 3, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/04/Yak_52__G-CBSS_FLAT_SPIN.jpg” thumb_width=”150″ /]Is the Great Oz Behind the Curtain? Updated for The Box and additional articles. Before a skeptical audience Monday afternoon at the American Association for Clinical Chemistry‘s (AACC) annual meeting in Philadelphia, Theranos‘ CEO Elizabeth Holmes, due to be banned from the industry by CMS for lab violations, unveiled a new lab technology. According to Ryan Cross in the MIT Technology Review, “Holmes claimed her company had developed a sophisticated “miniLab” capable of carrying out an array of tests, including detecting the Zika virus, from a finger prick of blood.” A cube-like box, developed in secrecy, she called it a “single platform” able to carry out a wide array (or several–depending on what quote you read!) of different test types using small volumes of blood (apparently finger sticks). The device will be small, portable and directly connected to the internet to centrally send and verify test results. Ms Holmes actually took questions from a three-person scientific panel. When asked if she would be sharing the device with other researchers, she said she was “working on it right now.” It is not, of course, FDA-approved or in production.

Updated for video and new articles (as of 8/19/16).

  • MedCityNews’ Stephanie Baum must have some OSS/CIA blood in her, because it appears she’s beaten everyone on the miniLab Box picture plus posting the Theranos presentation video, which went up via AACC’s YouTube site within hours of the presentation. Other commitments prevent me from an analysis of the hour until later, but gone is the black turtleneck, remaining is the talent for tap dancing around hard facts. The comments in the article and from elsewhere echo the profound skepticism and cynicism found in the MIT and WaPo articles. Yes, the ‘Sympathy for the Devil’ intro was dark humor, served up the way we like it!
  • Bloomberg interviews attendees (scientists, clinical directors, professors, doctors) who believe they were baited and switched. The bait was the justification for Edison performance. The switch was The Box–a new technology, untested, untried and not even peer reviewed–that simply crunched down multiple existing tests into one container.
  • (Updated 8/19) AACC’s published article was short and straight up. “(Dr Steven) Master told Holmes that her data “fell far short” of what he expected based on the wide menu that Theranos promised previously.” Plenty of promises from Ms Holmes at the end, but if CMS has their way, which is likely, Ms Holmes’ “I’ve made the decision to double down and stick by it no matter how hard the path” and to be involved with AACC in the future, will be more empty Theranos promises.

Also WaPo, TechCrunch and POLITICO Morning eHealth

Is Theranos–and Ms Holmes–too far ‘gone’ to be credible or funded? Will there even be a Theranos company to develop this? Will Ms Holmes remain in the business through successfully appealing her imminent ban? The only sensible conclusion is that we’ll believe the technology–and her–when we see it is properly and independently verified–and operated by a company with proper governance and controls.

Stay Tuned to See if The Fix Is In.

Thumb through the prior 17 chapters of the Theranos Story here. Hat tips to @EdifInstruments and Editor Chrys Meewella for the links (WaPo and MIT respectively).

Google’s Verily joint ventures with GSK into bioelectronics (UK/US)

August 3, 2016 | by

Verily, the Alphabet (Google) life sciences research group, and GlaxoSmithKline are partnering in a joint venture that may replace drugs for disease with micro-electronic implantable devices. GSK will own 55 percent of Galvani Bioelectronics, with Verily owning 45 percent. They have pledged an investment of £540 million in the new UK-based business over 7 years, as well as contributing intellectual property rights to Galvani. Most of the staff will be at GSK in Stevenage with some at Verily’s HQ in South San Francisco, and led by Kris Famm, formerly GSK’s vice president of bioelectronics R&D. The deal is expected to close by end of year.

According to Business Insider UK, GSK has been involved with bioelectronics for four years. It’s defined as “a relatively new scientific field that aims to tackle a wide range of chronic diseases using miniaturised, implantable devices that can modify electrical signals that pass along nerves in the body, including irregular or altered impulses that occur in many illnesses.” The diseases that are being targeted are inflammatory, metabolic and endocrine disorders, including type 2 diabetes. According to the MedCityNews interview of Verily’s CTO Brian Otis, the systems will be closed loop where the devices listen to the nerve signals, do real-time signal processing and send the optimized signal back to the nerve to restore healthy function. GSK has the diagnostic and biologic expertise, Verily has the device smarts. Also Mobihealthnews, Recode

Tunstall Americas introducing Vi+ telecare home monitoring

August 3, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/Big-T-thumb-480×294-55535.gif” thumb_width=”150″ /]We don’t hear much from Tunstall Healthcare in the US other than their traditional/mobile PERS business (formerly AMAC‘s). That may be changing with their introduction (finally) of the Vi+ telecare home unit. It has medical alert, fall detection (via ‘intelligent pendant’) and integrates with home monitoring an array of what they call ‘Virtual Sensors’–motion and other sensors to monitor activity in the home, including wireless sensors for fire, flood and gas leaks. They do make a point of having an integral ambient temperature sensor which will alert their response center if an unsafe high or low temperature is detected.

Other than the press release, no information on Vi+ is on the Americas website yet, including pricing. (Vi without the sensor array has been sold for some time.) Vi+ is marketed in most Tunstall countries in Europe, Australia and New Zealand. The fact sheet from Ireland is representative of Vi+ in most markets.

It’s interesting that Tunstall Americas has chosen to enhance their PERS/call center services with sensors, versus entering the hotter telehealth area. Sensor-based activity/danger monitoring is hardly new. (more…)

Philips dives into global consumer health tech with new wearables ‘ecosystem’

August 3, 2016 | by

Philips has made another substantial, if traditionally risky, move into the direct to consumer (DTC) health monitoring segment with a limited wearables ‘ecosystem’ under a new Personal Health Solutions division. It contains five FDA-cleared products for monitoring vital signs. Four peripherals download via a watch to iPhone/Android phone apps which run on version 2.0 of the Philips HealthSuite (with Salesforce1) mobile app. Earlier the apps were marketed in NL and BE.

While the release states they are globally available, initially it appears they are being marketed direct to consumer for the US only. Purchase is direct on the site. All devices are Bluetooth LE and sync with the watch and smartphone app/dashboard (available on Google Play and the Apple Store). The watch/app also tracks exercise with activity recognition, calorie tracking and sleep patterning, with the app providing some education content.

  • Watch $249
  • Body Analysis Scale (weight, body fat, BMI) $100
  • BP/pulse (upper arm) $100, (wrist) $90
  • Ear Thermometer $60

Interestingly, their existing DTC PERS enterprise, Lifeline, is not linked to or mentioned.

Prices are mid-range to high, making this a prima facie tough sell. (more…)

Changing care models to connect better with care, age at home

August 3, 2016 | by

While this Editor didn’t get to the second annual d.Health Summit in NYC this past May, the organizers Avi Seidmann, PhD & Ray Dorsey, MD [TTA 20 July] of the University of Rochester have conveniently distilled the day down to a 13-page policy paper on successful aging at home. The keynote speaker set the theme around the core needs of older people:

  • identity (“help me stay me”)
  • routine (“help me stay in control”)
  • sociability (“help me stay engaged”)
  • vitality (“help me stay physically and mentally fit”)

Innovation around healthcare delivery, mobility solutions, assistive technologies that adjust to a wide variety of needs, socialization outlets and home services can improve health and wellness while reducing costs for the healthcare system as a whole.  Impediments are regulatory, interoperability and that old devil, payments. It needs to move to ‘next generational care” where healthcare tech fully becomes an extension of the healthcare system. Can’t come soon enough. Download the PDF here. Also read contributor Sarianne Gruber’s perspectives on the conference in RCM Answers on 18 May and 24 May.

The State of the Connected Patient is a 21-page survey with plenty of bar charts of over 2,000 Americans taken in June by the Harris Poll sponsored by Salesforce, which we’ve noted here is partnering notably with Philips in the HealthSuite digital platform. Analysis is separated by boomers, millennials and Gen X.  62 percent of respondents would be open to some form of ‘virtual care’–and 52 percent of ‘millennials’ would prefer to choose a doctor who uses virtual care tools. Most are content with their primary care doctor, though that doctor may not recognize them in the street. Only a quarter actually keep track of their health records, digital and otherwise. Apps are used, but all age groups are split evenly in using a wearable if an insurance company or provider gave them to wear in exchange for (respectively) lower rates and health information access. Download PDF via EHR Intelligence.

Tech savvy ageing

August 2, 2016 | by

Future technologies are expected to play an important role in supporting independence in later life says one of the main findings [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/08/How-tech-savvy-are-we.jpg” thumb_width=”150″ /]from research published this week in the UK. People aged 65 and over who have not grown up with technology around them, perhaps unsurprisingly, find it more difficult to master the latest technologies initially than younger groups do and there are concerns that society could become more inactive and too reliant on technology. This are some of the other main findings given in the report ‘How Tech Savvy are We?’  from the Institution of Engineering and Technology (IET) in the UK.

Although the research was not focused on just the older age group there are some aspects which are particularly looking at this group of people.

There is no clear consensus on which of the six proposed technologies in the research would be most useful in later life – smart healthcare devices are rated most useful by 27%, whilst driver-less cars and robot help are deemed the most useful by only 10%. This suggests a possible disconnect between what industry is developing and what the public actually wants says the IET.

Commenting on the report’s findings, Chris Cartwright, Chair of the IET Information and Communications Sector, is quoted as saying: “It’s great to see strong public support and understanding for the potential benefits new technologies offer an ageing population. But it’s less encouraging that this support is still hindered by concerns around cost, lack of physical activity and loss of human contact. There is also a lack of clarity about which technologies people will find most useful, probably because they are unclear of the benefits.

(more…)

A brilliant opportunity to learn from digital health experts, and get most of your T&S paid!

August 1, 2016 | by

In this editor’s view rarely do opportunities as good as this come along for aspiring digital health innovators working on early warning systems for infectious diseases: I-Sense, in UCL, has announced that applications are now open for the 2nd round of I-Sense Mobility Fellowships – designed to support incoming researchers from academia and industry to work with I-Sense.

They are currently inviting incoming fellowship proposals from academia and industry in the following areas – (more…)

Jawbone bites back: Fitbit loses three patents (updated)

July 27, 2016 | by

The wearables war continues, and the Law of Unintended Consequences seems unbreakable. This one was decided in a US International Trade Commission court, with the judge ruling that the three patents in question “don’t cover ideas eligible for protection” and dismissed the August trial between Fitbit and Jawbone. This is a reversal of fortune for the two competitors as a similar patent challenge to Jawbone was won by Fitbit back in April in the same court. In the new ruling, the judge said that Fitbit “seek(s) a monopoly on the abstract ideas of collecting and monitoring sleep and other health-related data.”

The skirmishing has a deeper context. Jawbone has accused Fitbit of hiring former employees and purloining trade secrets like product design and marketing plans, and alleges that the suits were “brought improperly by Fitbit in an attempt to burden Jawbone with having to defend invalid patents in multiple venues.” Fitbit reportedly has 300 patents, so that is a lot of defending for a company that has issues of its own.  Jawbone has struggled in past months with its products, with various (and contradictory) reports indicating it’s exiting the wearable business, working on a new wearable and selling its audio business (which has also been crushed by competition.) Undoubtedly this will continue as Fitbit plans to challenge the ruling. Your Editor suspects that their legal and IP offense/defense activity is a substantial budget line for them. Bloomberg (20 July and April), The Verge

Update: Jawbone is rumored to be up for sale, with reports that they have approached at least one hardware manufacturer about a purchase. Reportedly they missed an August payment to a business partner. Investor BlackRock has marked down their shares, formerly valued at $5.97 a share, to less than a single penny. Since 1999, Jawbone has had funding of over $900 million.  9to5Mac, The Verge  Even the much-publicized hiring of high-profile exec Adam Pellegrini from Walgreens to Fitbit to lead digital health has a Jawbone twist, as both the former and latter were partners. MedCityNews

Scotland recognized by EC on innovative tech, practices for healthy aging

July 27, 2016 | by

Scotland recognized as ‘reference site’ for innovation in healthy aging. The European Innovation Partnership Commission on Active and Healthy Ageing (EIP on AHA), an initiative of the European Commission, since 2012 has awarded select regional and local areas ‘reference site’ status. To quote from their site, “Reference Sites are highly inspirational ecosystems, delivering creative and workable solutions that improve the lives and health of older people. These solutions can be scaled-up and replicated across the EU.”

This year, the 74 sites include Scotland. Previously, Scotland had been a three-star evaluation site twice for the national telecare programme and the joint improvement team’s work on anticipatory care planning. The reference site solutions include digital solutions via NHS 24 and the Health and Social Care Alliance in Scotland. The Reference Sites Award Ceremony is will take place in Brussels at the next European Summit on Innovation for Health and Active Ageing, 6-8 December 2016. Holyrood, Alliance Scotland release  Hat tip to Mike Clark via Twitter

Parkinson’s disease monitoring app promising for advanced clinical decisions

July 26, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/07/Kinesia1.png” thumb_width=”150″ /]A study in the July Journal of Parkinson’s Disease presents a small (N=40) study on the use of wearable sensor data and the KinesiaOne mobile app to assist in clinical decisions around advanced therapy referral for Parkinson’s disease patients. The KinesiaOne sensor is worn on the fingertip and tracks motor response on the mobile app (left). The patients were followed for one year, with half receiving standard care and half using motion sensor-based remote monitoring once per month in conjunction with standard care. Remote monitoring led to five times more advanced therapy patient referrals, compared to standard care alone (63.6 percent versus 11.8 percent, p <  0.01). These therapies are highly considered due to their nature–deep brain stimulation (DBS) or an implantable medication pump–and this initial screening may lead to more advanced algorithms and/or continuous monitoring, which the KinesiaOne developer, Great Lakes NeuroTechnologies, also has. Release, JPD abstract, Mobihealthnews Also see our short article on Ireland’s Beats Medical.

The Theranos story, ch. 17: closing the barn door after the horse

July 26, 2016 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/04/Yak_52__G-CBSS_FLAT_SPIN.jpg” thumb_width=”150″ /] And it may work, though the horse is in the next county. Late last week, with American eyes elsewhere, Theranos announced that they hired two executives with regulatory responsibility–a chief compliance officer and an VP regulatory and quality–and formed a new board committee focused on same. The CCO is Dave Guggenheim, the former assistant general counsel for regulatory law at HIT/medical distribution giant McKesson. The VP, Daniel Wurtz, comes from a similar senior director position at biotech Thermo-Fisher Scientific.

The country maxim, ‘closing the barn door after the horse has bolted’, applies. In fact, the horse is in town and having a growler of beer at the local tavern. The Newark, California lab is shut and the principals, including the CEO Ms Holmes, are technically prohibited from operating a lab for at least two years (that means you, Ms Holmes) starting in a month. Messrs Guggenheim and Wurtz (or similar) should have been on board years ago. Even small companies in our field realize they HAVE to do this!

This also doesn’t affect the interesting interest that DOJ and SEC have in Theranos. [TTA 10 July]

However, this Editor will take the contrarian view that somehow, some way, the ‘fix’ is being worked out, if not in. Don’t make reservations for the fire sale quite yet. The ban on Ms Holmes won’t take place for another month, minimum. That gives time for David Boies, their legal supremo, and his firm to stall for more time, and time for some calls to ask favors from friends, of which he has many in this administration. More than likely, Boies on behalf of Theranos will appeal the CMS rulings to an administrative judge. Ms Holmes may take the hit, but may get a handsome payday to depart despite her reported control, if the investors can salvage something out of the company.

At HQ, they may be rehearsing saying ‘mea culpa, mea culpa, mea maxima culpa’ three times, kneeling deeply, in preparation to Going Forth And Sinning No More.

The Object Lessons taught by the Theranos Troubles, to us in healthcare tech, continue.

WSJ, Theranos Hires Compliance, Regulatory Executives  (more…)