California’s Center for Connected Health Policy, which is the National Telehealth Policy Resource Center, has published a study which concludes that community health centers (CHC)–a general term covering Federally Qualified Health Centers (FQHC) and Rural Health Centers (RHC)–have difficulty sustaining telehealth programs to support the underserved and ill with chronic conditions including mental health without grants or other subsidies. Consultant Milliman studied five California CHCs and determined that other than financial, major impediments to successful implementation were structural: complex billing and reimbursement rules, and difficulty tracking telehealth visits through multiple EHRs that weren’t necessarily compatible with each other or with billing systems. Many of these CHCs cannot financially provide telehealth without grants or other subsidies. This study holds lessons for telehealth companies which are working with ACOs, hospital discharge programs and practices in rural areas, as well as the Indian Health Service. Study (link to PDF), Healthcare Informatics, California Healthline Hat tip to Elizabeth Olis of Viterion Digital Health
FDA, new technology approval and the Ossification Tango (US)
When it comes to new technologies–and drugs for that matter–the worst thing that can happen to your invention is to receive a letter from FDA that you have been classified into Class III. Based on regulations passed by Congress in 1976, there are three FDA classes primarily based on device risk. Exception: Class III. Anything not ‘substantially equivalent’ to an existing device is automatically put into Class III, regardless of risk level. Author and health tech legal advocate Bradley Merrill Thompson of Epstein Becker Green takes a comprehensive review at this flawed and outdated system that puts groundbreaking health tech at an extreme disadvantage in his latest article on regulation in Mobihealthnews. (more…)
IoT’s biggest problem? Communication of Things.
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]The Gimlet Eye joins us for a ‘blink’ from an undisclosed, low-tech dot on the map. The fave rave of 2015 is IoT, the annoying shorthand for Internet of Things. Well, can Aunt Madge go into a store and buy an Internet Thingy? But it seems fundamental that The Things Speak with each other, if only to compare football scores and conspire against their owner to drive him or her Stark Raving Mad by producing too many ice cubes in the fridge, turning lights on/off at the wrong times or sending out for a deli order of 20 pounds of Black Forest sliced ham. Our fear about The Things was in considering that they could be hacked in doing Things Against Their Will and Not In The Owner’s Manual. But never mind, it’s not this we should be concerned about, or whether Uncle Aloysius will go off-roading in his Google Galaxie after it’s hacked for fun by an eight-year-old Black Hat. It’s that practically all of these same or different brand TVs, parking meters, cars and health/activity monitoring devices to make life simple for Auntie and Oncle are built on different platforms without a communication protocol. The Eye is now relieved of the fear that IoT devices will be crawling out of the water onto her faraway from dull care beach anytime soon. But you may not be. The Biggest Problem with the Internet of Things? Hint: It’s Not Security (Tech.co) Hat tip to follower @ersiemens via Twitter
Health data changes Down Under: My Health Record, Tim Kelsey and Telstra
Australia’s federal government is hoping for a boost to its national personal health records system, starting with a renaming of Personally Controlled Electronic Health Record (PCEHR) to My Health Record. Proposed in the government’s $485 million budget announcement on eHealth is a resolution of implementation issues and introducing trials of participation models including designing opt-out approaches. Currently enrollment stands at a paltry 10 percent of Australians. Computer World (Australia) Hat tip to Mike Clark via Twitter
Come December, also taking the long trip there will be NHS England national director for patients and information Tim Kelsey to join Telstra Health as commercial director. Telstra is Australia’s largest telecom developing a footprint in health, and earlier this year acquired Dr Foster LLP, the UK-based health informatics company. Coincidentally (?), Mr Kelsey co-founded Dr Foster prior to 2006, when he joined the NHS to start up the information site NHS Choices. During his NHS tenure, Mr Kelsey faced numerous controversies which are detailed in the Guardian and IT news/opinion site The Register reports, mainly concerning the Care.data database for all English medical records. Concerns were raised about inadequate privacy, transparency and confidentiality provision in its design, and after a halt it has still not restarted, although 1 million people have preemptively opted out–another issue in common with My Health Record. According to the Guardian, “The scheme was recently labelled “unachievable” by a Whitehall watchdog, the Major Projects Authority, which said the future of the programme should be reassessed.” A successor to Mr Kelsey has not yet been named.
Now mobile metabolism tracking
“I have a slow metabolism.” Anyone who’s fought The (Literal) Battle of the Bulge has always wondered if this statement could be true. For $350, you can find out. At last June’s CE Week, one mobile health technology was Breezing, which through breath analysis measures how many calories are burned at rest and reports the results on your smartphone. It’s available for sale in US and demo’d on video (YouTube)
IMS Health report: mainstream health app adoption remains elusive
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/Key-findings2-thumb-IMS1.jpg” thumb_width=”200″ /]Despite 165,000 apps (and counting). A followup to IMS Health’s report of 2013, Patient Adoption of mHealth demonstrates how far mHealth has to go. Over 50 percent of apps have a single functionality, but connectivity to external sensors (e.g. wearables) has improved to 10%. 36 apps account for nearly 50 percent of downloads and 40 percent of all health apps have 5,000 downloads or less. Providers give limited if any guidance to consumers on app choice despite greater interest; ‘curation’ efforts, including IMS Health’s own [15 Dec 13], have largely failed. Other barriers to adoption are reimbursement (though many are free), limited healthcare system integration, regulator and privacy unknowns.
Where’s the progress? Chronic condition monitoring (left), with clinical trials more than doubling in the past two years, and focusing on treatment/prevention largely for older adults. These clinical trails are looking at mental health, diabetes, cardiovascular disease, weight management and oncology. IMS Health also recommends that users and stakeholders, including clinical organizations such as the CDC, ASCO and the Cancer Support Community tap into their clinical resources to develop and promote patient-centered apps. Download report (information required.) A decidedly less cheerful take on the report is Stephanie Baum’s at MedCityNews.
Have we arrived at another, multi-functioning generation of telecare?
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/Onkol.jpg” thumb_width=”150″ /] Profiled in Reuters in an article on home monitoring for older adults is a desktop-sized, sleekly telecare unit called OnKöl (that’s On Call for those who wonder what an umlaut is doing there) for the home market. Debuting back in January at International CES, it monitors activity in an area of the home (that green eye looks like a vintage radio DuMont Magic Eye tuner) and is extended through home monitoring sensors such as bed, door and window. Like Lively, it also has an in-home wrist/pendant emergency alert device and is self-installed. But what’s new about it is its telehealth side–connecting via Bluetooth and USB cable to typical medical monitors such as weight scales, blood glucose and pressure, as well as a med reminder setup. These seem to be brand-agnostic. A unique safety feature is a caller ID recorder for tracking calls. Activity and health information are stored, with alerts going to designated family members. According to the article, the founder designed it for monitoring his mother recovering from colon cancer. The Milwaukee-based company is financed through Series A (Capital Midwest Fund, $2.8 million), moving towards Series B, and OnKöl will be in market early next year. What is not apparent (more…)
Online Masters and Modular Learning in eHealth – last chance to enrol
Build your skills and study while you work!
The University of Edinburgh has a few places left on their Masters programme in Global eHealth. This is studied part time, via interactive online learning, supported by a network of international experts in the field (disclosure, of which this editor is one), and is designed for working professionals with some experience in healthcare, IT or eHealth, who are looking to grow and consolidate their knowledge and skills. Courses are available as individual 10-week modules, or accumulated for a certificate (6 courses over 1 year), diploma (12 courses over 2 years) or MSc (the latter plus a supervised research project).
Readers may be particularly interested in the courses on ‘mHealth’, ‘Telemedicine & Telehealth, ‘The Business of eHealth’ (summer term), ‘User-Centred Design in eHealth’ and ‘Consumer Health Informatics’.
Applications for the new academic year close on Monday 21st September, so don’t delay applying!
For more information, please visit their website or contact the programme team on Global.eHealth@ed.ac.uk or the programme director claudia.pagliari@ed.ac.uk
Philips tests diabetes app developed with Radboud UMC, Salesforce (NL)
Philips Healthcare unveiled a prototype of a diabetes tracking app that also links to a secured social ‘community’ at this past week’s Dreamforce 15 conference in San Francisco. It was developed in conjunction with Salesforce and the Radboud University Medical Center (NL). Philips claims the app is the first to collect and connect data from EMRs, multiple personal health devices and patient self-reported data, with the patient directing sharing via private messaging and shared posts with providers and fellow patients (‘community’). It is built on the HealthSuite Digital Platform which is a product of Philips’ collaboration with Salesforce. The app provides tracking information to the patient on blood glucose levels, insulin use, nutrition, physical activity, mood and stress. The patient also receives data-driven feedback and coaching guidance. It will be ready before end of this year in select non-US markets. At Dreamforce, Philips demo’d their joint Virtual Health Record initiative, which is being promoted as “a digital toolkit that makes it easy for health systems, institutions and care providers to utilize the power of the HealthSuite Digital Platform technology in dedicated localized solutions.” Release
GE Healthcare staying together: CEO (updated)
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/04/2000px-General_Electric_logo.svg_.png” thumb_width=”150″ /]It’s ‘black and white’ but not GE blue all over! During an investor conference Wednesday, GE Healthcare’s CEO John Flannery insisted that “Bottom line is we have been black and white that all aspects of healthcare are part of our portfolio,” reported in Reuters. Investors have questioned the flatlining of both revenue and profit and the fact that GEHC doesn’t seem to fit well in the engineering/manufacturing bent of the Immelt-ized GE.
The speculation by investors and we in the healthcare press is rational. Earlier this year, GEHC announced the phaseout of the Centricity Enterprise (hospital) EHR. [TTA 15 April] Healthcare Financial Services and the services it would provide were also up in the air. Currently it lends to healthcare entities including hospitals and other health facilities to purchase equipment (made by GE) and real estate/facilities (not made by GE). Initial indicators was that GE would continue to finance what it sells. The real estate financing then is questionable, and undoubtedly an issue for healthcare facilities, as GE Capital has been sold. GE also sources funding for healthcare innovation through the Healthymagination Fund and GE Ventures, and of course has an interest in the Intel-GE JV, Care Innovations. What shape this financial arrangements will take in the future is not clear from the available information.
Also announced, according to Biospace, is $1 billion funding over the next five years for education to reach more than two million healthcare professionals worldwide–physicians, radiologists, technologists, midwives, nurses, biomedical engineers–geared to local needs. It will include new clinical, product application, technical and leadership training and education. A forward commitment of this magnitude does seem to confirm that GEHC is in the healthcare game.
Soapbox: The burning technological platform for person-centred care
Rising demands of an aging population are putting increasing pressure on care providers across health and social care. But the technology and thinking that can help alleviate some of those pressures is analogue in a digital world, argues Tom Morton of Communicare247.
Analogue thinking in a digital world
Integrated, person-centred care is seen as a driving force for building public services around individual needs. It aims to bring care out of the hospital and into the community and home to cope with the growing burden of the 3 million people who will have over three long-term conditions by 2018. It will also help acute hospitals to address the ever increasing costs associated with our aging population.
Meanwhile life in our homes and communities is becoming fragmented. One in four (2.9 million) people aged 65 and over feel they have no one to go to for help and support, according to a 2015 report from Age UK and The Campaign to End Loneliness(1). With research indicating that social isolation leads to higher mortality, what point is there keeping people out of hospital, if only they are left home alone, and without the necessary support?
Person-centred care will have minimal success if we do not recognise this fact; people need someone to look out for them. And current approaches are not building the foundations that society needs to help grasp the nettle of providing round-the-clock personal care. (more…)
Conference report: MedCityNews CONVERGE
Guest columnist Sarianne Gruber (@subtleimpact) attended Breaking Media’s annual MedCityNews CONVERGE two-day conference at Philadelphia’s Hyatt at Bellevue earlier this month, and has a few observations on the surface contradiction of innovation and health insurance.
Breaking Media rightly titled this year’s MedCity News conference “Converge”. Listening to the speakers, meeting the founders of new startups and talking to presenters, it became clear that today’s healthcare ecosystem is interdependent on the all the players to move the needle for better quality health. It was fascinating to learn was how innovation is breaking down the old silos of engagement, and is emerging from all the industry players, as well as joining at new intersections. The proliferation of better products, methodologies and engagement is closing the gap with more data, technology and ideas.
When you think of your health insurance company, usually two words comes to mind, cost and coverage. Keynote Speaker, Daniel Hilferty, President and CEO of Independence Blue Cross, wants to change the focus to consumer and care. Hilferty paralleled the new ventures at Independence to the work of the great innovator, Thomas Edison. Not only did Edison invent the light bulb, but his work is evidenced in the scalability of electricity that changed the world and how we now live.
In what directions is Independence Blue Cross converging? (more…)
A day in the life of a blind business man (guest blog)
Chris Lewis, the world-renowned telecoms expert and regular presenter on disability issues has kindly offered to share some thoughts with readers prior to his presentation at the Royal Society of Medicine event on the Medical Benefits of Wearables on 23rd November. This is the second of two he has written specially for TTA.
You’re blind: How do you ‘read’, join in social media and find your way around, let alone run a business?
Picture the scene: a blind man walking down the street moving white stick to and fro. He is muttering to himself while clicking a small black thing in his left hand. What is he doing? Actually, he is running his business, doing email, messaging, reading documents, checking-in for his flight and working out the best route using bus and tube to get to the airport. The black device is a mini keyboard, controlling the iPhone in his pocket and it is talking to him via his in-ear Bluetooth device….
Having been registered blind for over 30 years, I am accustomed to the regular question about how the hell do you run a business? I thought it worth while to put this down in writing both as a record of how things stand in 2015, but also as evidence of how my world has changed since the days of cumbersome magnifiers, papers being sent off to be recorded, and very clunky interfaces with early PCs.
Equipment & technology
Want to update your mobile technology knowledge?
Hatching a new business idea? Interested in mobile and IoT innovation? Need to bring mobile technology and business know-how in to your organisation?
Or perhaps you just want to move your career on…
Stuart Revell has kindly drawn TTA’s attention to the Mobile Academy which sets up shop at UCL’s innovation hub in Shoreditch, London. This year’s CPD-certified annual course will run from the 1st October to 3rd December 2015 on Tuesday and Thursday evenings. Tutors (including Stuart) are extremely high quality, and give their time for free.
Looks to be a great opportunity. Registration is here.
Big Data at work in the Emergency Room
Did you watch the Panorama programme yesterday on BBC (only available in the UK, I understand)? [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/Beth-Israel.jpg” thumb_width=”150″ /]Subtitled “Could a Robot do my Job?” reporter Rohan Silva was looking at the impact of Artificial Intelligence (AI) on the workplace and jobs, primarily in the UK.
The last section of the programme was on a data analysis system at a Boston hospital (Beth Israel Deaconess Memorial Center). The reporter mentioned they use an “artifical intelligence supercomputer” (!) in their emergency department that can “forecast if you’ll die in the next 30 days”. Well, not quite, but, “forecast the probability of a patient dying with almost 96% confidence” according to the very enthusiastic doctor (and the only one featured in the programme) at the hospital. Not sure if that is all PR or verified independently.
I was very impressed when it was mentioned that the computer had 30 years of data from over 250,000 patients,so it could recognise rare deceases quicker than a doctor. After all my navigator can find me a route a 100 times faster than I can, so why not.
But then I got thinking. 30 years ago they didn’t collect patient’s blood oxygen level and blood pressure every 3 minutes like they are doing now. This was an emergency department, not the obvious place for lots of people with a rare diseases to turn up. How many rare diseases had this system diagnosed so far? So there was a fair bit of mirrors and smoke to make it look far better than it really is I think. In fact, I think the Boston system is actually just good example of what is called Big Data at work.
This tendency to exaggerate was true of the rest of the programme too which can be fairly described as sensational rather than educational.
No doubt the publicity will help the hospital. I see that the story about the dying prediction appears on many newspaper websites right now with headlines like “the supercomputer that can predict when you’ll die”!
Thanks Donna for telling me about the programme.
Qualcomm Life, Cox Communications buy into integration–differently (US/FR) updated
Qualcomm Life, known for building partnerships with independent companies to form a continuum in transitional/chronic care management utilizing the HealthyCircles platform [TTA 19 Dec 14], yesterday announced not a partnership but an acquisition–Capsule Tech, a company that builds systems for healthcare facilities, mainly hospitals, to collect and integrate data from myriad medical devices. Their medical device information system (MDIS) is dubbed SmartLinx and is used by 1,930 hospital clients in 38 countries. Headquartered in Andover, Massachusetts, Capsule has international offices in France, Singapore, China, Australia, UAE and Brazil. Majority owner was Turenne Capital, a French PE company. Acquisition terms were not disclosed. Release. Also Forbes, Neil Versel in MedCityNews.
Update: Fortune is quite bullish on how this aids Qualcomm in narrowing the quality gap of data transmission between the home and the hospital setting.
Cox Communications, the third largest cable and internet company in the US with ad media and business data divisions, is dipping more than a tentative toe in healthcare with last week’s acquisition of Trapollo, a program design/supply chain/logistics provider that currently works with multiple telehealth, telecare and monitoring device companies. Cox is clearly seeking another type of integration of their data carriage capabilities with systems and programs; they have also invested in HealthSpot Station’s virtual visit/telehealth kiosk and formed a strategic alliance with Cleveland Clinic. Release.
Neil Versel’s columns also note IBM Watson‘s growth and development of its own Care Manager with Apple HealthKit/ResearchKit [TTA 10 Sep] and Salesforce’s entry into patient management with Health Cloud, with another big announcement rumored to be on the way.
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