Care Innovations goes East–down home to Kentucky

October 14, 2015 | by

Intel and GE’s joint venture, Care Innovations, is opening an IT and product development center in Louisville KY’s Norton Commons live/work community. According to reports, the 10-person office was opened to develop “software for medical monitoring systems that allow people to measure their vital signs in own homes and that will analyze the data for health care providers”, which sounds like a description of Health Harmony as mentioned further in the article. Also cited by CEO Sean Slovenski was the recent acquisition of several major clients in Mississippi, Louisiana, Kentucky and Tennessee. Headquarters will remain in Roseville, California, northeast of Sacramento and far east of Silicon Valley. Why Louisville? It’s the headquarters of Humana, currently in the early stages of a merger with Aetna. Mr Slovenski is an alumnus of Humana who undoubtedly recognizes that there’s always talent which shakes loose with any merger, often proactively. He has reorganized the company top to bottom since the days in the doldrums under Louis Burns, and added initiatives such as the Validation Institute plus academic relationships with the Jefferson School of Population Health, Xavier University and the University of Mississippi. Louisville is also a lot closer to Washington DC (1.5 hour flight time) and all those wonderful Federal programs with lots and lots of funding.  Louisville Business First, release.

Speaking of the Aetna-Humana merger, it now has a strong boss man to make sure it works–Rick Jelinek, CEO for a year of OptumHealth, 19 years at predecessor now unit UnitedHealthcare including leading the Medicare Advantage and Medicaid businesses. The stakes are high in that the merger will create the second-largest managed care company in the US. Mr Jelinek also will lead Aetna’s enterprise strategy division, and will report directly to Aetna’s CEO. The timeline, unless the Feds put on the brakes, is to close in second half 2016. The combined operating revenue is projected at about $115 billion, with about 56 percent from government-sponsored programs, such as Medicare and Medicaid. The plan, according to Louisville Business First, is to headquarter the combined Medicare, Medicaid and Tricare businesses in Louisville. But, as they say, the meal is still being prepared, and assuredly not everyone at either company will find a seat at this table, or one they want to sit in.

TECS Project Manager finds Situation Wanted!

October 14, 2015 | by

TTA Situations Wanted poster succeeds! Back in August, Hannah Lowish, an experienced project manager formerly with one of the UK’s leading remote monitoring health providers, asked this Editor to run a listing posting her background in our ‘Who’s available?’ section (above). It was our pleasure to do so (and also revive this section under Jobs.)

Hannah has now written us advising that she has now started a new position with Tunstall Healthcare in their programme delivery team. Congratulations Hannah! And thank you for advising us.

And if you are seeking a new situation, or have a position to fill, we are listing–free as a service to our industry. Please write Editor Donna. We will post both confidential and identity revealed contacts.

Who’s hiring? mHabitat (UK)   Who’s available? Industrial engineer with 20 years experience seeks Silver Economy company (Spain)

When disruptive healthcare tech disrupts the wrong things, including safety

October 13, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/04/Thomas.jpg” thumb_width=”150″ /]Last week’s Health 2.0 conference was (of course) a three-ring circus of new technology and its corollary, a lot of hype. An astute writer new to this Editor, Michael Millenson, draws together the key points of two prominent, but not hyped speakers there: Robert Wachter, MD and Michael Blum, MD, both practicing in University of California San Francisco’s (UCSF) medical center. Dr Wachter, chief of the Division of Hospital Medicine, has been profiled in these pages earlier this year in a review of an excerpt from his book, The Digital Doctor: Hope, Hype and Harm at the Dawn of Medicine’s Computer Age. There he wrote about the example of Pablo Garcia, nearly dying from over-prescribed doses of an antibiotic that a chain of errors in their EHR started. Dr Blum is Director of UCSF’s Center for Digital Health Innovation. But their points are on the same track: “the danger of disruptive technology that disrupts the wrong things: upsets checks and balances that keep patients safe, makes working conditions more stressful and simply doesn’t play well with others.” His conclusions are on the money: #1, it’s not the technology but the adaptive change that front and back line clinicians will need to make; #2, entrepreneurs with whiz-bang tech that zips data to the clinician without fitting it into a care process are doomed to fail; #3 some kind of curation is needed. But whether that will be Care Innovations’ Validation Institute or Social Wellth (which purchased the late Happtique from GNYHA) is another story. Key for Health IT Entrepreneurs: Don’t Disrupt the Wrong Thing (Forbes)

Veterans eHealth & Telemedicine

October 10, 2015 | by

Currently in the US, the Department of Veteran Affairs may waive [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/10/Dept-of-VA-logo.jpg” thumb_width=”150″ /]the state license requirements for telemedicine services if both the healthcare professional and the patient are located at facilities owned by the Federal Government, according to Sen Joni Ernst from Iowa (see Ernst pushes for expansion of telehealth care for veterans). She is introducing the Veterans E-Health & Telemedicine Support Act in the Senate which, if enacted, would permit VA to allow the use of any location, such as a patient’s home. This, it is argued, will give better access to elderly, disabled and rural veterans. Ernst says that with 21 million veterans nationwide and 12% of veterans receiving some form of telehealth care in 2014 this could reduce costs for the VA. It is. however, not clear how many of the veterans receiving telemedicine care necessarily need out-of-state healthcare professionals to provide that care.

A similar Act is being introduced (or rather, re-introduced) in the House of Representatives by Rep Charles Rangel, a Democrat from New York with 18 co-sponsors (see E-Health Legislative Summary: The Veterans E-Health & Telemedicine Support Act of 2015). That act has previously been introduced in the House in 2012 and 2013 according Govtrack and its chances of being enacted this time round are considered very low (1%).

Taking our own transformation medicine: how to integrate digital health into healthcare

October 8, 2015 | by

An antidote to Dan Munro’s top-down and pessimistic vision of healthcare transformation (having much in common with Ezekiel Emanuel’s, see below) are two parallel prescriptions on integrating digital health into our healthcare systems and maybe, just maybe, transforming it.

The first acknowledges basic reality: we have all the health tech and funding we need right now. We are way beyond the fictional one device, app or service that will deus ex machina and transform healthcare. What we in the field need to do is integrate them, measure (and integrate) the data, get these systems and services into the home and–interestingly–seek out atypical early adopters. Your users/patients may not be the sexiest market for cocktail party chatter–older adults, the developmentally or cognitively disabled–and you’ll have to think beyond smartphone apps, but here is an opportunity to make an impact on a real, large, high-need and open market which can improve care, outcomes and reduce/redistribute cost over time. How The Digital Health Revolution Will Become A Reality (TechCrunch) Hat tip to reader Paul Costello of Viterion Digital Health.

The second analyzes a key point often neglected in healthcare discussions but well-known to students of behavior, like marketers: the patient’s perception of value. (more…)

Beyond Proteus, delaying medication release in the body–almost all the way

October 8, 2015 | by

How to deliver medication reliably, well into the colon, to treat gastrointestinal disease most effectively? Purdue University researchers have developed an electronic drug capsule that delivers medication far into the digestive system. When triggered by the magnetic switch or electronic implant, it ‘detonates’ the capsule, releasing the medication. This delivery mechanism was tested through the stomach and into 20 feet of the small intestine. The promise is that it can deliver targeted medications farther into the colon, cost-effectively, to better treat IBS, Crohn’s and bacterial infections. The Purdue team is currently partnering with a biomedical company to take this into clinical trials. This takes the idea of Proteus’ ingested sensor to track medication one step further. Smart capsule to target colon diseases (Reuters)

Are we in the midst of healthcare disruption–or not at all?

October 8, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]If you believe we are in the midst of a slow, tidal disruption of healthcare and the ascendancy of patient-centered care–to the point of Topolesque patient ownership–then you will be upset to tears by the contrarian assertions of Dan Munro in Forbes. He maintains that disruption isn’t what we think it is, but (and we cut to the chase here) it’s more like ‘process improvement’ and that it has to be driven by ‘K Street’ (translation: the street in Washington DC where Lobbyists Rule). Technology–patches on the flawed system. Doctors–desperately seeking to pay back their educational loans by picking the most lucrative specialties. (If they survive the internship and residency system without killing a patient or themselves; see The Misery of a Doctor’s First Days)

But..there’s more. (more…)

DARPA testing electricity to self-heal the body

October 7, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/10/darpa-electrx-electric-prescriptions-2.jpg” thumb_width=”200″ /]I sing the self-healing Body Electric! With apologies to Ray Bradbury, in this Editor’s view, DARPA’s ElectRX research is almost revolutionary, yet logical. Like a pacemaker, it monitors a condition (like heartbeat) and if ‘off’ stimulates the organ through an electric shock. Scale it to a nano-sized neuromodulator and you have ElectRX. In broad terms, a tiny device, perhaps delivered by a needle, analyzes an anomaly and delivers an electrical signal to nerve pathways to correct it. For diabetics, it could stimulate insulin production; to treat depression, control inflammation in the brain; for PTSD patients, stimulate the vagus nerve for neural plasticity. Controlling inflammation has other benefits, such as in spinal injury and in TBI. While the Gizmag article spends time musing on ‘super-soldiers’ and the negative aspect, this Editor sees this research on the relationship between neural circuits and health as a significant development for both medicine and for Version 3.0 of digital health. DARPA web page on ElectRX.

Is digital health going to add to Digital Big Brother Watching You?

October 6, 2015 | by | 1 Comment
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/10/Doctor-Big-Brother.jpg” thumb_width=”150″ /]“They’re watching me on my phone. They’re watching me on Facebook. They’re even watching me when I want to hide. Machines are a form of intelligence, and they’re being built into everything.”–Dr Zeynep Tufekci

The world of digital health is largely based on tracking–via smartphones, wearables, watches–and analytics taking and modeling All That Data we generate. Are we in compliance with our meds? Are we exercising enough? How’s our A1c trending? Drinking our water? All this monitoring–online and offline–is increasingly of concern to Deep Thinkers like Dr Tufekci, a reformed computer programmer, now University of North Carolina assistant professor and self-proclaimed “techno-sociologist.” At IdeaFestival 2015, she took particular aim at Facebook (surprisingly, not at Google) for knowing a tremendous amount about us by our behavior, of course using it to anticipate and sell us on what we might want. The ethics of machine learning are still hazy and machines are prone to error, different than human error, and we haven’t accounted for machine error in our systems yet. Like that big health data that mistakes a daughter for her mother and drops critical health information from a patient’s EHR [TTA 29 Sep]. A thought-provoker to kick off your week. TechRepublic 

Related: The Gimlet Eye took a squint at Big Brother Gathering and Monetizing Your Big Blinking Data–data mining, privacy and employer wellness programs–back in 2013, which means the Eye and Dr Tufekci should get together for coffee, smartphones off of course. While Glass is gone, the revolt against relentless monitoring is well-dramatized in the well-watched video, ‘Uninvited Guests’. And we can get equally scared about AI–artificial intelligence–like Steve Wozniak. 

Digital health supporting daily living with autism

October 6, 2015 | by

A developing area for healthcare tech is in the assistive technology (AT) area–in this instance to support those with autism. The spectrum of abilities and capabilities here is very wide–as are the needs. Some major challenges: organization, communication, managing stress levels, managing transitions in everyday living as a college student with autism must. Last week’s Autech 2015 at Old Trafford, Manchester spotlighted AT such as Brain in Hand, a smartphone/tablet app that touches on all three: it helps with planning daily activities, logging stress levels, providing help with coping strategies and if it is overwhelming, a direct connection to a support worker at the Wirral Autistic Society. Other promising technology includes biometric wristbands to monitor signs of stress and provide feedback to identify and work to modify the autistic person’s reactions; the Kaspar assistance robot for socializing children; the Proloquo2go tablet app which speaks for those without speech by using speech-producing icons. AT for the autistic is at the very early part of the development curve, but this Editor could see dual or triple uses for these technologies for those with TBI, stroke or dementia. Studies on cost savings are early, but the Brain in Hand test in Devon estimated a 100-200x savings: £300-500/week for social care versus £20/week for the service (but does this include the live support worker?) There’s an app for that: how assistive tech changes lives of people with autism (Guardian)

Related: on a late adult diagnosis of autism, how it is to live with it on your own (Guardian)

Connected health to help cure–physician burnout?

October 6, 2015 | by

Here’s an interesting proposition: digital health tools such as telemedicine, telehealth and mobile health can help to reduce physician burnout. Except that if one is looking for support points in this HCI Healthcare Informatics article, one would be hard pressed. There’s no link to QuantiaMD‘s study (a 225,000-member US physician community), an inexplicable lapse. Your persistent Editor tracked it down, and found it connects the dots a bit more. It starts with the proposition that nearly half of doctors wouldn’t recommend medicine as a career to their children, then identifies a key frustration–“healthcare technologies that sap time and money are among the top reasons.” The solution? Other “emerging technologies—in the form of telemedicine, mHealth tools, and connected health devices—may actually help reverse this trend of physician burnout.” The paper then describes how telemedicine virtual visits, giving patients telehealth tools which will aid compliance and monitoring, especially with new treatments, and the opportunity to improve care all are Good Things. But not entirely convincing that these can be effective in mitigating the complex reasons why behind doctor burnout. Read the QuantiaMD study for yourself. Hat tip to Stuart Hochron, MD, JD of Practice Unite via LinkedIn

Blueprint Health’s 8th Demo Day: 8 new companies show their stuff

October 6, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/10/blueprint-health1.png” thumb_width=”150″ /]Last Friday, in the middle of a NYC nor’easter, Blueprint Health had its eighth Demo Day, where startup companies in this accelerator’s latest three-month Summer class, having worked on their innovations and developed a business plan, ‘graduate’ and ‘pitch’ their audience. There’s been a shift over the past few classes to B2B-oriented digital health, from reducing readmissions through geolocation (Position Health)  to HIPAA compliance (HIPAAfix) to streamlined billing for chronic care management (Oculus Health), but half are more consumer-oriented companies, providing more accessible genetic testing (Bind Health), workplace stress reduction (Psocratic) and point of service lending to patients with high-deductible health plans (Crediyo). The other two companies are MedPilot (simplifying patient billing and debt through electronic billing) and DocDelta (streamlining provider talent search). Annually, Blueprint Health’s invites in about 20 digital health companies with an investment of about $20,000 each, has graduated 68 companies and hosts in their space over 24 digital health companies. Release. Company profiles.

European Assistance for Innovative Procurement (eafip) Conference Manchester, Nov 24th

October 2, 2015 | by

When this editor first saw European, Innovative and Procurement in the same title, he thought he’d misread it as one of the complaints that has been made at almost every recent meeting attended, especially those relating to the Accelerated Access Review, is how European procurement rules disadvantage small suppliers who are typically the principal source of innovation in the health & care sector.

So here’s your opportunity to hear from the experts and to make your concerns known to them, in this European Commission sponsored joint NHS England/eafip event on ICT solutions procurement.

Date is 24th November; more details here – booking for this free event will open soon apparently.

Better’s fast fail, ending health assistance service 30 Oct

October 2, 2015 | by | 1 Comment
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/10/Better.png” thumb_width=”150″ /]Better is sadly not. This two-year old service that provided personal health assistance, including a real, live health assistant, to guide members through health questions, the thickets of insurance claims, finding doctors and specialists, apps and more, announced earlier this week that it was ending operations as of 30 October. While it was announced via their Twitter feed on Tuesday, most of the industry learned of it through Stephanie Baum’s article in MedCityNews today. Better formally debuted only 16 months ago [TTA 23 Apr 14] and at the time this Editor felt that it was a service in the right direction, a kind of ‘concierge medicine for the masses’ needed when individuals have to direct more and more of their own care.

A solid start, as our Readers have seen, does not guarantee success, but this fast fail is still fairly shocking. A concern at the time was the pricing for the full service model at $49/month, which later became the family price (individuals were $19.99/month). CEO/co-founder Geoff Clapp was among the most Grizzled of Health Tech Pioneers; he had been a co-founder of Health Hero/Health Buddy from 1998 to its sale to Bosch Healthcare, a very long pull in telehealth, and he had spent much of his post-Health Hero time generously advising other startups. Yet despite the involvement of blue chip Mayo Clinic as a service provider, its financial backing from their investment arm and socially-oriented VC Social+Capital Partnership, it managed to raise only its initial seed funding of $5 million (CrunchBase).

So what happened? (more…)

76 percent of post-surgery patients prefer telehealth followup: study

October 2, 2015 | by

A 50-patient study at Vanderbilt University Medical Center in Nashville, Tennessee found that online-only post-surgical followup was acceptable to 76 percent of patients after uncomplicated surgery (hernia repairs, laparoscopic gall bladder). These patients, all of whom had internet access and a smartphone, tablet or digital camera, took their own pictures of their surgical site and transmitted these digital images through an online patient portal established by Vanderbilt. Both patient and doctor communicated through the portal to discuss follow-up care (though not necessarily at the same time). Another plus was that the online visits took significantly less time for patients (15 versus 103 minutes) and surgeons (5 versus 10 minutes). The surgeons reported a comparable effectiveness number–68 percent–for both online and in-person visits. Clinic visits were more effective in 24 percent and online visits for 8 percent. What was also notable was that no complications were missed via online visits. The program used to analyze images, typically used in wound management, was not disclosed in the study, which was performed between May and December last year. mHealthNews, Journal of the American College of Surgeons (abstract only)

NJ Innovation Institute gains $49 million HHS grant

October 2, 2015 | by

The New Jersey Innovation Institute (NJII), a New Jersey Institute of Technology (NJIT) corporation, has been selected as one of 39 health care collaborative networks participating in a Health and Human Services (HHS) program, the Transforming Clinical Practice Initiative. According to their announcement, NJII was selected as a Practice Transformation Network and over four years will receive up to $49.6 million for technical assistance support to help equip 11,500 clinicians in the New Jersey region with tools, information, and network support needed to improve quality of care. This is part of a $685 million HHS program awarding grants to 39 national and regional health care networks to help equip more than 140,000 clinicians with the tools and support needed to improve quality of care, increase patients’ access to information, and reduce costs. This is in addition to an $2.9 million grant from the Office of the National Coordinator for Health Information Technology (ONC-HIT) announced in August for sharing of quality data through its New Jersey Health Information Network (NJHIN). Through its Innovation Labs (iLabs), NJII brings NJIT expertise to key economic sectors, including healthcare delivery systems, bio-pharmaceutical production, civil infrastructure, defense and homeland security, and financial services. Release via Ridgewood Patch, HHS release. Hat tip to contributor Sarianne Gruber via LinkedIn.