Announced but missed in the pre-holiday/mHealth Alliance news crunch was Continua Health Alliance’s release of a newly approved global interoperability standard for eHealth devices. The recommendation is contained in ITU-T H.810,“Interoperability design guidelines for personal health systems”. Release. Hat tip to Jerry Kolosky of Panasonic via LinkedIn.
The CES of Health: post-scripts
It’s Everywhere, Everyday, Disruptive, Not Impressive and Still ‘Bicycles for Fish’.
Neil Versel’s first major article recaps the Digital Health Summit ‘Point of Care Everywhere’ panel with Dr. Joseph Kvedar of Partners HealthCare/Center for Connected Health, Walter De Brouwer, founder and CEO of Scanadu (the tri-corder everyone’s waiting for) and Laura Mitchell, VP of business development at ‘grizzled pioneer’ in telecare and telehealth GrandCare Systems. The key is integration–for Dr. Kvedar, making it ‘about life, personal and social’; for Mr. DeBrower, bringing digital health into the home; for Ms. Mitchell, persuading long-term-care providers that technology provides useful, actionable information. Some surprises here: Scanadu will be shipping 8,800 units in March to its Indiegogo supporters and is going into a Scripps Health clinical trial; Dr. Kvedar admitted that the latest CCH startup, social wellness site Wellocracy [TTA 30 Oct] is “still searching for its audience.” The headline is “Mobile health has a lot of power, but it’s raw and new”–but is that helpful in positioning it to the Big Users–payers, pharma, providers–who are not all that daring? Mobihealthnews
Everyday Health with the Digital Health Summit announced on Thursday their 2014 awards for innovation to five US companies for ‘achievement in technology innovation aimed at improving health outcomes.’ They include Scanadu but also four less heralded companies: (more…)
Telecare – time to lose the last “e”?
Many years ago when I co-founded eForum to promote what was then called “eGovernment”, it was common for smart speakers to begin their conference presentations by saying that it’d soon be plain “government”, which indeed it has been now for many years; around the world, government sector workers have embraced technology to offer huge improvements in quality of service to citizens at reduced cost. Sadly health services have proved far more resistant to the beneficial use of technology, so eHealth & mHealth seem likely to take rather longer to lose their prefixes, in spite of pleas from the VA. If any support for this view was needed, the telehealth news from the flat earth society of a recent survey of GPs (more…)
The CES of Health (Friday)
Rounding up the 10 Ring Vegas Circus-Circus, it’s time for ‘best and worst lists’: hopping with the Kiwi tracker, no one’s kind to Mother, in the kitchen with 3D printers and what may be up with Google, FDA and contact lenses.
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/02-itoi-620×400.jpg” thumb_width=”150″ /]ZDNet rounds up its Friday coverage with a Best of CES selection. It’s always interesting to get the broader non-healthcare techie view of ‘what’s hot’–they spotted fitness bands early when even diehard QSers were skeptical– and to then see if their picks make it into the broader market. Their health tech picks are the Mimo Baby onesie + detachable turtle monitor from Rest Devices (sure to be a hit at your next baby shower; TTA 10 Sept], movement profiler Notch(see Thursday; it also made The Guardian’s roundup), MakerBot’s home 3D Replicator Mini (Wednesday) and the Epson Moverio BT200 digital content projection smart glasses (in-market March, @ $699.99 a bargain for what use?). Au contraire, see 11 born-to-fail worst gadgets which includes being mean to Sen.se’s Mother and, in worst design, an iPad video ‘periscope’ from iTOi which looked like it was stolen off the set of the 1956 space opera Forbidden Planet. For today’s market, it definitely could have used a steampunk vibe to carry off its ‘Blue Blazes’ design.
Yet one of their writers gives Mother, a/k/a the “M2M Mollycoddle”, “part-Russian doll and part-Doctor Who monster”, a more thoughtful once-over. (more…)
WellDoc raises $20 million from Merck, others
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/BlueStar-promo-image-WD.jpg” thumb_width=”150″ /]WellDoc, developer of a prescribable Type 2 diabetes management smartphone app (BlueStar), announced today a $20 million Series A round from Merck Global Health Innovation Fund and Windham Venture Partners. The interest by Merck is understandable in several ways. Pharma companies are moving beyond the meds into other management models as blockbuster drugs become scarce (those cuts in R&D do hurt down the line), operating costs higher and profitable drugs go off patent. Because it is prescribable, BlueStar is reimbursable by US insurers (not disclosed by WellDoc); it is currently offered as a pharmacy benefit by Ford Motor and major drugstore chain RiteAid. In addition to these, WellDoc has developed strong partnerships (AT&T, Alere) since their founding in 2005 (see below). BlueStar also can be considered a strong fit for a Merck subsidiary, Vree Health. (more…)
The CES of Health (Thursday)
Beaucoup fitness bands and wearables, an ‘all-in-one’ glucose meter and finally, a lack of hype!
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/razer-nabu-main-banner.jpg” thumb_width=”150″ /]Mobihealthnews rounds up 18 mobile health launches in a slideshow format (a bit difficult to page through). It’s heavy on fitness monitor bands and wearables from well-known and startup companies at price points from the $100 range up well past $400: Sony, LG, Garmin, Polar, Razer, Virgin Pulse (clipon), Lumo, iFit, Movea, Wellograph and Epson. (Also see Medgadget’s roundup if you can’t get enough!) Outside of fitness monitors: from China’s iHealth Lab (Andon Health), a blood pressure monitoring vest, an ambulatory ECG device that supposedly sticks to the wearer’s bare chest (no FDA approvals yet); Zensorium Tinke’s pulse oximeter plus for Android (seen by this Editor at New York CES in November 2012), the Qualcomm Life-backed YoFiMeter cellular glucose meter (more below) and the Medissimo Medipac GPS tracking pill box from France. Already covered here: Withings Aura, Qardio, Mother, Kolibree. (more…)
App helps guide the visually impaired
You may be familiar with the floor tapes used in large buildings to guide people to different areas or departments – [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/Kirugi-Hospital-Floor-Lines-2.jpg” thumb_width=”150″ /]I have seen these in many hospitals. A team in Italy’s University of Palermo have extended the idea to develop an inexpensive way to guide visually impaired people.
In a paper published last month Pierluigi Gallo and colleagues have described their work in developing Arianna, a system which can be used to guide people along complex paths (more…)
The CES of Health (Wednesday)
Qardio, Withings, CSR, iOptik, ‘Robotics on the Runway’, 3D printing and…Mother
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/Qardioarm.jpg” thumb_width=”150″ /]Qardio is making its official debut with the QardioArm blood pressure cuff and the QardioCore chest strap for monitoring EKG (plus heart rate, heart rate variability, physical activity intensity and skin temperature). Both were previewed by this Editor at CEWeek 2013 in June and do not yet have FDA nor CE approvals. A price for QardioCore was revealed in Business Insider–$449. QardioArm is listed at $75 on Indiegogo where $29,500 of their $100,000 goal was raised in the past three days. Video. Also MedCityNews.
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/Withings-aura.jpg” thumb_width=”130″ /]Withings’ Z-Z-Z-Z market entry, the Aura, gets a fave rave at length from Dan Munro in Forbes, adding that the price will be $299. Its stationary aspect, nothing to wear and pricing makes it ideal for high-end QSers who don’t travel a lot or have multiple homes. (more…)
Certifying health apps: is it at all possible?
This article in iMedicalApps takes a look back at the controversy that swirled around Happtique only four weeks ago–when Harold Smith III of Monckton Health and Fixmo went public on major data security flaws in two of their 19 certified apps–and moreover how Happtique did not respond to his concerns either in December or on the process in March [TTA 13 Dec]. It was the talk of the last big US gathering prior to International CES, the mHealth Summit.
Unfortunately, Satish Misra, MD, one of their editors, provides an argument best described as a ‘circular firing squad.’ Dr. Misra is absolutely correct on the enormity of curating and certifying tens of health/medical apps. But the point of the article seems to be that any kind of evaluation mechanism or certification is a fool’s errand.
The logic presented as this Editor interprets the article: Since Happtique’s certification process had standards which were complicated and arbitrary (plus, as it turned out, flawed), it proves that it’s useless to pursue standards and certification. In addition to being ‘resource intensive’ for reviewing tens of thousands of apps, standards cannot decide what app is the right choice, even if that was not the intent of the certification. So doctors and ‘end users’ have to become ‘app-literate’; hang the fact that the point of curation and certification is to do at least some of the heavy lifting (pre-screening) job for them beforehand! Back to the start: reading all the peer review stuff on thousands of medical apps, if it’s reviewed at all, as iMedicalApps does for some. (And will these reviews be 100% accurate? Will they subject every app to data security screening? What are their standards?) Back to Square One: DIY and Dodge City. Apps present too much (unpaid) work for docs to think about, patients use (then abandon) apps that can be privacy risks, because they don’t know any better and they aren’t white-hat hackers after all….
Remaining unconsidered by iMedicalApps is the plausibility of what Master Data Cruncher IMS Health is taking on with AppScript and AppNucleus [TTA 15 Dec]: a proprietary 25-point methodology (AppScore) that automates the classification and evaluation of health apps plus a hosting platform that uses IMS information to assist developers in creating secure, effective apps.
A far more detailed exploration of why at the very least an objective certification/evaluation process is needed is explored by Editor Charles in his continuing series Driving Up Medical App Usage in the UK, especially Part II (Part I here.) Watch for Part III shortly.
Driving up medical app usage in the UK – part II
Introduction
This series of posts covers some work I have been doing over the past three months: attempting to answer the question of how best to improve the perception by clinicians and patients of the efficacy of health-related apps. This work has been done for the i-Focus project, part of the Technology Strategy Board’s dallas programme.
Part I attempted to summarise the EU regulations covering health-related apps. The point was made that any health-related app must comply with data protection and consumer protection requirements, irrespective of whether the risk level is sufficient for it to be classified as a ‘medical device’. Where an app is classified as a ‘medical device’ it also has to be classified so that the appropriate adjudication work can be determined for it to receive a CE mark (Class I, lowest risk, requires least investigation; Class III, highest risk, requires greatest investigation).
This post summarises the principal findings from discussions with a very wide range of potential stakeholders, (more…)
A New Year’s Resolution, ADLs and a new care option
Here are three items that are each important and have hit my screen in the past couple of days – sadly, try as I may, I’m struggling with a common linking theme.
The first, that the 3G Doctor alerted me to, is a simply brilliant talk by Telcare‘s CEO Dr Jonathan Javitt at the Technion Social-Mobile-Cloud Meets Medicine Conference on the 17th December 2013. We’ve all made the arguments that technology enables the genuinely continuing care that long term conditions require, rather than the episodic care our health service is set up to provide, and that technology ensures that patients have clinical support 24/7 rather than in the brief period the doctor or nurse sees them. However Dr Javitt brings all the arguments together to make such a powerful case that the only sensible way to treat long term conditions is to use technology to help the patient that anyone opposing it might as well try to argue that the earth is flat. As a result I have decided that my New Year’s resolution this year will be no longer to rise to the challenges of the naysayers. (I wonder how long I can keep it.)
The second item is a new take on monitoring activities of daily living (ADLs). For those new into telecare, continuous ADL monitoring looks a brilliant way of picking up an early decline in cognitive or physical decline, often well before symptoms show up in a change of vital signs or response to questions. The challenge though is whether the computer analysing the ADLs is smart enough to cope with activities such as the invasion of the grandchildren, or can cope with multiple occupancy. So it’ll be interesting to see how well CarePredict’s service is received. This uses a bracelet to track someone being cared for, rather than relying on PIRs or similar sensors as many other ADL systems do. Of course, like falls detectors, the problem with wearables is that people take them off, although the mHealth News item claims that ‘seniors’ like the bracelets.
The third item is a BBC item on the attractions of care homes in countries where the cost of living is lower, such as Thailand, which does feel a tad mercenary, although where there is genuine reverence for older people the quality of care can be excellent, and recent revelations suggest that care for older people in the UK is hardly without its problems. A combination of Skype and cheap flights certainly means that it is possible to keep in touch regularly. If it gets to be considered a viable option, it will certainly complicate the economics of technology to stay at home vs care home.
Hat tip to Prof Mike Short for alerting me to the BBC item.
The CES of Health (Monday)
A managing director of Accenture, writing in Forbes, looks at the health tech trends as ZDNet did (TTA 5 Jan) and lobs a few surprises. He checks the boxes for wearables and real-time monitoring (what ZDNet called The Internet of Things), but also added in–happily for us–aging in place technologies, giving as examples household robots, med dispensers, video calling, easy navigation screens and interfaces (Bosch Health Buddy Web, GrandCare?). Surprisingly on the list: telecare–“motion sensors that can tell if a person has fallen”. Could it be QuietCare’s and Healthsense’s time–or will these be in a watch form factor? And how about proactive fall detection to help prevent them in the first place?
Withings gets into the Z-Z-Z-Z market: the Aura Smart Sleep System monitors noise, room temperature and light level. It also has an under-mattress sleep sensor to monitor breathing, body movements and heart rate. The app on your mobile device makes sense of the data so you can understand your sleeping patterns and make needed changes for better rest. It’s one of ZDNet’s top 10 products (so far) today.
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/10/blue-blazes.jpg” thumb_width=”100″ /]Our Blue Blazes award (so far) goes to the Kolibree Bluetooth Toothbrush. It connects with an app which somehow sizes up how well you–and other members of your family–are polishing their pearlies. Crowdfunding this summer, available either in July or 3rd Quarter (depending on reports) for iPhone and Android (Samsung Galaxy III and S4). It sounds like a good fit for the Hammacher Schlemmer catalogue. MacRumors The Guardian takes an even more dim view by including it in its ‘Day Zero vapourware at CES’ list but Engadget likes it (the job to be done by the inventor related to the kids).And if you are already there, accelerator/investor RockHealth has a guide to where they will be participating at CES through 9 January here, if you’re interested.
Bosch, Remedy’s Health Buddy Web debuts at CES
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/Health-Buddy-Web-Image.jpg” thumb_width=”200″ /]Bosch Healthcare’s partnership with Remedy Health Media for a web-based version of Health Buddy for telehealth premiered today at International CES. It will be available on desktop, smartphone and tablet. The format seems to combine both the monitoring aspect of the hub-based Health Buddy with extras such as an integrated reminder system, patient engagement and behavior modification tools such as brain games to improve memory and cognition, and patient educational content. The countries it will be available in were not disclosed. While Bosch has vigorously maintained that the Health Buddy hub will continue to be supported [TTA 24 Sept], Editors Charles and Donna have maintained that it will be relegated sooner, rather than later, to a secondary product line. Release.
Health kiosks, insurers–perfect together?
The real revenue stream of health kiosks revealed? The business model of free health kiosks placed in places like Wal-Mart and sibling Sam’s Club has to date been advertiser-dependent. Now SoloHealth [TTA 27 Feb 13]is adding an agreement in California with insurer Anthem Blue Cross to solicit name, email and phone number of individual users who want more information on insurance. They must opt in to add this, but it is not disclosed by the friendly animation (a doctor, no less) that a broker will be contacting them; to find out, the user has to hit a blue button–not the one that ONC has designed for personal health record access–to read two pages of disclosure, or wait till after they supply information. In addition, SoloHealth collects even more qualitative user information during its exams for blood pressure, vision and BMI. Here is the real gold mine in ‘dem der kiosks’–a fat database which can be sold as deidentified data without violating current privacy regulations. (Did anyone think otherwise? And what about all that fitness data being gathered by Fitbit, Pebble, Shine, Jawbone?) KQED’s California Report gears up into high dudgeon on the privacy issues.
Driving up medical app usage in the UK – part I
Our recent post on ‘the last mile’ for medical apps in the US is a great introduction to some work I have been doing over the past three months: attempting to answer the question of how best to improve the perception by clinicians and patients of the efficacy of health-related apps. This work has been done for the i-Focus project, part of the Technology Strategy Board’s dallas programme.
As the research is quite detailed, and as I’m keen to get as much feedback as possible, I have split the work into three parts, to be delivered over the week – comments to this article or a direct email to me (on charles.lowe@btinternet.com) on errors, omissions or additions would be hugely gratefully received.
This post aims to answer the question of what regulations affect the development, sale and usage of health-related apps and, in particular, when an app is a medical device. (more…)
The CES of Health preview
International CES in Las Vegas will be the annual ten-ring circus it always is, but this year even the tech watchers are concentrating on health. There appears to be no blockbuster consumer electronics debuts this year, so what you will see in the rinse-and-repeat cycle are the connected categories of Wearables and The Internet of Things. Basically everything will be connected, automated…and gathering lots of data on you (what ZDNet’s Jason Hiner in his CES preview article has dubbed Contextual Computing, and he likes it). Lisa Suennen of Psilos Group, writing in MedCityNews, coins her own slightly dismissive term, ‘The Internet of Wearable Things’, and makes the entirely sensible point that sensing your fitness is one thing, doing something about it another. But the critical health app that soars over her goal posts is the Surf Life Saving WA Twitter account. If you’re in Western Australia and hitting the water, you want to know where the sharks are. This gives it to you. This Editor also sees that Samsung received FDA 510(k) approval for their heavily hyped S Health app built into the US-released Galaxy S4 smartphone. While the UK enjoyed third party device connectivity back to the S3, the US version of S Health, according to Mobihealthnews, only connected to three unreleased Samsung peripherals and relied on manual entries. This undoubtedly will change–expect there to be buzz about where Samsung will now take this at CES. And there’s always hay to be made with sleep analysis tracking–high-end multi-sensor fitness watch Basis Science has now added advanced sleep tracking to its BodyIQ analysis of running, walking and biking, as well as upgrading its looks (VentureBeat).
Certainly more to come out of CES and conferences within CES this coming week!
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