Can technology be a help in reducing loneliness?

August 18, 2015 | by | 2 Comments

Those who are older, disabled, new mothers and those who work from home often experience something in common–a feeling of isolation, of being in a vacuum. This Guardian article discusses how online networks targeting special interests can relieve that feeling: Mumsnet for new mothers, Scope for the disabled. For older people, Mindings (UK) can connect them to their own private network with text messaging, reminders, calendaring and photo sharing; it has been piloted by NHS Midlands and East as well as Suffolk County Council for dementia sufferers.

This Editor tried the artificial intelligence software powered chatbot Mitsuku recommended in the article, and found it monumentally silly after a minute of ‘dialogue’, kind of like a person you’ve met at a cocktail party with whom you find some common ground, only to find out that you’ve met a parrot, and not the Monty Python Dead Parrot.

One-on-one relationships that don’t need apps is in a related Guardian article where their writers take up Health Secretary Jeremy Hunt’s invitation for people to invite their elderly friends and neighbors into their homes for a chat and a cup of tea. (more…)

The NHS fail at encouraging digital health startups

August 18, 2015 | by

While Minister of Life Sciences George Freeman MP speaks very highly of the need for innovation and digital health in an NHS integrated health system, the reality is less encouraging for UK startups and their growth. The story of Big Health’s Sleepio and its move from the UK, told by Bloomberg, illustrates the difficulty that new companies and technologies have in fitting into a national framework, then selling into the 209 NHS regions plus related healthcare spenders. The long cycle and the narrowness of the frameworks are disincentives for many digital health technologies and their funders. Even if you win clients as part of being on the framework, when it expires after a few years, the business can be lost.

It’s hard to crack the code, and small companies are dependent on partners. A personal anecdote from this Editor’s time at Living Independently: the company achieved getting on a national framework with the QuietCare telecare product (2007) through partnerships with several larger telecare providers. We relied on them to offer QuietCare to the regions and councils. This had limited success and the US business far outstripped that in the UK.

Ten years ago, the situation was reversed. NHS, Government and council funding helped the earliest development and acceptance of telehealth and telecare, much as the Veterans Health Administration (VA) did with home telehealth and telemedicine in the US.  Other European markets and Canada have established private spending in this area, but these smaller markets–and funders– don’t have the potential that is possible in the US private market, even without reimbursement. The trend is reflected in investment: $4 bn in the US, less than €100 million in Europe. US developers now have a bonus in the potential of Asia, with China having the greatest interest and now funding. [TTA 23 July].  How the NHS Is Locking Out Britain’s Digital-Health Startups

A virtual reality version of dementia

August 14, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/08/virtual-dementia-experience@2x.jpg” thumb_width=”175″ /]The Virtual Dementia Experience simulates for caregivers and other medical professionals the visual distortions typically suffered by those with dementia. Designed by four graduates of Australia’s Swinburne University, it was built on the Unreal Game Engine to run on Microsoft Kinect or Oculus Rift VR. VDE recently won the World Citizenship Award at Microsoft’s Imagine Cup. It is is being developed commercially by Swinburne spin-off company Opaque Multimedia. (It would have been neat to have a video simulation on the website.) It reminds this Editor of a training developed by Second Wind Dreams which more fully simulates the visual, hearing, perceptual and behavioral effects of dementia to heighten sensitivity among caregivers.  Gizmag

UK Department of Health views digital technology, future for the NHS (updated)

August 14, 2015 | by

A freshly released video starring the Minister of Life Sciences George Freeman MP takes just under three minutes to touch on a dizzying number of aspects of revising a NHS organization structured around 1940s siloed medicine to serve a million new pensioners in the last five years and to ease the burden of chronic disease. There are the usual echoes of the Triple Aim:  to be more ‘seamless’ and improve both patient treatment and their experience; precision (and early) diagnosis; to keep people out of hospital; ‘more health out of every pound spent’; pioneering treatments; new models of care….Embracing digital technology in an integrated health care system.

(Updated) A comment from a reader (anonymous by preference) pointed out that the video wasn’t subtitled for the hearing impaired, which is quite odd coming from the DOH! (The UK has the Equalities Act which may be similar to the US Americans with Disabilities Act.) Google Subtitles produced nonsense. It would also have been helpful for the non-hearing impaired (or accent impaired) to better understand the fast-talking Mr Freeman. (Hat tip to our commenter!)

This Editor would also point out that the echo on the soundtrack (from recording in a room without sound dampening as an actuality) makes Mr Freeman even more difficult to follow. What would have made this a far more powerful video are beginning and end slides setting out and summarizing important points–even better, interstitial point slides (or intertitles). Closing–an email/board for comments–it is publicly funded, after all, and Government transparency is always helpful.

Is IoT really necessary–and dangerous?

August 14, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/08/is-your-journey-neccessary_.jpg” thumb_width=”150″ /] With the news full of health data security breaches, your Editors have also worried about medical device hacks that could threaten life. Back in May 2014, we noted Essentia Health‘s info security head deliberately hacking their own devices to find the security holes (which he drove a truck through), the concern on Dick Cheney’s defibrillator as far back as 2007 and other devices being agents of murder (postulated by the late Barnaby Jack). Multiple computer assists and internet connectivity are everywhere now–in our cars, home security, smart appliances and more. Except that they are all highly vulnerable to hacking. (Imagine your air conditioning being shut down by a hacker on a 95 degree day).

The Hacker News (a first mention) named the top international ‘smart cities’ most suspect to a chaos-making cyber attack, in rank order:  Santander, Spain (!); New York City; Aguas De Sao Pedro, Brazil (?); Songdo, ROK; Tokyo; Hong Kong and Arlington county, Virginia (adjacent to Washington DC), noting security systems, transit, (more…)

TBI neuromodulation therapy in phase 3 trials with US Army

August 14, 2015 | by

Helius Medical Technologies and the US Army Medical Research and Materiel Command (USAMRMC) jointly announced the phase 3 trial of Helius’ mPoNS (Portable Neuromodulation Stimulator), a non-invasive brain stimulation device for the treatment of balance disorder in patients with mild-to-moderate traumatic brain injury. This commercializes the research of USAMRMC and University of Wisconsin-Madison we covered two years ago [TTA 28 Feb 13] in using electrical stimulation of the cranial nerves located in the tongue. The phase 3 study will be at three sites for seven months: the Montreal Neurofeedback Center, the Oregon Health & Science University Center for Regenerative Medicine, and the Orlando Regional Medical Center. The mPoNS is also being researched in Canada for treatment of gait and balance in multiple sclerosis. Press release

Pharma company ‘breaks the Internet’ with Kim K, gets FDA testy

August 14, 2015 | by

But it may break them…well, give them a fracture. Or a good hard marketing lesson. Specialty pharma Duchesnay thought it had hit the jackpot with negotiating a promotional spokeswoman endorsement from pregnant celebrity Kim Kardashian of its morning sickness drug Diclegis. The Kardashian Marketing Machine cranked up. Kim (and mom Kris Jenner) took to Instagram, Facebook and Twitter in late July with (scripted) singing of Diclegis’ praises to their tens of millions of followers. The Instagram posts linked to an ‘important safety page’ a/k/a The Disclaimers. That wasn’t near enough for the Federal Drug Administration (FDA) which governs the acceptable marketing of all drugs in the US. On August 7th a tartly worded letter arrived at Duchesnay’s Pennsylvania HQ cited multiple violations of marketing regulations, notably risk information, and told Duchesnay to cease these communications immediately or withdraw the drug, which would be highly unlikely as it is successful. They also were require to provide “corrective messages” to the “violative materials”.

Our takeaway:

* Duchesnay reaped a bounty of free media (see below), on top of the (undoubtedly expensive) Kardashian endorsement. Yes, they did pay the cost of a FDA nastygram and a legal response, and the warning will live on in their file. However, a lot of target-age women now know Diclegis and others know about the relatively obscure Duchesnay.

* This was a calculated marketing risk that tested the boundaries of social media and celebrity endorsement. (more…)

Nokia’s second act to spotlight healthcare?

August 13, 2015 | by

Building its way towards a comeback is Nokia, once a global power in mobile phones and now, after selling its handset business to Microsoft two years ago, strictly (and profitably) in telecom networking equipment–for the time being. In April there was the €15.6 bn Alcatel-Lucent acquisition which includes famous research powerhouse Bell Labs; in January it launched the N1 Android tablet in China and days ago a “virtual-reality camera”. It also will license its name to other mobile phone makers when their non-compete expires in 2016. The real value of Nokia rests in its IP and worldwide patents which can be used in multiple areas. Since 2012 it also staked a claim in healthcare with the Nokia Sensing XChallenge for innovation in remote health monitoring. Mentioned but briefly in the Reuters article is that their technologies division is working on health-related projects. Deliberately staying below the radar? Hat tip to David Doherty (@mHealthInsight) via Twitter to remind this Editor of Nokia’s health ‘chops’. 

Extent, cost of health ID theft exposed in Wall Street Journal

August 11, 2015 | by

Confirmation that your Editors (including Founder Steve) are no longer Voices Crying In The Wilderness on health data insecurity came this weekend on the front page (print) of The Wall Street Journal. It concentrated less on the profit of stolen PHI–$50 per record on average versus $7 for a credit card, according to Ponemon Institute–than on the horror of the 2.3 million individuals suddenly finding out that hospitalizations, procedures and prescriptions in their name were being used by others, leaving them with the bill and unable to clear both their financials and their health records.

EHRs are treasure troves of health and financial information. Unlike credit card theft, there’s no warning–and no limits. Providers and insurance companies put the onus on the person with the stolen data. There is no healthcare equivalent of the Fair Credit Billing Act (FCBA) and the Fair Credit Reporting Act (FCRA), which since 1974 and 1970 respectively have limited the individual impact of fraudulent credit card charges.

Consumer security programs like LifeLock are not particularly effective in proactive notification. In other words, you’re stuck. You may run through your benefits and then be responsible for the bills. Second, you may never get the bad information and diagnoses out of the supposedly accessible health record because of privacy laws, especially if you are a caregiver.

Victims sometimes only find out when they get a bill or a call from a debt collector. They can wind up with the thief’s health data folded into their own medical charts. A patient’s record may show she has diabetes when she doesn’t, say, or list a blood type that isn’t hers—errors that can lead to dangerous diagnoses or treatments.

Adding insult to injury, a victim often can’t fully examine his own records because the thief’s health data, now folded into his, are protected by medical-privacy laws. And hospitals sometimes continue to hound victims for payments they didn’t incur.

According to Ponemon, “65% of victims reported they spent an average of $13,500 to restore credit, pay health-care providers for fraudulent claims and correct inaccuracies in their health records.”

Very rarely does this Editor look for a Federal remedy to a problem, (more…)

First ResearchKit health app released in UK, Hong Kong

August 11, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/08/ResearchKitApps-640×360.jpg” thumb_width=”150″ /]On Thursday, Stamford University released MyHeartCounts, the first iPhone health app using the Apple ResearchKit platform. Initial launch is in the UK and Hong Kong. It is designed to study factors around heart health by collecting data about physical activity and cardiac risk factors. Every three months, participants monitor one week’s worth of physical activity and also complete a 6-minute walk fitness test. The latest version of the app also includes feedback on users’ behaviors and risks. While the initial phase of the MyHeart Counts study both collects heart health data and provides personalized information to participants, the next phase will be to study motivational tools for users. Currently 41,000 participants have registered for this study. Medaxs via eHealthSpace.org (both Australia)

Study: success of behavioral telehealth for caregivers

August 11, 2015 | by

Caregivers for those with neurocognitive disorders (Alzheimer’s disease, dementias and other related progressive diseases) have unique, long-term stressors that lead to increased risk for distress, depression, and negative health outcomes. Conventional approaches through support groups and community based programs are helpful but not adequate, especially for those living in rural areas at a distance from care. This study of 74 women caregivers with mild to moderate depression tested two approaches: a 14-week behavioral intervention using video instructional materials (DVD/VHS), in-person telephone coaching in behavioral management and reinforcing workbook materials, with pleasant events scheduling and relaxation, versus a basic education guide and limited telephone support. The first approach was a statistical improvement over the second, easing caregiver depression and helping in their managing patient behavior. Results were maintained six months after the program ended. “Distance-based interventions (e.g., telephone, video, Internet, and bibliotherapy) hold promise for family carers, especially those living in rural or metropolitan areas with limited transportation.” Now if we could add in some tablet based interactive support? A telehealth behavioral coaching intervention for neurocognitive disorder family carers (International Journal of Geriatric Psychiatry)  Hat tip to Mike Clark via Twitter

What a big VC thinks of digital health

August 11, 2015 | by

Bessemer Venture Partners has been a major investor in healthcare tech for over 30 years, not only with Rock Health and their eponymous fund, but also with WellTok, MindBody, Health Essentials, DocuTap and others. Observations from one of their VPs include that the IPO window for digital health has been only open a short time–six months; B2C and B2B2C sectors have been resilient, with ‘Uber for healthcare’ concepts like PillPack [TTA 14 July] gaining traction; and that they like a third-party administrator concept for employee population health called Collective Health. Rock Health blog.

USAF researching brain stimulation for performance enhancement

August 11, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/08/TCDS.jpg” thumb_width=”100″ /]At the Air Force Research Lab, Applied Neuroscience Branch at Wright-Patterson AFB, researchers are testing transcranial direct-current stimulation (tDCS) as a performance enhancer. We noted last August that DARPA was one of the lead research organizations on tDCS for mental illness and neurological problems [TTA 18 Aug 14]. AFRL is evaluating its effects on boosting cognition, memory and attention–all important factors when one is flying RPAs (remotely piloted aircraft, a/k/a drones) for multiple hours in front of a computer console. USAF RPA pilots (a/k/a Drone Drivers) now log three times as many flight hours as do pilots of real aircraft, which says volumes about priorities. Drone Drivers are also reporting combat fatigue and high levels of stress, so AFRL is also evaluating non-invasive ways of detection through pupil dilation and heart rate. Video (09:16)  USAF photo. Also Mosaic Science (Wellcome Trust)

Australian military health data went straight to China: report

August 7, 2015 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2015/02/Hackermania.jpg” thumb_width=”150″ /]The Australian Defence Department confirmed to the Sydney Morning Herald that protected health data of hundreds of Defence Forces personnel went to (guess where!) China. However, as breaches go, this was an easy hack–it was sent by a health contractor, Luxottica Retail Australia, which contracts with manufacturer Tristar Optical in Dongguan, Guangdong province. Those affected included soldiers posted overseas to Afghanistan and special forces commandos who went on to be deployed to Iraq. Luxottica has since lost its contract with principal contractor Medibank Health Solutions. Both Medibank and Defence have had a lot of ‘splainin’ to do with the Government. According to the SMH, “the revelations raised particular concern within the Defence establishment because of China’s extensive involvement in state-sponsored hacking and cyber-espionage, with Beijing showing a particular interest in accessing personal records of government workers in the US.” A ‘twin-spin’ of Data Insecurity: healthcare and military! Hat tip to Malcolm Fisk of Coventry University via LinkedIn updates.

Arizona plans using health tech to engage Medicaid recipients

August 7, 2015 | by

Arizona’s smartphone app-based outreach plan for its Medicaid (low-income health insurance) program has raised a few eyebrows. The app/online site would:

* Help beneficiaries find primary and urgent care providers
* Provide beneficiaries access to chronic disease management tools
* Send beneficiaries appointment reminders

The programs would use mobile, online and texting, which doesn’t require a smartphone and has historically worked well in compliance and information (e.g. Text4Baby). For the critics, however, Pew Research found that half of those with incomes under $30,000 have smartphones. This number also includes the elderly, and does not take into account recent growth–smartphone prices have decreased smartly, and are now available on pay-go plans. iHealthBeat

ATA Fall Forum updates

August 7, 2015 | by

If you are thinking about attending ATA’s Fall Forum sessions in Washington, DC this September, the early bird discount of $100 has a week to go–14 August is the last day. This year’s meeting also has, in addition to the conference, a National Telehealth Lobby Day (16 Sept) with short briefings on how to lobby, the key issues and a half-day to make those previously scheduled visits to your Senator or Representative. The updated schedule for the three-day conference is here.

Also for ATA 2016 in Minneapolis next 14-17 May, the call for presentations has just opened. See details here.

TTA is a media partner of ATA Fall Forum, and previously ATA 2014 and 2015.