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
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
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!
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
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?
[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…)
More on DARPA’s ‘brain chips’ for PTSD, TBI
DARPA’s continued research on deep brain stimulation (DBS) implants to treat PTSD and TBI, as well as other neuropsychological conditions, is given the once-over in this Defense One article. New information from the time this Editor last wrote about it in December is that the SUBNETS program (Systems-Based Neurotechnology for Emerging Therapies), funded with $12 to 26 million, will work with the University of California at San Francisco, Lawrence Livermore National Lab and Medtronic to create an implant with electrodes reaching into the brain and which does not require staying still under a machine in a lab. The prototype development is expected to take five years. The article also points out the US Air Force initiative studying the effects of low amounts of electricity on the brain to boost alertness delivered by an external cap.
Samsung’s ‘shot over bow’ in health
Watched closely as part of Samsung’s various moves in health (here in the US heavily promoting the S5’s heart monitoring capabilities) is their unveiling of a reference hardware called the Simband, a wristband designed for interchangeable body sensor modules yet in fact to be developed. Its platform is dubbed Samsung Architecture for Multimodal Interactions (SAMI) and is part of an open ecosystem which invites developers “to design and integrate their own sensor technology and, through the SAMI platform, develop applications and algorithms for wearables.” The design was in partnership with the biosensing institution Imec and will be available before end of 2014.(Gizmag) Coming before Apple’s Worldwide Developers Conference (WWDC) and the rumored announcement of the Healthbook iOS app [TTA 22 Mar]…the Samsung-Apple wars continue, and not in court. Also Gizmodo
‘Fashionable safety’ alert device for women
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/Guardian-Angel-necklace.jpg” thumb_width=”150″ /]Out of Singapore is a pretty silver necklace or bracelet that does more than adorn: with the press of its small silver button, it can help the wearer get away from an uncomfortable or harassing situation in a public setting (like the workplace, a bar or party) by sending that ‘nick of time’ fake call to your iPhone by Bluetooth LE. Or if held down for over 3 seconds in an emergency, it sends an SOS text, coordinates and a Google Map link via the phone to designated recipients (not law enforcement.) The Guardian Angel pendant was developed by ad agency JWT Singapore to support AWARE (Association of Women for Action and Research) in Singapore through a 10 percent per unit donation, and is available at local retailer My Room Retail or internationally via their website for US$120 (UK£71) plus shipping, handling and optional bracelets. What isn’t clear is if a smartphone is needed–the website indicates that an app must be downloaded from the Apple AppStore but the Daily Mail article says it works with any phone. Also PSFK review, ABC (US) News. What’s a little disappointing is that the first function (‘get me away from this creep’ self-call) is being more widely touted than the second (‘the creep is coming after me with handcuffs, and he’s not a cop’ SOS). This Editor also wonders how reachable the necklace in particular would be in a truly dangerous situation. But it is certainly better than the alternative. Hat tip to Editor Toni Bunting.
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/03/first_sign_clip-1.jpg” thumb_width=”120″ /]In TTA 6 March we covered another ‘fashionable safety’ item, the First Sign hair clip, which is more violent crime deterrence and recording-oriented. It senses impact and sends audio/video/GPS location to monitors plus designated recipients along with a pre-recorded announcement that it is gathering evidence. It succeeded in its Indiegogo financing round and is available for pre-order here for estimated November delivery at $50-75 plus monitoring. But so far, fashion hasn’t made its way into the maddeningly institutional PERS design (though Chubb has given it a whirl with its Glasgow competition recently.)
Addiction: Improving Outcomes using Computer-based Therapy
A recent randomised control trial gives support to the use of computer-based therapy for treatment of addictions. The results were reported this week at the annual convention of the Association for Psychological Science in San Francisco, following publication in the American Journal of Psychiatry. Although the trial focused specifically on cocaine-dependent individuals, it replicates findings of a RCT carried out in 2008, in which participants had a wider range of substance addictions.
Results of this latest study show that those who received computer-assisted therapy were significantly more likely to attain three or more consecutive weeks of abstinence from cocaine as compared to those not receiving any form of Cognitive Behavioural Therapy (CBT) – 36% compared with 17%. And the effects appear to last; the control group also had better outcomes six months after treatment had ended.
Individuals who receive CBT learn to identify and correct problematic behaviours by applying a range of techniques. Central elements of the therapy include anticipating likely problems, correcting harmful thought patterns, and developing effective coping strategies. The techniques enable people to counteract addiction’s powerful effects on the brain, so they can regain control of their behaviour and lives. (more…)
A random walk through ATA 2014
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/ATA_Button_color_filled.jpg” thumb_width=”150″ /] Editor Donna attended ATA 2014 on Monday only. This article is a set of impressions (mainly) of the exhibit floor and visits to a number of select booths.
Donna, it’s Baltimore. You’re not in NYC or Las Vegas.
Arriving after a long trip to a city you used to visit regularly, but haven’t been to in over 30 years, is disorienting, especially when you are heading on a fair spring day to a section that didn’t exist then. The Inner Harbor and Camden Yards resemble Atlanta, not necessarily a bad thing since the parts of ‘Charm City’ they replaced were largely past ‘gentrification’. The Baltimore Convention Center was unexpectedly huge, the distance to registration made longer by a taxi driver who dropped me off at another entrance two blocks away. Any resolve I had to drop in on the many educational sessions was dissuaded by the sheer length of the halls. The thick Exhibit Guide confirmed that the show floor filled two city blocks–a challenge to cover and spend time with my appointments before the close of the day.
Was it a hardware show, a software show or somewhere in between?
You could make a case for both views. One observer I walked with at the start compared it to a radiology trade show–all hardware. Yet a closer look indicated that the hardware–the PCs, tablets and smartphones–was there to show software that integrated: systems to track patients, distribute information, workflows, store and forward images and reports. It was about enabling secure consults, platforms, interoperability, two-way data flows, mitigating readmissions and putting telehealth, telemedicine and education into provider and patient hands. It was also about making the business case. It was most definitely NOT about gadgets and single purpose peripherals, though the latter were still quite visible. The old picture of telehealth closed systems, of proprietary monitoring devices feeding data onto a proprietary PC platform where it’s seen by a care manager, is so 2011.
Noteworthy: the growth in specialized services like telepsychiatry, teleneurology, teleradiology and teledermatology. Contrast: despite VGo‘s ubiquitous telepresence robots accosting you on the floor, a tablet-faced robot following a nurse down the hospital hall and ‘consulting’ with patients will likely still be a rarity.
Patient engagement on top
Traditional telehealth device makers are connecting their devices and opening up their reporting platforms to be accessible to patients. But there are bumps along the way in this transition. A&D Medical has gone ‘Wellness Connected’ with a mobile app (more…)
Tunstall’s unhappy lenders and the consequences of debt service
A ‘slipped under the radar’ story (in this Editor’s judgement, based on the lack of news references) is Bloomberg News’ exclusive on last week’s (12 May) meetings between Tunstall Group Ltd and its creditors over the company’s recent performance. According to Bloomberg’s sources, the meeting was called “after income plunged and management changed following a refinancing in September.” In a statement from Charterhouse that cleverly tap-danced past the reason for the meeting, “Tunstall continues to be a successful, profitable, cash-generating business and comparable to many other organizations, experiences short-term fluctuations in performance.” and “The group has been impacted by a number of factors including specific market factors and the continued strength of sterling against the major-trading currencies.” The business has also been hurt by delays in awarding major contracts, according to the statement.
From the Bloomberg article:
As Tunstall’s profits have declined, its ratio of debt to earnings before interest, taxes, depreciation and amortization increased to 5.6 times as of March, from 4.7 times in September, the people said. The loan terms in the March test dictated that the leverage ratio shouldn’t exceed 6.3 times, they said.
Lenders are expecting the company to give a new profit forecast today for the 12 months to September 2014, according to the people. The company didn’t comment on earnings targets or leverage in its statement.
AND: Its 350 million pounds ($590 million) of loans dropped to as little as 77 pence on the pound, according to broker quotes, from 99 pence in September. (Ed. note: these loans are publicly traded and a lowered value is highly significant as to the debt quality.)
The outcome of the meeting is not yet known.
As our readers know, private equity firm Charterhouse Capital Partners LLP acquired Tunstall Group in 2008 from Bridgepoint Capital for £514 million (US$ 1 billion), funded in part with over £242 million in debt and with Bridgepoint and management retaining small shares (FT.com). The September 2013 refinancing was for £350 million ($590 million). This paints a picture of a highly leveraged company beholden to many beyond its owners and its contractors in local authorities and housing associations. Tunstall and Charterhouse also received negative publicity when the Guardian did an exposé on their use of the (wholly legal) ‘Quoted Eurobond Exemption’, where they pay loan interest at high rates to their parent companies through a mechanism via the Channel Islands Stock Exchange.
Management changes over the past six months have also rocked the top layers of the company. (more…)
More telehealth for the bassinet set
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/12/3019806-poster-1280-sprouting.jpg” thumb_width=”160″ /][grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/product_sock-Owlet.png” thumb_width=”160″ /][grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/0ca96884.MimoKimono.png” thumb_width=”160″ /][grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/Sensible-baby.jpg” thumb_width=”160″ /]Industry talk is that wearables are no longer the hottest things on the hype curve because of smartwatches and smartphones getting even smarter, but one area is the exception: baby wearables. MedCityNews has an overview of four, three of which we’ve noted since late 2012: Sproutling, Owlet, Rest Devices’ Mimo Turtle (which fastens into Kimono, a/k/a the ‘onesie’) and (new to us) Sensible Baby SmartOne. All have some combination of heart rate, skin temperature, movement/sleep position monitoring from sensors into a smartphone app. Form factors: Sproutling and Owlet are anklets, Mimo Turtle’s monitor fits into a designated secure pocket in the lower (baby’s) left of the onesie, Sensible Baby goes into a pocket or attaches to clothing so it’s likely more suitable up to toddler age. Last December’s FastCompanyDesign article on Sproutling targeted its debut for this summer [TTA 10 Dec 13], but there’s no trace of a website so it’s still in development. Owlet’s been in market since fall 2013 [TTA 27 Aug 13] as has Mimo Turtle which is now sold through major retailer Babies ‘R’ Us. Sensible Baby is still inviting beta testers and pre-orders at $99, projecting $149 when on sale later this year. There’s also no reassurance on the site that the SmartOne can be safely chewed — and of greater concern, its size appears to be small enough to swallow. With pricing between $150 and $300, they are at the Velocity of Cute as ‘ooh-ahh’ gifts for those baby showers which are coming up on many calendars and for your favorite Quantified Self Moms. (Just hold the obsessive smartphone checking.)
Also: Investor/engineering lab Lemnos Labs’ blog posting on Sproutling’s development from application/prototype to a scalable production model will be interesting especially if you are being challenged in the hardware development process.
Previously in TTA: Wearables on the hype cycle: a ‘Fitbit for babies’, Owlet baby monitor sock exceeds funding goal (But Huggies Tweet Pee seems to have stayed in Brasil…), Owlet baby monitor sock moving to market, Cute sensor fashions now for baby.
Sleep monitor for telecare in epilepsy, abnormal night activity
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/SAMI-Camera.jpg” thumb_width=”140″ /][grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/SAMI-image05-300×169.png” thumb_width=”175″ /]
A truly underserved area is monitoring children who have epileptic seizures or other conditions at night. There’s danger to the child and loss of sleep or inability to detect by the parent or guardian. Sleep/activity monitors, baby monitors and movement sensors haven’t been adequate nor accurate. The Epilepsy Foundation (EF) in the US has developed SAMi, a monitoring system consisting of an camera (left) with built-in infra-red LED illumination connecting to an iPhone, iPad or iPod app. At night or designated sleep times, it alerts only for prolonged movement typical of a seizure or other suspect night activity, activating the phone with both audio and video. The movements are also recorded and logged for date/time/duration. It is not inexpensive: the SAMi camera alone is $399 and $949 for the fully configured kit with a iPod plus Wi-Fi router. The new Indiegogo campaign is to raise $90,000 for the next gen camera and to purchase units for charitable distribution to families. Also Medgadget. (A search here on ‘epilepsy’ will confirm the lack of attention to–and the need for–epilepsy monitoring)
UK Telehealthcare MarketPlace 2014 (UK)
UK Telehealthcare is again having a free-to-attend London Market Place in Kensington Town [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/05/UKTHC-logo-final1.jpg” thumb_width=”150″ /]Hall, on 2nd June 2014. In case you are wondering, UK Telehealthcare is the re-branded London Telecare. The change which took place in September last year is taking the London Telecare model nationwide.
These Market Place events provide the supplier members of UK Telehealthcare the opportunity to show their telehealth and telecare products and for visitors to try them out and discuss their requirements. The Market Place is open for five hours and there is a programme of talks running in parallel. See the flyer (pdf) for other details. As the flyer says, there is no need to book but please let Doug Miles know id you are planning to attend.
Of tricorders and lemmings
Telehealth & Telecare Aware is privileged to break the news of the new Tricorder-like device developed by iMonsys called EIMO, a compliment we take to heart. Watch the demo video:
It seems perhaps a trifle churlish therefore to point out that there is similar functionality in other products under development, such as Wello, which looks like it is going to become available about the same time, too. However the Wello slips over your phone so is much less intrusive and, some would say, has more cool. There are of course a bunch of competitors for the Tricorder X prize too, perhaps most famously the Scanadu Scout.
To explain where the lemmings come in, this reviewer went to a Wayra event recently (at which there were some brilliant pitches, especially from Cookiesmart (telepathology), Handle My Health, My Clinical Outcomes, Virtually Free and BreakBad, that we hope to cover in a future blog).
On arrival, the warm-up had already started, given by a financier who asked if anyone remembered Star Trek. He went on to say (more…)
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