A healthcare/smartphone survey not from usual suspects

June 20, 2014 | by

From FICO, an analytics software company best known in the US for your creditworthiness score (FICO Score), are some results on the healthcare portion of a just released cross-industry survey (with mobile banking, insurance) on smartphone usage:

  • 80 percent would like to be able to interact with healthcare providers on their smartphones
  • 76 percent would like to be reminded of medical appointments
  • 69 percent would like to receive reminders to rearrange appointments, or be prompted to take their medication
  • Texting as a push communication is preferred for all three above except for medication reminders
  • 56 percent trust healthcare organisations with personal data (lower than it should be at this stage–Ed.)
  • 2 in 3 want to receive medical advice through digital channels instead of visiting a doctor (cheering news for Better and online providers such as Everyday Health and WebMD)
  • But presently, users do most of their research the ‘old-fashioned’ online-on-your-PC way

To get full results on the healthcare preferences of smartphone users in the US, Australia, Brazil, China and the UK, you’ll have to visit their webpage and answer five questions. Release.

“A rose by any other name would smell as sweet” take II (UK)

June 17, 2014 | by

Names again! E-Health Insider today has published a typo-prone summary of a Technology Strategy Board survey of the public’s understanding of “‘health and safety devices”. Unsurprisingly, just as most people would not know what acetylsalicylic acid is (though would be happy to take it when it was called aspirin), so only 10% knew that “‘health and safety devices” meant telecare and telehealth. Not sure I’d get that one right either.

There is better news though. The article also quotes the survey as finding that “38% of people said they did not understand the benefits for both self-care technologies and for health and care apps for smartphones and tablets” which I reckon is fantastically marvellous because it means that 62% of the population did understand the benefits of these technologies, which is a heck of a lot more than I suspect a random sample of GPs would, and shows we have been successful beyond our wildest dreams, especially if those happen to be concentrated in the oldest 62% of the population.

Sadly not all was quite so good as “…the research found that 43% of people would not consider telehealth because they would prefer to be seen by their clinician face to face.” Just as whenever in conversation someone tells me they wouldn’t share their health data, and I’ve asked whether they’d still feel like that if they were lying dying in the street and could be saved only if a clinician had instant access to that data, so I wonder if the question had been posed,  as with our local surgery for non-urgent consultations, “would you prefer to wait 28 calendar days to see your clinician face to face or would you be consider remote consultation within 24 hours”, the answer might be slightly different.

The good side of course is that (more…)

Medtronic, Covidien and what it might mean for digital health

June 17, 2014 | by

“This acquisition will allow Medtronic to reach more patients, in more ways and in more places,” Medtronic Chairman and CEO Omar Ishrak

Cover the Earth? While the healthy Medtronic offer ($42.9 billion in cash and stock) for Ireland-headquartered Covidien plc is not a ‘digital health deal’, it does point to Medtronic’s strategy which includes digital health. There is of course the obvious: growth by acquisition and integration. Acquisitions require cash, and the highly controversial change of domicile to Ireland via ‘tax inversion’ will fatten the exchequer in two ways. First is through the lower overall Irish corporate tax versus the 35 percent US tax, one of the highest in the world. Second is much more flexibility in repatriating plentiful foreign earnings at lower Irish corporate rates rather than the high US rates which Medtronic has avoided. Third is increasing dividends, which can drive up stock price and investor interest. Of interest to the latter is also that Covidien adds horizontal (and global) competitive strength to Medtronic in the clinical area–surgical, vascular, respiratory and wound care.

More Ways-More Places. Not just staples and sutures, Covidien has developed its own advanced in-hospital mobile patient monitoring in Vital Sync as well as several hospital monitoring devices in their Nellcor line. In addition to technology collaboration, the next point of integration could then be with Medtronic’s post-acute telehealth devices from Cardiocom, purchased less than one year ago. We noted at the time that it gave Medtronic entreé into the “chronic condition management continuum– not only into telehealth via Cardiocom’s devices and hubs, but also their clinical and care management systems.”

Approval will take time. Both the US and UK, through various regulatory agencies, scuppered the Pfizer-AstraZeneca deal on similar tax domiciling and competitive grounds. If it does go through, there will be a lot of reorganization. But while it digests, this Editor will be watching Medtronic for its usual pattern of making smaller ‘more ways/more places’ deals in the interim with an eye to diversifying past US-taxable medical devices. One pointer is their just-announced partnering with Sanofi to develop drug delivery-medical device combinations and care management services for diabetes patients (MedCityNews).

Related reading: Medtronic hints at more acquisitions following $43 billion Covidien deal (MedCityNews); The Medtronic, Covidien Inversion Deal Is More About Dividends Than Tax (Forbes); Medtronic agrees to buy Covidien for $42.9b in cash, stock (Boston Globe); Medtronic’s $43B Covidien deal—and Irish tax move (CNBC)

 

Edinburgh Global Health MSc

June 13, 2014 | by

A quick plug for the above which is a flexible part-time distance learning programme delivered entirely online using a combination of online tutorials, multimedia interactive learning materials, peer to-peer discussion and independent study. It looks very interesting. More details are here.

Claudia Pagliari tells me that the mHealth course will be available as a stand alone option or as part of a certificate of diploma track.

Post-market device surveillance – boring though very important

June 13, 2014 | by

Thanks to Claudia Pagliari for passing me a news item from the Diabetes Technology Society, announcing that the Steering Committee has been assembled for its Surveillance Program for Cleared Blood Glucose Monitors. To quote:

“This program is intended to identify poorly performing blood glucose monitoring products on the market.   This surveillance program will provide an independent assessment of the performance of cleared blood glucose monitors following Food and Drug Administration (FDA) clearance.  The program will generate information that can assist patients, healthcare providers, and payers in making informed product selections.  The information will also be provided to FDA, which is the government agency that regulates these products.”

So why is this so important? Well one of the things this Editor discovered when doing research into how to encourage GPs to recommend medical apps is that none of the existing organisations that evaluate medical apps appear to recognise adequately that every change of operating system, every upgrade in functionality needs to be carefully checked to ensure the app is still as safe and effective as it was when the app was first evaluated. For example, some apps such as Mersey Burns check that the mobile is running the required operating system superbly; most don’t.

“After a product has been cleared for use by the FDA, there is currently no systematic post-market surveillance program that monitors for ongoing product quality post-clearance. Poorly performing BGM system can interfere with the ability of people with diabetes to reliably monitor their blood glucose levels, and make correct decision based upon the readings.  Inaccurate readings can lead to incorrect actions and therefore to adverse outcomes. Ongoing efforts by the FDA to improve accuracy standards for pre-market clearance would be undermined if performance was not maintained post-market.  Therefore, a post-market surveillance program is critically important to ensure the accuracy of cleared products for people with diabetes.”

So hats off to the Diabetic Technology Society – let’s hope others pick up this excellent initiative, particularly for medical apps. As David Klonoff, M.D., founder of Diabetes Technology Society and a Clinical Professor of Medicine at University of California, San Francisco said “This surveillance program will provide a significant benefit to both patients and manufacturers”.

 

Anyone doubting the benefits of clinical mobile access, read on…

June 13, 2014 | by

Yes of course it is a survey produced by a supplier, so possibly a trifle biased, however EU News’s  item on the benefits of mobile access by community health people makes a very strong case for good access to clinical information when visiting patients that makes sense.

Notable quotes include:

Lack of access to patient information in real-time is affecting the ability of 88% of community health workers to perform their roles…

70% of participants said mobile working technology had resulted in greater patient involvement in care and the management of conditions, and had also improved the quality of visits, with more time focused on treatment.

Almost a fifth of respondents said they spent more than ten hours a week, the equivalent of more than two hours per day, on a combination of travelling back to base to file reports, and other administrative tasks – time that could be spent providing enhanced patient care or home visits.

mHealth: a salmagundi of items

June 8, 2014 | by

Overloaded with Horizon2020 proposal adjudication and conference management (including the first DHACA members’ day on 11th July), this editor has been unable to do much Telehealth & Telecare Aware blogging. However the interesting items have continued to attract my attention and Prof Mike short (especially), Alex Wyke and Nicholas Robinson have continued to add further to the pile (huge thanks to all). So much seems worth highlighting: where to start? Perhaps with the 18 factors to make telemedicine a success, enumerated by the EU-funded Momentum project. Telecare Aware readers will be unsurprised by all 18, which look pretty basic. However many will notice obvious absences, such as the need to adduce evidence of the success of the intervention. Gluttons for punishment will find much more (more…)

Medvivo comes of age (UK)

June 7, 2014 | by | 1 Comment

A year after this editor began his three year stint with Telehealth Solutions, we had a corporate near-death experience, as money got very tight waiting for that first big telehealth order (thankfully it came, courtesy of NHS Norfolk). In those days of reduced salaries, and few employees, we could only dream of becoming a full service remote healthcare monitoring organisation.

This week’s announcement of the acquisition of Magna Careline shows how things have changed in just five years. After being acquired by Moonray Investors, (more…)

Enterprise wearables for clinical health–and more

June 3, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/06/Evena-veins-620×454.jpg” thumb_width=”150″ /]This ZDNet story technically has only one wearable in health–the Evena Medical Eyes-On Glasses which help medical staff find that vein (left) and is being trialled at Stanford University Medical Center. The other four profiled are being used in businesses as wide-ranging as engineering, restaurants, retail stores and manufacturing, but they are being used in the ‘here and now’: Abeseilon work-stream video; Google Glass for reviewing/recording work, training and coaching; the Theatro Wearable Computer ‘targeted’ messager; and, somewhat Big Brother-ish,  the Hitachi Business Microscope, an RFID-like device the size of an ID card that captures employee interactions and collaborations. A savvy HIT developer or implementer could, as has been done with Glass, find different uses for the other three in hospitals, home care or practices.

And you’ll be surprised what made TechRepublic’s list of wearables’ 10 biggest flops. (Already!)

Apple Health, minus the ‘book’, announced

June 3, 2014 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/06/healthkit-apple-wwdc-2014-87_verge_medium_landscape.jpg” thumb_width=”170″ /]Breaking and developing… Apple announced their long-rumored health tracking app [TTA 22 Mar] this morning at their WWDC (World Wide Developers Conference) in San Francisco. The consumer app is called Health (not Healthbook) and the developer platform HealthKit which are both part of iOS8 for iPhones and iPads in the fall. HealthKit facilitates pulling in of health data from third-party developers so that all health-related information for the consumer user is in one ‘hub’, similar to what Apple’s Passbook app does now as a ‘virtual pocket’ for airline boarding passes, movie tickets and coupons. Apple’s Craig Federighi, senior VP of software (pictured, courtesy of The Verge), made the announcement of the app and platform as part of the broader debut of iOS8 this morning.

Already on board is Mayo Clinic with an app that logs information like blood pressure, tracking normal range and it appears from reports that a severe enough deviation will initiate a contact with medical professionals. Nike was prominently featured as an app provider, further confirming that it’s leaving the hardware to their close corporate partner now that it’s out of the FuelBand business [TTA 22 April]. Epic Systems, a leading large system (hospitals/practices) EHR, appears to be integrating integrating its personal health record (PHR) with HealthKit, “suggesting a framework for getting information collected via HealthKit into patients’ MyChart (Epic PHR–Ed.) app.”

Editor Donna wonders if the still-in-early-days Better iPhone health personal assistant app (PHA), developed in conjunction with and backed by the aforementioned Mayo Clinic [TTA 23 Apr], will prominently integrate into Health. (We’ll cover when this develops, as we think it will–but mum’s their word for right now.)

In Mashable, the news was applauded by the CEO of leading app MyFitnessPal as a big validation. In his opinion, Apple would work with the existing field of apps and devices. Leading fitness bands Jawbone and Fitbit had no comment. Fitbit was shown during the presentation: CNET (one of six pictures here) and The Verge (article below). The latter makes the excellent point that Jawbone, Fitbit and the Nike FuelBand have all been sold in Apple’s stores.

The speculation is that Health will be a key part of the features of the iWatch to come, but Mashable in quoting Skip Snow of Forrester Research does bring up a significant wrinkle. Bluetooth LE as a network protocol chews up a lot of battery power, and bigger batteries make for clunky devices. Not exactly the Apple design ethic. Could it be that what’s delaying the iWatch is development of a new, more power-efficient network standard?

Update 3 June: With iOS8 having apps communicating with each other, have the Apple-oids opened the door for a Happy Hacking Holiday?  Stilgherrian in ZDNet points out that the ‘attack surface’ in info security-ese just got a whole lot larger. A future ‘oopsie’?

Hat tip to Editor Toni Bunting

More information: Mashable can’t stop mashing stories: Apple Reveals iOS 8: Interactive Notifications, Health App and More, Apple Gets Into Fitness Tracking With Health App and HealthKit for iOS 8, Apple’s First Step Into Health Tracking Is Small But Powerful. Mobihealthnews gets into the act noting Epic’s involvement: Apple reveals tracking app HealthKit and partners with Mayo Clinic, Epic. The Verge positively is on said verge with Apple HealthKit announced: a hub for all your iOS fitness tracking needs.

Monday’s ‘in the news’ briefs

June 3, 2014 | by | 1 Comment

Proteus raises $120 million from “major new institutional investors based in the United States, Europe and Asia” for further development of its ‘smart pills’. Mobihealthnews. Previously in TTA here (starting in 2009!) It’s a long way from ‘tattletale pills’…..InTouch Health now has an FDA-cleared iPad app, CS for iPad, to support a digital stethoscope component on the mobile devices. The app is designed to assess heart and lung sounds in real time in acute-care settings particularly tele-ICU. MedCityNews…..In the mood to read your brainwaves? The Muse is here to help with neurofeedback. MedCityNews takes it on a test drive and if you don’t mind wiping your head down to get a good connection, it definitely points to the future of controlling computers with brain waves and in the meantime, pairing up health apps to get a correlation with those waves….And finally a ‘think piece’ in HeartSisters by Carolyn Thomas, “To just be a person, and not a patient anymore” is largely an impossible dream for those with chronic disease. It’s part of the basis behind non-compliance and other patient behavior that doctors have difficulty understanding. The experience of the patient–the frustration (the ‘perpetual battle of Stalingrad’) and the burden that person carries is the argument behind ‘Minimally Disruptive Medicine’. Must reading as those same patients will be pressed now even more to Quantify Themselves and also to keep track of every fluctuation in vital signs on their iPhone.

More Samsung ‘we try harder’ telehealth moves

June 2, 2014 | by

Is Samsung playing Avis “We try harder®” to Apple’s Hertz?

Samsung’s other, less noticed end-run in addition to the Simband reference hardware and SAMI ‘open ecosystem’  is an initiative creating a joint research center with the University of California, San Francisco (UCSF) called the Center for Digital Health Innovation (CDHI). It is being headed by Michael Blum, a medical doctor who is the UCSF assistant vice chancellor of informatics. From the statements made to The Atlantic, Dr Blum’s intent is to clinically validate the sensors and algorithms produced within the Samsung ecosystem. Already featured are four initial projects: CareWeb (a collaborative care platform built on Salesforce.com), Tidepool (infrastructure for diabetes apps), Health eHeart (clinical trial app on heart disease) and Trinity (‘precision team care’). On the frontier: ‘novel vital signs’ which he predicts will come out of the analysis of standard vital signs, “…new markers of health and wellness that come out of these large datasets.”  Is Samsung, rather than going head-to-head with Apple on Healthbook [TTA 22 Mar] is leapfrogging into something akin to Telehealth 2.0 or 3.0? Yet this Editor notes that we haven’t figured out, for the most part, the FBQs (Five Big Questions)* of 1.0….

* The Five Big Questions (FBQs)–who pays, how much, who’s looking at the data, who’s actioning it, how data is integrated into patient records.

Grant funds telemedicine for brain aneurysm

June 1, 2014 | by

A grant of $150,000 has been awarded by a charitable foundation to fund a telemedicine [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/06/The-Missy-Project-logo.jpg” thumb_width=”150″ /]programme to help patients with brain aneurysms. The grant from The Missy Project, a Texas non-profit founded in 1999 after the sudden death of 12-year old Marisa (Missy) Magel due to a brain aneurysm, is being awarded to the Dartmouth-Hitchcock Hospital Center for Telehealth.

The funding will enable brain aneurysm patients in northern New England to have rapid access to neurovascular specialists, according to Dartmouth-Hitchcock. This will be achieved through telemedicine platforms to access the specialists at Dartmouth-Hitchcock from local facilities and community hospitals in what will be virtual aneurysm clinics. Once a patient has had a CT scan they will be able to proceed to a specialist consultation faster and more conveniently under this programme. In addition to virtual aneurysm clinics, the Dartmouth-Hitchcock project will include a 24/7 emergency department telemedicine acute consult service for pediatric and adult patients with suspected subarachnoid hemorrhage (which accounts for half of all hemorrhagic strokes), and customized educational video content, according to the Dartmouth-Hitchcock.

The number of deaths each year in the United States due to brain aneurysms  is estimated to be 32,000, more than either AIDS or prostate cancer, according to The Missy Project and an estimated 1 in 50 people, or 6 million people in the US have an unruptured brain aneurysm according to the Brain Aneurysm Foundation, so this project brings telemedicine to an important area.

Dartmouth-Hitchcock Center for Telehealth was awarded nearly a $1M from the USDA in February this year (see USDA invests $16M in distance learning and telemedicine) to deploy telemedicine equipment and services in New Hampshire and Vermont.

Suicide-alert sensor for prisons – no wearables needed!

June 1, 2014 | by

GE_prison-suicide_sensor

GE Global Research has developed a non-contact monitoring system for prisons that aims to alert staff of a suicide attempt in progress. It works by tracking inmate’s movements and vital signs – but without the need for a wearable monitoring device! To achieve this the research team modified standard radar equipment to pick up the delicate movements of the chest caused by breathing and heartbeat.

The system which is designed to be mounted inside a prison cell could be an effective way to monitor at-risk individuals, without resorting to more expensive or more intrusive surveillance solutions. The US Department of Justice funded study proved to be 86 per cent accurate at determining whether someone required assistance.

The final technical report of the three part study is available in full at the National Criminal Justice Reference Service (NCJRS). GE is now exploring ways to commercialise the system in prisons and other settings. Read more: New Scientist; National Institute of Justice

Health funding cuts in Australia

May 31, 2014 | by

Health and science funding in Australia are facing huge cutbacks under the new Government [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/Australian-budget.jpg” thumb_width=”150″ /]of Prime Minister Tony Abbott leading to expectations that the existing telehealth programmes will be reduced or abandoned as a direct result. A raft of cuts include closure of health and science agencies, funding cuts to major research institutes and the introduction of co-payment for each GP visit.

The Guardian reported that a cut of $1.8 billion of planned health payments to the States will take place over the next four years and The Lancet reports that the government’s share of the health service funding will be cut by $15 billion per year by 2024. The treasurer for New South Wales has stated that NSW itself would need to find an extra $1.2 bn over the next four years. ABC reported yesterday that the South Australian Government is planning to shut hundreds of hospital beds in next month’s budget in what will be the largest cut in its history.

Where will this leave the Australian telehealth and telecare services which have been showing rapid take-up in the recent past, helped along by several far-sighted Government initiatives such as Medicare Locals and telehealth pilots? And what impact will there be on the recent One in Four Lives industry initiative?

 

Another Khosla pronunciamento: self-promoting but myopically correct?

May 30, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /] The Gimlet Eye returns and delivers some hefty weekend reading…. Like General Douglas MacArthur, The Eye had to return from my Remote Pacific Island sometime. What better reason than to deliver to our readers Mr Vinod Khosla’s, tech investor and now Health Futurist, latest pronunciamento via VentureBeat.

It is, as they said in 1950, a beaut. It’s apparent Mr Khosla need not even speak at conferences anymore, because he can publish on his investment company’s website a ‘Draft’ entitled ’20 percent doctor included: Speculations and musings of a technology optimist’. It is being treated in certain quarters like Moses toting The Big Tablets down Mount Sinai; at the bottom the DH3 (Digital Health Hypester Horde) swoon in the usual places.

Mr Khosla reiterates some of his bomb-thrower memes from a couple of years ago: 80 percent of doctors could be replaced by machines, doctors were clinging to ‘voodoo-like practices’ and eventually we will not need doctors because we’ll be weller through technology and Big Data anyway. But the Eye’s Review of the ‘Draft’–which Eye was prepared to give the Gimlety Treatment–is that his prior attention-getting statements are not only more qualified (or stated more gently), but also backed up with real data, examples and mostly memorably, legitimately forward thinking whch largely avoids blaming doctors and shifts it onto the laggard Medical Establishment. “In fifteen years, data will transform diagnostics, to the point where automated systems may displace up to 80-percent of physicians’ standard work. Technological developments will AMPLIFY physicians’ abilities (more…)