Turn down the noise! Is it possible in a hospital?

November 25, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/11/sleep.jpg” thumb_width=”150″ /]Try texting and more. One of the more unfairly overlooked mHealth tools is text or SMS. While simple, the back end and integration can be complex, especially when integrated within healthcare IT systems.

In the US, one of the key metrics that hospitals are rated on in their HCAHPS scores (Hospital Consumer Assessment of Healthcare Providers and Systems) is quietness of the hospital environment. Hospital noise is more than annoying–it is at a level that blocks healing and deprives patients of needed sleep (see study). There are door slams, people walking and talking, TVs and incessant boops and beeps from equipment. This annual survey told Inspira Health Network, a three-location hospital system in southern New Jersey, that they had a noise pollution problem.

One noise IHN hospital management could control was overhead pages–over 150 daily at their Vineland hospital. In a Quiet Hospital initiative, they replaced the overhead page system largely with a secure texting system developed by Newark, NJ-based Practice Unite, implemented by their reseller, Futura Mobility and consultant Pursuit Healthcare Advisors. Texts now go from nurses to physician smartphones, reducing overhead pages to perhaps two emergency ones daily. Scores for quietness satisfaction have improved drastically: at the Elmer hospital from 60 to nearly 100 percent, Woodbury from 45 to 56 percent, and Vineland from 55 to 62 percent.

Where the interesting integration–and workload reduction–happens is that those nurses can also make a stat consult request to a physician via Inspira’s EHR which is then sent to the physician’s phone. It also leaves an audit trail so that completion can be tracked. Lab results also can be sent to the EHR or phone, depending on physician preference, and patient round lists to residents’ phones. According to Healthcare IT News, these features have been adopted by affiliated medical practices; it has improved response times, patient consults and EHR updates, plus reduced patient stays. Health Data Management, HIT Consultant (Photo Cambridge Sound Management from their article on sound masking in hospitals.)

165,000 apps, 3 bn downloads and counting: global mHealth apps study

November 25, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/11/mHealth-Developer-Economics-2015.jpg” thumb_width=”200″ /]The results of the fifth annual mHealth App Economics survey are out. Our Readers were invited to participate back in March when it was sponsored by German research firm research2guidance in collaboration with mHealth Summit Europe and HIMSS and kicked off at the Riga meeting in May.

Major apps stores reported more than 165,000 mHealth apps published by 45,000 companies, and projected 3 billion downloads by close of 2015.  Some other key findings from R2G do surprise:

  • The target for apps is DTC–chronically ill patients–with their hospitals as #2. Physicians are important, but less so than last year’s survey.
  • App publishers aims appear altruistic. 53 percent of mHealth publishers claim that their main motivation is to help people improve their medical conditions. However, 60 percent aren’t reaching their goals yet mainly due to low reach. The vast majority of apps (62 percent) mark up less than 5,000 annual downloads. (See the chart below for some possible reasons why)
  • Diagnostic apps lead in anticipated business potential until 2020. And app publishers have added medical professionals to their team.
  • What app publishers find works to change behavior is not gamification. What does: integration of provider feedback or dialogue.
  • Yet providers, such as doctors and nurses, are seen as the most threatened group by mHealth solutions.
  • A scant 3 percent of mHealth publishers generate more than $1 million–and they are far more focused on sales and brand awareness than their brethren which make little. (chart)

(more…)

Telecare: the cost of a failure (updated)

November 24, 2015 | by

The value of a telecare service, typified by the familiar red-button alarms worn round the neck or [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/11/NHS-Highland-logo.jpg” thumb_width=”150″ /]wrist and providing the less able to confidently live an independent life is, of course, well known. Telecare also provides a range of unobtrusive wireless sensors that detects possible problems around the home such as a gas hob or tap left on,  smoke from a smouldering sofa where a cigarette may have fallen and so on.

There are many companies around the world providing telecare services. But what if the service suffers an interruption? What needs to be done and what is the cost?

The UK’s NHS in Scotland had to face these questions recently when the telecare service it provides in the Highland Council area suffered a total failure last week. The system had failed for about four hours last Saturday and, although a  backup system existed, that failed to deploy. (more…)

Calling all those interested in the Internet of things: draft PAS 212 awaits your review

November 22, 2015 | by

BSI is inviting comments on the draft for PAS 212 during its four week consultation period.

PAS 212 is entitled “Automatic resource discovery for the Internet of Things” so is clearly very relevant to the Telehealth & Telecare Aware community, particularly for those involved in deployment of sensors/wearables.

Go to the DHACA blog for more details; comments have to be in by January 8th.

Hat hit to Melvin Reynolds for drawing this to my attention.

Senate Veterans Affairs Committee takes evidence on VETS Act (US)

November 21, 2015 | by

Further to our report in October on the introduction of the Veterans E-Health & Telemedicine [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/10/Dept-of-VA-logo.jpg” thumb_width=”150″ /]Support Act (“Veterans eHealth & Telemedicine”, 10 October 2015), Sen. Joni Ernst’s website reports that Sen. Ernst was the first witness to testify in front of the Senate Veterans Affairs Committee on Wednesday (19 November 2015) about the proposed legislation.

“The VA has been practicing telemedicine since 2001, and they are largely cited as leaders and innovators in the field. Their efforts in telemedicine have saved money and veterans’ time by eliminating often an hour or more long drives to the VA, and reducing bed days at the VA” Ernst is reported to have said.

“For example: According to the VA, in Fiscal Year 2014, telehealth reduced bed days of care by 54%, reduced hospital admissions by 32%, and saved $34 in travel savings per  consultation. (more…)

Is Theranos’ ‘blood testing for all’ a responsible selling proposition?

November 20, 2015 | by

Theranos’ recent troubles on their blood testing (Walgreens halting expansion, FDA halting nanotainers as ‘uncleared medical devices’ and last week chain grocery/drugstore Safeway dropping their $350 million deal for 800 locations) have been well covered in media both here and elsewhere. But what if their Unique Selling Proposition–that people should have the ‘basic human right’ to order up their own inexpensive blood tests and then be responsible for their own interpretation–is counter-productive for many patients? After all, it’s what Theranos has been organized and raised $400 million+ on. Dr Robert Wachter of UCSF, who is no top-down Ezekiel-esque ‘nanny stater’, lends a caution: “There are a lot of companies, including Theranos, that have an interest in making you believe that more data will magically make you healthier. It won’t, at least not in the short-term.” When is ’empowerment’ confusing without recourse to interpretation? Some results are easier to read than others. Does having the data make the average person healthier for real? Personally, this Editor would welcome the ability to walk into her local Walgreens and order up a few to see what’s up–but then again she can do her own research and ask a doctor or nurse to help. Who can (inexpensively) close the interpretation gap? Theranos is wrapped in scandal but goes hard to change laws to its advantage (Mashable)

NYeC honors four at annual gala

November 20, 2015 | by

The NY eHealth Collaborative, which develops policies and standards supporting NY state-wide initiatives in healthcare information/data exchange, including the development of the SHIN-NY (Statewide Health Information Network -NY), Wednesday night honored four major NY-based forces in healthcare in New York City. Steven Safyer MD, CEO of Montefiore Health System, Jason Gorevic of telemedicine provider Teladoc, Thomas Mahoney MD of Finger Lakes Health System and Lisa Perry of Community Health Care Association, NYS. While award ceremonies usually don’t come bearing insights, Dr Safyer’s was succinct in what health systems face: that price is compressing over time and that it’s about managing that, not ‘managing care’ which is the usual shorthand. NYeC News.  This Editor missed the usual event in conjunction with the gala, NYeC’s Digital Health Conference, and hopes it makes a reappearance next year. NYeC also partners with the Partnership Fund for NYC in the three-year old New York Digital Health Accelerator (NYDHA) which has six companies in its 2015 five-month program.

Successful large-scale deployment of Telehealth: a “cookbook”

November 19, 2015 | by

Following a two and a half year evaluation of data from different connected health programmes in five European regions, a report [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/11/ACT-programme-logo.jpg” thumb_width=”150″ /]was released this week described as a “cookbook” for large-scale deployment of coordinated care and telehealth. The work was carried out by a consortium led by Philips Healthcare and included participants from The Netherlands, Greece, the UK, Spain, Italy and Germany.

After monitoring coordinated care and telehealth initiatives in five EU healthcare regions – Lombardy (IT), Basque Country (ES), Catalonia (ES), Northern Netherlands (NL), and Scotland (UK) – the EU-funded Advancing Care Coordination & Telehealth Deployment (ACT) Programme has produced this ‘cookbook’ of good practice to facilitate their deployment across Europe. (more…)

Telecare pioneer Alertacall receives National Business Awards-UK honor

November 17, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/11/Alertacall-logo1.jpg” thumb_width=”150″ /]Alertacall received the ‘Highly Commended’ distinction in the Market Gravity Innovation category at the Lloyds Bank National Business Awards UK. The company was cited over eight other finalists for its ‘OKEachDay’ phone check-in service in a field of over 150 other competitors in various business areas. Founded in 2004, Alertacall was one of the Grizzled Pioneers of UK telecare and lately has expanded into housing management with its Housing Proactive system. The winner was DNAFit, which integrates genomics into nutrition and fitness. The National Business Awards were announced in a ceremony on 10 November keynoted by astronaut (and second man on the moon) Buzz Aldrin and addressed by Prime Minister David Cameron. Scotland’s Digital Health & Care Institute was the other digital health finalist; DHI is an incubator for 85 live projects also funding academic research with a combined level of over £3 million. Awards page (click on Market Gravity Innovation), Alertacall release

Care Innovations finds a home in Mississippi

November 17, 2015 | by

The Intel-GE Healthcare joint venture, Care Innovations, last week inked a full five-year deal with the University of Mississippi Medical Center to use remote care management tools, such as their Health Harmony telehealth platform, in the home setting to reduce readmissions and ER/ED use. The chronic medical conditions they will be tracking are congestive heart failure, diabetes, chronic obstructive pulmonary disease (COPD), asthma, and hypertension. According to Healthcare Finance, the RPM, data analytics and application integration services they are developing may be offered outside the state. This follows on reported positive results produced by a statewide population health program, the Diabetes Telehealth Network, involving both CI and UMMC’s Center for Telehealth. The results for the six-month first phase of the remote care management program, which included 100 Mississippians with diabetes: a 1.7% average A1C reduction, zero hospitalizations and ER visits, and a savings of $339,184 over six months. The CI and UMMC goal is to enroll 1,000 patients per month through 2016, and to save $189 million in Medicaid cost among diabetics alone.  Care Innovations release. Health Data Management. This follows on GE Healthcare’s acquisition of healthcare consultancy Camden Group [TTA Nov 12]

Pilot Health Tech: call for applicants 18 December (NYC)

November 17, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/11/Pilot-Health-Tech-logo.png” thumb_width=”150″ /]The New York City Economic Development Corporation (NYCEDC), in partnership with Health 2.0 and now Blueprint Health, are calling for joint applicants for the third annual Pilot Health Tech NYC. The program invites innovative healthcare companies and “host” partners (mainly providers) to jointly apply by 18 December for $1 million in competitive commercialization awards. If chosen, these will pilot together to validate a technology solution for commercial use or investment.There are 10 awards across three categories: complex systems, scalable solutions and turnkey projects. Application is here; they also have a Q&A Webinar at noon on 1 Dec to ask questions about the funding program and details about the application process. Prior program winners include GeriJoy, QoL, Nonnatech, Flatiron Health, eCaring and Canopy Apps.

Smartphone measures heart and breathing rates without wearables

November 17, 2015 | by | 1 Comment

Researchers at MIT are working on a project to measure the heart rate and breathing using a smartphone’s accelerometer in the user’s pocket or bag without the need for wearable sensors. When the user is at rest the slight movements due to breathing and heart beat are measured using the smartphone and used to derive the heart and breathing rates.

According to a paper published recently, in a test with a dozen participants (a very small sample for this type of test) the heart rates measured using the new method were within one beat when compared to FDA approved sensors they were using simultaneously. The measurements of breathing rate were about a quarter of a breath of the approved sensors.

The aim is to sense when someone is stressed by using the heart rate and breathing and then help cope with the situtation by suggesting, say, breathing exercises or calling for help.

A brief article on the work is published on the MIT technology Review and the full paper is available here.

Scientific survey of telehealth/telemedicine in the US

November 14, 2015 | by | 2 Comments

The Robert Graham Center for Policy Studies in Family Medicine and Primary Care sent [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/11/Robert-Graham-Center-logo.jpg” thumb_width=”150″ /]surveys to more than 5,000 randomly selected phyicians, intentionally oversampling rural ones, and received a high 31% response (1,557 respondents). Fifteen percent of the respondents indicated that they used telehealth  according to the report  on the analysis the data (the terms telehealth and telemedicine are used interchangeably in this report), “Family Physicians and Telehealth: Findings from a National Survey”, co-written by six authors, which is available now.

Compared with non-users, family physicians who use telehealth  are more likely to practice in a rural location, be younger, have practiced for 10 or fewer years, and employ an electronic health record (EHR), says the report. Almost half (49 percent) of telehealth users practice as part of an organization that is not physician owned (e.g., an integrated health or hospital system). More than half of telehealth users reported using telehealth one to five times in the past year, while more than 23 percent reported using telehealth on more than 20 occasions during the same period. Almost half of telehealth users stated they had used real-time video consultations in the past 12 months. In addition, 55 percent of surveyed telehealth users had used telehealth services for diagnosis or treatment in the past 12 months, and one-fourth of surveyed telehealth users reported using telehealth services for chronic disease management. (more…)

‘Tis the season of mellow fruitfulness..and consultations

November 13, 2015 | by

Suddenly it seems there are consultations all over the place that are important to the digital health world. If you can spare some time, you will be doing society a great turn by responding to as many as possible. They include:

The Accelerated Access Review (disclosure, which is editor is very involved with) is holding a consultation on pricing & reimbursement schemes. This is important because in the area of digital health (one of three areas covered by the AAR, the other two being medicines and medtech), selling at scale almost always involves a competitive tender (either at the time or previously in establishing framework contracts, or sometimes at both stages). We therefore have much to learn from the pharma sector in particular who have established a wide range of price-setting, and thus tender-avoiding, mechanisms. We are very keen for the digital health and medical technology voices to be heard.

Deadline for submissions is Friday 20th November.

Next we have an EC consultation with a characteristically long-winded title Public consultation on the preliminary opinion on ‘Disruptive Innovation. Considerations for health and health care in Europe’. For this, the EC is partnering with an organisation previously unknown to this editor: the Expert Panel on Effective Ways of Investing in Health (EXPH). Having learned about disruptive innovation at the feet of the man himself, Clayton Christensen, this editor gets just a little uncomfortable when experts seek to impose order on the process (especially ‘taxonomies’), as by definition it is chaotic and opportunistic. However the four areas that the survey seeks views on are:

1. New models of person-centred community-based health delivery that allow a decentralisation from traditional health care venues like hospitals to integrated care models (e.g. transfer of records to patients);

2. New technologies that allow early diagnostics, personalised medicine, health promotion, community-based therapy and care and the empowerment of patients/citizens, as well as potential curative technologies (e.g. regenerative medicine, immunotherapy for cancer);

3. Person-oriented approaches for the treatment of patients with multiple chronic diseases, situations of frailty and/or of loss of functionalities in a multi-cultural context;

4. Education of the health workforce and transfer of skills and tasks from highly trained, high cost personnel to personnel that have less specialised trained and are more affordable; (e.g. from specialists to generalists, from generalists to nurses, from nurses to health care assistants and to other care providers such as pharmacists, and ultimately to citizens themselves.)

The preliminary opinion is just 95 pages long, and here. The consultation closes on 16th December.

Closer to home and potentially of more immediate significance is the consultation on the draft EU Code of Conduct on data privacy for medical apps which is now being opened up for general consultation prior to a meeting in Brussels of the group producing the Code (of which this editor is a member) on December 7th. Please send your comments directly to charles.lowe@DHACA.org.uk and I will pass them on.

Finally, London’s Southbank University is planning to establish a set of qualifications for digital health-related topics and is keen to understand the likely willingness to pay for them. They are currently in discussion with the Royal Society of Medicine regarding use of educational material. They have produced this short survey which they would appreciate as many TTA readers as possible completing.

Hat tip to Dee O’Sullivan for alerting me to the disruptive innovation consultation.

 

mHealth Grand Tour: ‘magical’ for cyclists, clinical level information for diabetes

November 13, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/11/1111150945.jpg” thumb_width=”200″ /]

From the HIMSS Connected Health Conference (CHC)/mHealth Summit

The last Executive Spotlight/keynote on Wednesday morning stepped outside most of this year’s CHC content, first for presenting a European mHealth program and diabetes patients not as overweight, inactive and co-morbid but as athletes. Presented by Benjamin Sarda, Head of Marketing for Orange Healthcare, the mHealth Grand Tour has developed in three years from a fully organized, challenging 2,100 km Brussels-Barcelona ride primarily (but not exclusively) for cyclists with Stage I and II diabetes as a test bed for blood glucose monitoring under extreme exercise, to a 1,500 km Brussels-Geneva three-stage tour with even greater ascent, extreme monitoring and also a full spectrum of vital signs feedback via smartphone to the riders. This past September, 24 riders accumulated 7 million measurements. The cyclists used these measurements (left) [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/11/1111150950.jpg” thumb_width=”200″ /][grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/11/Orange-phone-grand-tour.jpg” thumb_width=”200″ /]to help manage their food intake, blood glucose, performance and overall wellness. The data is currently being analyzed by France’s Society of Diabetes (SFD), but an early result is that medication compliance was 97 percent. Some had difficulty (with a 22,000 meter climb, who wouldn’t?) but the app helped them manage their ride and what they can do that day. Orange’s interest as a telecom is obviously data but their work with multiple research and mHealth partners (including the Personal Connected Health Alliance which is part of the CHC) and with organizations like the JDRF are part of their big scale. It also represents a ‘jump shift’ in thinking about what is possible in living with diabetes.

What happened in between? Plenty! (More coverage to come.)

GE Healthcare acquires health consultancy

November 12, 2015 | by

GE Healthcare announced on Monday that it has acquired a US healthcare consultancy firm, The Camden Group. [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/11/GE-Healthcare-logo.png” thumb_width=”150″ /]Founded in 1970, The Camden Group advices US healthcare organisations such hospitals, health plan providers, medical groups and ACOs and will become the US business unit of GE Healthcare’s international consultancy GE Healthcare Partners.

The Camden Group has been expanding for some time and acquired Health Directions LLC in January of this year for an undisclosed price. By acquiring The Camden Group GE Healthcare will get access to a range of ongoing customers. The $18bn GE Healthcare business announced a $300M commitment two months ago to create a Sustainable Healthcare Solutions unit covering emerging health markets in Asia and Africa.

The price paid for the acquisition of The Camden Group has not been disclosed.