A boffo week for telemedicine. Will 2015 be online visits’ Big Year?

December 18, 2014 | by

(Boffo: extremely good or successful, sensational–Webster)

Adding to Monday’s news of ATA’s telemedicine accreditation program was American Well‘s near-simultaneous announcement of an $81 million Series C funding.  This brings total funding for the eight year-old Boston-based company to over $128 million, though it is not yet profitable. According to Modern Healthcare, “The capital injection will be used to serve a number of big projects the firm has underway, company co-CEO Dr. Ido Schoenberg said in an interview. Among those are campaigning to ease regulatory constraints, scaling its provider networks and customer outreach, working with insurers to secure more favorable reimbursement and working on its technology, he said.” The institutional, private equity, and corporate investors alluded to in the company release were not disclosed. Its mobile app, Amwell, claims over 1 million downloads with a year-to-year 1,000 percent increase. Major partners include payers Anthem Health, EmblemHealth, the Blue Cross Blue Shields of Massachusetts and Louisiana, Optum Health as well as corporate clients. American Well press release, BostonInno, SEC filing. (Note to American Well: you’re telemedicine, not telehealth)

If this round of funding represents a substantial bet on American Well’s future, another is the new relationship between Walgreens‘ and rival MDLIVE. (more…)

ATA in the accreditation arena for online patient visits

December 17, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/12/ata-seal-of-accreditation.png” thumb_width=”150″ /]The American Telemedicine Association (ATA) has joined the gold rush of accreditation, in this case for online ‘virtual’ visits between doctor and patient only. US providers (only) can apply to ATA’s Accreditation Program for Online Patient Consultations through a multi-step process for vetting up to three years.

  • First round application clears a company for eligibility. Through 28 Feb 2015, it is also open to ATA members only: Institutional Members, Sustaining President’s Circle and President’s Circle. On 1 March it will open to all companies in the US. Canada accreditation will start at a date to be announced in 2015.
  • Once eligible, the second round application contains ATA Administrative Rules & Terms, Standards and Guidance, Application Form, Program Overview and Fee Schedule. Fees are annual, based on the numbers of providers of online, real-time patient consults in all service lines, which presumably means areas such as primary care, behavioral, pediatric etc.
  • The company provides an application and supporting documentation. ATA then conducts a survey to review the documentation, online resources and demonstration of online services. During the process, ATA says it will notify about areas which are not compliant and organizations will have the opportunity to “provide a plan of corrective action and present corrective materials to show compliance before a final decision regarding accreditation is rendered.”
  • The accreditation is valid for three years, contingent on submitting an Annual Accreditation Report at the beginning of year 2 and 3 of its accreditation cycle.

Of interest to your Editors and readers is how this accreditation was developed.  (more…)

VA calls IBM Watson for decision making, PTSD assistance (US)

December 16, 2014 | by

The US Department of Veterans Affairs (VA) Veterans Health Administration (VHA) area is working with IBM Watson to develop and pilot a Clinical Reasoning System to assist and accelerate decision making by primary care physicians. The $6.8 million, two-year project will concentrate on acquiring and analyzing the data generated by hundreds of thousands of VHA documents, medical records, EMRs and research papers. The second focus of the VA-Watson relationship will also include mental health–supporting veterans with PTSD who constitute 12-20 percent of US veterans from Vietnam to present. The pilot phase, interestingly, will use simulated, not real, patients.

(more…)

buddi wins £20 million in contracts, signs up with Care Innovations in US

December 16, 2014 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/12/lavender_set_34.jpg-buddi.jpg” thumb_width=”150″ /]buddi, a well-known UK personal tracker/tagger company, announced over the weekend that they have signed two contracts worth £20 million ($25.1 million). The first and most of interest is with Intel-GE Care Innovations for their new, quite attractive wrist-worn fall detector/two-way emergency alert/activity monitor. According to the Telegraph, it was designed by Sebastian Conran (left) and was ‘fully certified by the US government in recent weeks’ which may mean that it gained FDA clearance. The second was for their ‘Smart Tag’ used in criminal tracking with the New South Wales, Australia government. Care Innovations adds another consumer-facing device to the Lively activity tracker and iHealth fitness and telehealth devices. Timing for availability is not disclosed. (more…)

Breaking news out of the mHealth Summit

December 12, 2014 | by

mHealth Summit this year had an abundance of digital health company news announcements, not only from the conference but also timed to coincide with the heightened interest around it. Your Editor looks over the most interesting of them, briefly. Thanks to Ashley Gold of Politico’s Morning eHealth (@ashleygold, daily reports archived here), Stephanie Baum of MedCityNews (@stephlbaum) and Anne Zieger of Healthcare Dive for their coverage and their company in the press room!

Partners HealthCare researches, Validic expands, AliveCor and Omron ally, Happtique sells out, Doctor on Demand is telemental, Orange goes dental, VA Innovation Rocks

  • Partners HealthCare/Center for Connected Health’s cHealth Compass will use panel and other research to help companies, device manufacturers, startups and investors determine what end users–consumer and provider–want out of personal health tech. Focus groups, interviews and usability testing will help to determine product design, evaluation, assess applications and feasibility as well as interim/final product testing. Partners is already organizing in Massachusetts a 2,000-patient database which rewards participants $50 on registration and $110 annually to be in a monthly survey panel. cHealth Compass website, BetaBoston (Boston Globe)
  • Health data connector/aggregator Validic demonstrates the attractiveness of Anything Big Data on with new clients including the Everyday Health consumer/professional website and the adidas Group’s sport and fitness apps. Recently they added WebMD, Pfizer, University of Pittsburgh Medical Center (UPMC), NexJ Health and MedHost to their client list. The company claims that their ‘ecosystem’–probably the most popular buzzword at this year’s conference–of healthcare companies and tech developers now reaches over 100 million people with devices such as Omron, Alere, Qardio, Telcare, Jawbone and Withings. Release
  • AliveCor accentuates the retail with Omron. AliveCor, which developed the first FDA-cleared ECG for smartphones and gained clearance for an atrial fibrillation algorithm in August, is collaborating with Japanese device manufacturer Omron on developing its retail presence. Omron’s devices are available in major drugstores such as Walgreens, RiteAid and Walmart so certainly AliveCor is due to benefit. AliveCor is also part of a revived QualcommLife (more on this in an upcoming article)  Release, Mobihealthnews (Your Editor had the pleasure of meeting at last AliveCor’s CMO and founder Dr. Dave Albert.)
  • Happtique sold to SocialWellth. Last year’s floor talk was about Happtique’s first class of certified apps and a security expert’s untimely discovery of major flaws (more…)

NYeC Digital Health: two diverging visions of a connected future (Part 1)

December 5, 2014 | by | 2 Comments

The New York eHealth Collaborative’s fourth annual Digital Health Conference is increasingly notable for combining both local concerns (NYeC is one of the key coordinators of health IT for the state) and nationally significant content. A major focus of the individual sessions was data in all flavors: big, international, private, shared and ethically used. Another was using this data in coordinating care and empowering patients. Your Editor will focus on this as reflected in sessions she attended, along with thoughts by our two guest contributors, in Part 2 of this roundup.

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/12/Topol-Compressed.jpg” thumb_width=”150″ /]The NYeC Conference was unique in presenting two divergent views of ‘Future IT’ and how it will affect healthcare delivery. One is a heady, optimistic one of powerful patients taking control of their healthcare, personalized ‘democratized medicine” and innovative, genetically-powered ‘on demand medicine’. The other is a future of top-down, regulated, cost-controlled, analyzed and constrained healthcare from top to bottom, with emphasis on standardizing procedures for doctors and hospitals, plus patient compliance.

 

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/12/Topol-tech-adoption-compressed.jpg” thumb_width=”150″ /]First to Dr Topol in Monday’s keynote. The good side of people ‘wired’ to their phones is that it is symptomatic, not of Short Attention Span Theatre, but of Moore’s Law–the time technology is now taking for adoption by at least 25 percent of the US population is declining by about 50 percent. That means comfort with the eight drivers he itemizes for democratizing medicine and empowering the patient: sensors, labs, imaging, physical examination, records, costs, meds and ‘Uber Doc’.

(more…)

Data streams of the future analyzed at NYeC Digital Health

December 5, 2014 | by

Guest columnist Sarianne Gruber (@subtleimpact) also attended the NYeC Digital Health Conference and reflects on what to do with all that data patients and devices are generating–a natural for her as she is a consultant in data analytics for Encore Health Resources. 

The New York eHealth Collaborative hosted its fourth annual Digital Health Conference at New York City’s Chelsea Piers on November 17 and 18. There I was joined by 850 health-related professionals to listen, engage and see how life science meets digital technology. No doubt we have become a digital culture. Even seated on an airplane, I noticed the gentleman next to me wearing a Fitbit, and we strike up a conversation on step and sleep data and our dislike of the new dashboard. At the conference, Keynote Speaker Dr. Eric Topol, a Cleveland Clinic cardiologist and a leading practitioner of digital medicine, shared with us his thoughts on what it means be a part of this digital revolution as a patient and a doctor. Technology changes the scope of individual care. Advances in genomics now gives us answers based on our DNA that will genetically determine the success of medications and treatments. Epigenomics, a molecular diagnostics company, can prescreen an unborn baby of a mother with cancer with a simple blood test, sequencing the DNA, to manage her therapy. I was fascinated to hear that a genomic signal sensor can detect heart attacks and warn you of this possibly fatal event, and that necklace for heart failure patients can monitor fluid status averting repeated readmissions for these patients. Dr. Topol believes that digitized 24/7 patient health data will shift the patient–doctor relationship. Bringing in your self-monitored data, eliminates “the how are you feeling questions” and instead the doctor can confirm diagnosis and start treating the patient. “Patient owning data is a foreign concept and the digital revolution ushered this in.“ (more…)

Swasthya Slate: the Indian tricorder?

December 2, 2014 | by | 1 Comment
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/12/Swat-Slate-devices2.png” thumb_width=”150″ /]Just coming to this Editor’s attention — and wondering why it hasn’t received more — is the Swasthya Slate, a diagnostic tablet pre-loaded with 33 diagnostic tests, procedural apps and diagnostic devices for health workers who have basic medical training. It was developed by an Indian startup  headed by a former member of Arizona State University’s department of biomedical informatics, Kanav Kahol. He returned home to New Delhi three years ago frustrated in his desire to develop an inexpensive, simplified diagnostic tablet for use in remote areas, using the same sensors that far more complex devices used. The ruggedized tablet, in addition to the pre-loaded tests and artificial intelligence-based apps, incorporates a four-lead ECG, medical thermometer, water-quality meter, heart-rate monitor, 12-lead ECG and sensors for blood pressure, blood sugar, heart rate, blood haemoglobin, urine protein and glucose. (more…)

Why a smartwatch may feel…de trop

December 2, 2014 | by

De trop —French, adjective, meaning too much, too many, unwanted

Have you noticed that many early adopters have skipped smartwatches? Other wearables such as fitness trackers have taken their place successively on the wrists of your favorite Quantified Selfer or weekend warrior. (A sign: they are now mass market at drug stores like CVS and sports stores for the holiday.) But how many people are looking forward to a special delivery of an Apple Watch, Samsung Gear S or even the well-reviewed and well-priced LG G Watch R in Santa’s pack? Having just returned from the NYeC Digital Health Conference, I saw few on the wrists of DH mavens. Smartwatches (and clothing wearables) also faded out at CES Unveiled [TTA 21 Nov], a complete turnaround from June’s event.

If you’ve been wondering too, you’ll be nodding like a bobblehead at John Nosta’s blog post in Nuvium, The Death of Wearables. (more…)

Soapbox: Why an app isn’t like a book

November 30, 2014 | by

The suggestion has been made recently at a couple of events that this editor attended that there is an unnecessary fuss over regulation of medical apps because they are just like medical books; as there is no regulation of books, why the need to regulate medical apps? . In order to try to move to a consensus, this post puts the opposite point of view, to stimulate debate. In summary the arguments of why they are different are:

  • We are familiar with books and have worked out how to deal with them;
  • Books give formulae and leave users to compute; apps do it all, often without showing their working;
  • Tablets and, especially, smartphones have screens that are smaller than books so require a different design.

This issue of course only relates to serious medical apps – something like 99.5% of all health apps available are very unlikely to do serious harm, helping people as they do record things like their fitness and their weight, and so do not require such detailed scrutiny. It is the ones that get close to, or meet, the test of being a medical device that are of particular interest here. The goal is that once clinicians are comfortable prescribing medical apps, and patients are comfortable using them, the NHS will save substantial sums by, for example replacing drugs with apps for a range of diseases where both are effective and apps are far cheaper. There are also huge benefits for clinician-facing apps – properly certified medical apps like Mersey Burns and Mersey Micro are already massively improving patient outcomes and significantly reducing NHS costs.

In more detail, books have been with us for many centuries so we are familiar with their structure, with the processes for their removal from publication if they give dangerous advice, and with the idea of specialist publications accessible by appropriate experts only – the same is not true of apps. In the event that advice in a book was dangerously wrong, (more…)

TSA Conference a great success (UK)

November 29, 2014 | by | 5 Comments

The two day 2014 TSA conference held at the Celtic Manor proved to be a great success for their new Chief Executive Alyson Bell who masterminded the event.

That this was to be a conference like no other was very apparent from the start when a solo performance from Gracie of the Zimmers opened the conference, followed by a performance by the whole group. Plenary sessions by luminaries in the digital health and care world followed, interspersed by refreshment breaks and a breakout session. Sir Bruce Keogh was sadly unable to attend in person though gave a hugely inspiring talk to camera encouraging all to use technology to deliver better care, more efficiently. (In a show of hands however, responding to a question from the conference chair, Nick Goodwin, the audience did not agree that Sir Bruce’s “fertile permissive environment for technology” was in place).

The other standout of the first afternoon was (more…)

Care Innovations harmonizes and validates

November 25, 2014 | by

Updated 27 November

In what seems to be a repackaging and repositioning of their remote care management/telehealth services, Intel-GE Care Innovations is now orchestrating Health Harmony. It appears on their promotional web page to be a bundling into that latest rave, the care continuum, but also a refreshing of separate systems developed since 2011: for the patient, an in-home tablet hub/portal for monitors and PC-based content portal once known as Connect; and for the clinician or caregiver, what was formerly called the Intel-GE Care Innovations Guide (which succeeded the Intel Health Guide). According to the CI website and press release from earlier this month, Health Harmony is an ‘optimized experience” that promotes collaboration among the patient, family, friends and care professionals and will “organize caregiving tasks, coordinate schedules, track medications, monitor vital signs and crucial health information, and quickly share information.” The release gives the impression of a launch but no information on cutting over current clients to the new system.

Update: A test of the Health Harmony system in a hospital environment to reduce readmissions is underway with liver transplant patients at the University of Cincinnati Medical Center.  The shocking fact is that 50 percent of transplant readmissions occur within seven days of discharge. Instead of being discharged with a booklet and an exam one week later, the patients daily self-monitor vital signs (blood pressure, glucose, temperature), pain level and answer programmed questions. The clinical team reviews their data for 90 days post-discharge and can also do video consults. Currently eight patients are being monitored in the program with up to 20 projected through April 2015. Liver transplant bundled payments are approximately $250,000 with surgery being $180,000 of it, so there is an immediate benefit to the hospital system.

Another interesting development in Roseville, California is the expansion of the CI Validation Institute, announced in June, (more…)

CES Unveiled New York

November 21, 2014 | by

11 November, New York

The annual event that is CES Unveiled in New York City is meant to be a nanoparticle-scale preview of International CES in Las Vegas, 6-9 January.  It’s a smörgåsbord of what used to be called ‘consumer electronics’ and now is all about innovation–a taste of everything from ever-smarter video and audio to sensors, smarter homes with IoT (the cutely named Internet of Things), Big Data, robotics and (drum roll) Digital Health and the Quantified Self (QS). This Editor regrettably missed the opening briefing by Shawn DuBravac, CEA’s Chief Economist and Senior Director of Research which would likely touch on his areas of the innovation economy and disruption along with the other four 2015 trends to watch: big data analytics, immersive entertainment content, robotics and digital health. (CEA helpfully provides the 30-page white paper here.)

The exhibitors at the Metropolitan Pavilion did not fully represent the trends, however. (more…)

Wearables blog – update

November 17, 2014 | by

Since this editors’ piece on wearables four days ago there has been a stream of news about interoperability of various apps, resulting in frequent updates to the original blog, to the point where it was beginning no longer to resemble the original.

Chris Bergstrom of WellDoc has now kindly pointed me to the Mobihealthnews item on Samsung’s digital health partners announcement, and to his company’s specific interoperability announcement with Samsung, enabling activity and other data to be obtained from other Android apps to help those with diabetes to manage their condition better.

WellDoc of course developed the first prescription app – this item from mHealthWatch in turn based on a Telegraph article that suggests that GPs in the UK will shortly be prescribing apps for patients in large quantities. The source of the Telegraph’s intelligence is none other than Personalised Health and Care 2020, the recently published NHS document that we covered extensively yesterday, which was perhaps a tad less optimistic about medical app take-up.

Personalised health & care 2020 – required reading! (UK)

November 16, 2014 | by | 1 Comment

The NHS’s National Information Board (NIB) this week published its long awaited document on its plans for personalising health and social care activities, with a strong England focus. It breaks new ground for such a document in many ways (not least that when you put ‘apps’ or ‘telehealth’ or a myriad of other terms into the search engine, you get many hits!).

Before describing at some length why this editor considers the document to be so important, it is of course important to recognise that there will be an election in six months’ time so both the funding and the priorities of the NHS may well change before it has even got beyond the very first set of commitments. A further point is that, were the NHS to meet all the commitments it has made, even in recent years, it would be a very different organisation to that that it is: commitment do not necessary result in delivery.

The document is subtitled “A framework for action” which is a good description. it contains many individual commitments. However few are are sufficiently (more…)