Eric Topol, Robert Wachter have a patient-centered conversation

September 11, 2015 | by

Ostensibly an interview about Dr Topol’s book ‘The Patient Will See You Now,’ it is more a discussion of Dr Topol’s thesis that patients in control of their data are upending the relationship between doctor (as authority) and patient. What Dr Wachter questions– is the lack of analytics to turn this into useful information for both doctor and patient. Dr Topol agrees that the data is outstripping the analytics:

The field has not been developed nearly the way it should be to get us to the virtual medical assistant, which integrates all relevant data about an individual and provides great data visualization back to that person. Once it does, we have a tremendous opportunity to help people, even to preempt illness.

Dr Topol is also widely depicted as an advocate of ‘DIY’ (do it yourself) medicine, but he is not; “This is more about acquiring diagnostic or monitoring data and still having an intimate relationship with a doctor to help guide the appropriate treatment.” Doctors will have to change their methods too. A worthy Weekend Read (and audio excerpt 08:05) in this month’s AHRQ WebM&M.

Previously in TTA: Dr Topol on his book at last year’s NYeC Digital Health Conference (contrasting with the central control-stop medical intervention at 75 advocacy of Ezekiel Emanuel); Dr Wachter on The Overdose (excerpted from his ‘Digital Doctor’ book)

IBM Watson Health adds 5 partners, 2 solutions

September 10, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/pillar.jpg” thumb_width=”150″ /]Breaking News  IBM Watson Health not only cut the ribbon on their new global HQ on Kendall Square in Cambridge, Massachusetts (and on their new General Manager Deborah DeSanzo), they also announced two more data crunching power platforms and five new partners.

  • The IBM Watson Health Cloud for Life Sciences is designed to help life science companies fast track the deployment of a GxP compliant infrastructure and applications while adhering to stringent requirements for hosting, accessing and sharing regulated data.
  • The IBM Watson Care Manager is a population health solution that integrates Watson Health, Apple ResearchKit and Apple HealthKit into a personalized patient engagement program to improve individual health outcomes.

The five new partners are Boston Children’s Hospital (pediatrics), Columbia University (Pathology & Cell Biology and Systems Biology), ICON plc (pharma clinical trial matching–Ireland), Sage Bionetworks (Open Biomedical Research Platform) and Teva Pharmaceuticals (treatments for chronic conditions–Israel). They join CVS Health, Medtronic and Yale University. On opening day, the new headquarters also hosted demonstrations by health ecosystem partners Best Doctors, Modernizing Medicine, Pathway Genomics, Socrates and Welltok. Release (PDF)

Previously in TTA on IBM Watson Health: their big announcement at HIMSS 15 and we do wonder about their work with the VA on clinical reasoning and mental health.

Accessibility arriving at the Top Table (guest blog)

September 10, 2015 | by | 1 Comment

Chris Lewis, a 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 first of two he has written specially for TTA.

At this year’s Mobile World Congress (MWC) in Barcelona accessibility I took to one of the main stages for the first time. IBM, Microsoft, Google and the Mobile Manufacturers Forum (MMF) joined me to present perspectives on how accessibility is going mainstream.

I introduced the session with some of the key findings from the second Telefonica accessibility report “Digitising the Billion Disabled: Accessibility Gets Personal“. In summary, the billion disabled people represent a major spending group, combining earnings of some $2.3 Trillion and state support of $1.3 Trillion. Disabled people on average earn only 60% of their able-bodied peers and, of course, many disabled people don’t get the opportunity to work at all. 4% of children and 10% of the working population are disabled, but perhaps most striking, over three quarters of the elderly. Combine this dynamic with Douglas Adams’s theory of adopting technology getting harder as we get older and you can see the ticking time bomb of disability and age. (more…)

DHACA visits Lancaster University on 23rd September – come and join us!

September 10, 2015 | by

The Digital Health & Care Alliance is holding its sixth one day event on 23rd September, at the University of Lancaster.

DHACA Days are aimed at informing members, seeking feedback on DHACA activities and encouraging special Interest Group (SIG) engagement in topics of importance to members. On this occasion we have a very special SIG event which is the launching of DHACA’s medical apps regulatory process description, which looks at all the things you need to do to get a medical app fully approved. The draft is already available for members to comment on.

In addition, in the morning we will have presentations from:

  • Prof Peter Sawyer, Professor of Software Systems Engineering, University of Lancaster:sensing cognitive health through monitoring computer interaction and through ambient technology – this is a most exciting (and I guess to some a bit scary) new area of research where you can sense someone’s cognitive health from how they use smartphones and other devices.
  • Prof Jon Whittle; Head of the School of Computing and Communications,University of Lancaster: the uses for temporary digital tattoos, and how to make them – this will in part be an interactive session in which members’ suggestions and, if appropriate, future involvement will be sought.
  • Jeremy Moyse, Strategic Development Manager, SEQOL: a provider’s view of how technology will help deliver changes in the health & care world – SEQOL is a ‘spin-out’ social enterprise formed in 2011 from the NHS Transforming Community Service programme and now delivers a broad range of health & care services in Swindon; as Jeremy will explain, it has grown massively since then, and collected a cabinet full of awards.
  • Prof Awais Rashid, University of Lancaster: secure IoT use in digital health – Prof Rashid is a world expert on this topic which has become particularly important since the FDA recently withdrew approval from an infusion pump because it was too easy to hack. He will explain the critical importance of IoT security, how to assess it and how best to achieve secure solutions.

(more…)

Fancy £35,000 to develop a Quantified Self solution to meet a real need?

September 10, 2015 | by

Innovate UK has announced , launching Monday 14 September.

As most TTA readers will be well aware, Quantified Self relates to the use of digital technology in self-tracking, monitoring and sensing to improve wellbeing. In particular the contest will be looking for solutions relating to the areas of: nutrition, older people, younger people, mental health and data capture. The winning solutions will focus on ways of empowering users to take ownership of their data to influence behaviour change and improve wellbeing.

The contest will include five challenges each offering up to £35,000 and the chance to work with one of challenge partners: Jamie Oliver, Toshiba, AXA PPP Insurance, Saga and Bupa. The winning company will trial their solution with the challenge partner over a period of three months.

The Knowledge Transfer Network is running two briefing events for this call. To register please sign up below:  (more…)

The intent is good, the name–Hackfest–is unfortunate (Updated)

September 10, 2015 | by | 3 Comments
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/CI_Hackfest_15.jpg” thumb_width=”150″ /]Given another Big Blue Cross data breach (below), the juxtaposition of a release from Intel-GE Care Innovations is, how do we say, jarring. A great trumpeting of a prestige event 18-20 September in conjunction with the Stanford Center on Longevity on the Stanford University campus. “Inspiring a reconfigured care delivery process bringing care to the home and uniting patients, family caregivers and professional caregivers with the traditional clinical care team.” which will “…change the status quo. The event will bring together clinicians and care providers, health plan leaders, family and professional caregivers, patients, designers, engineers, students and faculty to explore the meaning and definition of a care team.” Yes they can be ‘hack(ing) a strategy to redefine the care team’…but given the tens of millions of health records hacked, breached and stolen in this year alone, is this the best name Stanford and Care Innovations could think of?  ‘Hackfests’ and ‘hackathons’ usually are coding or programming competitions, which long predate the negative use of ‘hack’ for malicious entry into systems. Even events in that context are increasingly met with raised eyebrow.

‘Hackfest’ for this is a stretch. Message to both: care teams need redefining, but it’s time for a better, and more descriptive, name. A ‘****-palooza’ (a voguish term in US), anyone?

Update: A Care Innovations spokesperson and this Editor had a Twitter conversation–a TweetFest, so to speak:

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/Care-Innovations.png” thumb_width=”450″ /]

Readers–what do you think? Is this Editor overly sensitive to the ‘h’ word? She might be…click on the title to see Comments.

Hackers hit another Blue Cross, put 10.5 million members at risk (Breaking)

September 9, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/02/Hackermania.jpg” thumb_width=”150″ /]BREAKING NEWS This time the data breach is at Excellus Blue Cross Blue Shield, which covers upstate New York (Rochester-Syracuse area). It was discovered by Excellus on 5 August but dated back to 23 Dec 13, and reportedly has compromised members’ names, addresses, telephone numbers, Social Security numbers, financial account information and in some cases sensitive medical information. According to the AP/NBC, it also breached other divisions of Excellus and the corporate parent, Lifetime Healthcare: Lifetime Benefit Solutions, Lifetime Care, Lifetime Health Medical Group, The MedAmerica Companies and Univera Healthcare. The source of the hack has not yet been determined.

Excellus joins fellow BCBS members Anthem [TTA 11 Feb], soon to be merging with Cigna, with 80 million; Premera Blue Cross [TTA 24 Mar] with 11 million, Care First with a ‘bag o’ shells’ 1.1. million [TTA 2 June]. The pattern has been such that the national Blue Cross Blue Shield Association (BCBSA) announced in July that it will offer all 106 million of its members identity protection starting next January. (Note for our mathematicians: Anthem has millions of non-BCBS members) Chinese hackers are suspected in the Anthem breach.

FierceHealthPayer broke the story, in this Editor’s estimation, to the healthcare trade area. Rochester Democrat & Chronicle. Excellus message to policyholders. The NBC/AP report also has a video interview with Eugene Kaspersky of the eponymous anti-virus software (and whose Kaspersky Lab was also a hacking victim earlier this year)

Updated via the Rochester Democrat & Chronicle:  FireEye is becoming the ‘go-to’ security company for health organization breaches–Excellus hired them in the wake of the Anthem breach and they discovered the vulnerability facilitating the breach.

Are you an entrepreneur dreaming of riches?

September 9, 2015 | by

Well if you are, you need to come along to the free London Health Technology Forum meeting on Monday 14th September when Neil Foster, Corporate Partner in lawyers Baker Botts, and the person responsible kindly for providing the Forum with a beautifully appointed room and excellent hospitality, will be talking to us about Exits.

He will be joined by David Blair, chartered accountant and chief financial officer of a number of companies. Between them they will tell you everything a good entrepreneur needs to know about exits. Exits of course are where entrepreneurs begin to cash in on all their hard work and long hours; some become very rich.

As planning for your exit should start when you establish your company, it is critically important to know what your options are now, in time to ensure that when the time comes, you are prepared, so you can secure the maximum value for the organisation you have personally established and grown.

They will cover the following topics: (more…)

Is ‘pure’ robotic telesurgery nearing reality?

September 9, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/Nicholson-Center-FL.jpg” thumb_width=”150″ /]Moving beyond robot-assisted surgery (e.g. the well-accepted use of the daVinci system with prostate surgery), controlled by a surgeon present in the operating room, is telesurgery, where a remote surgeon uses a robot to fully perform surgery at a distant location. The Nicholson Center at Florida Hospital in Celebration, Florida, which specializes in training surgeons and technicians in leading (bleeding?-Ed.) edge techniques, is studying how internet latency (lag time to the non-techie) affects surgical effectiveness. Latency is defined in this case as “the amount of delay a surgeon can experience between the moment they perform an action to the moment video of the action being carried out at the surgery site reaches their eyes.” Their testing so far is that internet latency for surgery between hospitals has a threshold of 200-500 milliseconds before dexterity drops off dramatically (not desirable)–and that given the current state of the internet, it is achievable even at a mid-range distance tested (Florida to Texas). Making this a reality is highly desirable to military services worldwide, where expertise may be in, for example, Germany, and the casualty is in Afghanistan. It would also be a boon for organizations such as the Veterans Health Administration (VA) where resources are stretched thin, rural health and for relief agencies’ disaster recovery. ZDNet

How technology can help fight elder abuse–ethically

September 9, 2015 | by

The increasing awareness of abuse of older people by their caregivers, whether at home or in care homes/assisted living/nursing homes, invites discussion of the role that technology can play. This presentation by Malcolm J. Fisk, PhD, co-director of the Age Research Centre of Coventry University, in the BSG Ageing Bites series on YouTube looks at technologies viewed by level of control and intrusiveness:

  • Social alarms, which include pull cords (nurse call) and PERS–what we think of as ‘1st generation’ telecare: high level of control, low intrusiveness–but often useless if not reachable in emergency
  • Activity monitoring, which can be room sensor-based or wearable (the 2nd generation): less control, slightly more intrusive–also dependent on monitoring and subject to false positives/negatives
  • Audio and video monitoring, while achieving greater security, are largely uncontrolled by the older person and highly intrusive to the point of unacceptability. (In fact, some feedback on tablet-based telehealth devices indicates that a built-in camera, even if not activated, can be regarded with suspicion and trigger unwanted reactions.)

The issues of consent, and balancing the value of autonomy and privacy versus factors such as cognitive impairment, personal safety and, this Editor would add, detecting attacks by strangers and not caregivers, are explored here. How do we ethically observe yet respect individual privacy? This leads to a set of seven principles Dr Fisk has published on guiding the use of surveillance technologies within care homes in the latest issue of Emerald|Insight (unfortunately abstract access only) Video 11:03. Hat tip to Malcolm Fisk via Twitter.

A Plum European app report

September 6, 2015 | by

plum logoFor a pleasant change, thanks to Prof Mike Short, we can share an excellent report on the app business in Europe with readers without explaining that to access it costs gadzillions. The Plum App Report gives a very level-headed yet exciting description of how apps are changing Europe and hints at some very exciting potential savings to realise from health apps, and elsewhere.

Accelerated Access Review – my blog

September 6, 2015 | by

As a member of the Stakeholder Reference Group of the Accelerated Access Review, this editor was recently invited to write a blog to encourage contributions to the review, the purpose of which is to identify actions necessary to accelerate the uptake of innovation into the NHS. It seemed a shame for the blog also not to be shared with TelecareAware readers, so here it is:

The Digital Health & Care Alliance (DHACA), of which I am Managing Director, has a strong interest in the success of the Accelerated Access Review, both because the majority of our 550-odd members work in SMEs whose very existence depends on the responsiveness of the health & care organisations in the UK, and because all of our members have a strong interest in improving patient outcomes & treatment efficiency.

One thing I’m going to be very interested in seeing emerge from the Review is the consensus on how innovators gather and use evidence to develop their product to meet the demands of the NHS and needs of patients. In DHACA we think we have a fairly clear idea about how our members go about this, however we can only claim to represent the digital health stream in the Review, and then only for small organisations. Allied to this is the much tougher question for many, particularly our smaller and more innovative members, of how to sell to the NHS. (more…)

What it takes to make telehealth really work

September 6, 2015 | by

In line with my fellow editor, forgive this editor engaging in a little nostalgia – going back to 2006, when the Whole System Demonstrator was a still a wonderful idea, before the competing forces of academia and management consultancy put short-term financial gain before long term patient outcome improvement. Those were the days when we genuinely believed that recording vital signs was what it was all about.

Move on nine years and it’s clear from the American Heart Association review referred to in this column recently, and subsequent articles, that one key success factor is drip-fed education. To quote:

“The amount of information that must be conveyed and the support that is necessary to counsel and motivate individuals to engage in behaviors to prevent CVD are far beyond what can be accomplished in the context of face-to-face clinical consultations or through traditional channels such as patient education leaflets,” the researchers say. “Mobile technologies have the potential to overcome these limitations and to transform the delivery of health-related messages and ongoing interventions targeting behavior change.”

This is underlined by a recent study of attempting to control hypertension using just text messaging, which was far from an unqualified success.

Another major driver of course is cost saving, as demonstrated by (more…)

NHS Expo & Testbeds – another view

September 6, 2015 | by

This year this editor went to NHS Expo in Manchester primarily to advise a US company, Humetrix, over the two day period, so got to see proceedings through a different lens.

Overall the event seemed to be much better attended than last year, in spite of the proximity to the Bank Holiday. Whereas last year the Future Care Zone was virtually deserted by both exhibitors and visitors, this year’s New Care Models Zone was buzzing. The Digital Zone was a particular attraction with some excellent talks, and the opportunity to meet many key people working in this area.

On the stage, the politicians painted their visions and senior health & care directors explained how these were to become a reality. This week’s NHS Networks blog, a perennial favourite of this editor, commenting on comparative performances, described Tim Kelsey as “more digital even than Mr Hunt but less binary”(reminiscent of Iain Banks’ description of lawyer LL Blawke in The Crow Road as “pencil-thin and nearly as leaden”). Of particular concern to this editor’s interests was the response to Jeremy Hunt’s commitment to enabling everyone to be able to access their detailed medical record in 2016, (more…)

Telehealth patient engagement program improves orthopedic outcomes

September 5, 2015 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/09/orthocare_06.png” thumb_width=”150″ /]VOX Telehealth‘s patient engagement program with Bon Secours St. Mary’s Hospital in Richmond, Virginia, which was announced back in January [TTA 12 Jan], published results for its pilot last month, and they appear to be outstanding. VOX’s model is ‘episode of care’, over a 90-120 day span starting 30 days prior to surgery to 60-90 days post-procedure; the online/tablet platform delivers educational content, reminders and notes on potential symptoms that ties into a customizable by patient alert escalation and notification system. The goal is to reduce post-discharge complications and readmissions, in this case for hip and knee replacement patients, through managing expectations and better preparation by the patient. And the results reported are encouraging:

  • 92 percent of enrolled patients were discharged directly to home–the US average is only 30 percent
  • Length of stay dropped to 1.6 days, nearly 50 percent lower than the US average of 3.7 days. It is lower than Bon Secours’ average of two days.
  • There were 0 readmissions after 30 days, compared to the US average of 6 percent
  • Patient satisfaction was also high: (more…)

‘Frontiers Innovators’ need apply by 11 Sept (UK)

September 3, 2015 | by

As Editor Charles mentioned last month in his autumn roundup, if you would like to be considered for the Wellcome Trust’s ‘Frontiers Innovators’ program, the deadline to apply is 11 September. Ten spots are open to early-career researchers, entrepreneurs, technology developers, healthcare professionals and representatives from the pharmaceutical and medical technology industry. If selected, you will travel and accommodation to attend the ‘Digital Phenotypes – Health research in the digital age?’ meeting on 5-6 November in London, which will explore the research potential of digital health data captured outside of normal healthcare settings. More information on the meeting is here. For ‘Frontiers Innovators’, to apply, send your CV and a video message to d.phenotypes-innovators@wellcome.ac.uk by 11 September 2015.