A pointer to the future is how the US Air Force is taking a new look at what we call telehealth and they call Human Performance Monitoring. Current sensors are large and complex in measuring heart rate, blood pressure, blood oxygenation and skin temperature–critical data for pilots and other airmen. For instance, the USAF measures O2 in F-22 pilots to determine effects and compensate to keep both man and machine safe. Not only do they want to make sensors smaller–like skin patches–but also these are key to a new concept in aviation medicine called Human Performance Augmentation, which will measure human health status in real time. And both play into Human Systems Integration, which integrates man and machine. The implications here for civilian use are many: miniaturization of sensors into wearables, real time telehealth and machine assistance for human tasks. Performance-detecting Biosensors (Armed With Science)
CVS Caremark’s employee wellness ‘stick’ revisited–in court (US)
Exactly a year ago, retail drug store/onsite clinic/PBM giant CVS Caremark unveiled its ‘big stick’ approach to employee wellness–if you are in their health plan, you must participate in their ‘voluntary’ health screenings and management program or be charged $50 per month. One employee is now suing about this in Alameda County (Oakland/San Francisco, California area) Court.
According to the Courthouse News Service, the complaint states that “During the ‘Wellness Exam,’ a doctor performs blood work, which, upon information and belief, is utilized by defendants to ‘flag’ employees who are at risk for a variety of medical conditions.” Also from CNS, “In addition to the exam, which Watterson says she had to pay for, CVS made her fill out a survey that asked personal questions such as weight, body fat percentage, whether she drinks or smokes and is sexually active. The survey was “required in lieu of a $600 fine,” according to the lawsuit.” (Editor’s emphasis) If she had the exam in-house–at a CVS MinuteClinic–it also would have cost her $125 out of pocket, so she went to a private physician who charged her the co-pay, $25. She’s seeking compensation for “class certification and damages for failure to pay hourly and overtime wages, failure to indemnify, illegal wage deductions, failure to provide accurate wage statements and unfair competition.”
All of which was easily predictable that CVS Caremark would be asking these questions, as they are fairly standard in a health workup –but is the ‘cross the line’ part (and what most of the dither may be about) the last item noted? (more…)
Pilot testing of telehealth service in Philippines
Filipino company Metro Pacific Investments Corporation (MPIC) plans to offer telehealth services in its hospitals allowing Filipinos in remote areas to avail themselves of healthcare services, reports Interaksyon, the online news portal of the Philippines TV network TV5.
In a briefing last week MPIC Hospital Group president Augusto Palisoc has said it is piloting a telehealth service involving two machines located in company-owned Asian Hospital and another in a government hospital in Batangas. This will allow patients in remote areas — with the assistance of a professional with medical training — to seek diagnosis or the advice of doctors in a base hospital, the article says.
Metro Pacific’s planned venture into telehealth is part of its efforts to look at other healthcare delivery processes in addition to its regular hospital investments. MPIC operates the largest private hospital group in the country with approximately 2,150 beds. Its network includes the Makati Medical Center, Cardinal Santos Medical Center, Our Lady of Lourdes Hospital, Asian Hospital & Medical Center, De Los Santos Medical Center, Central Luzon Doctors’ Hospital in Tarlac, Riverside Medical Center in the Visayas and Davao Doctors Hospital in Mindanao.
Health Technology Forum – evening of 26th March – free to attend (UK)
The next meeting of the Health Technology Forum will take place on 26th March. There no charge for attendance; Baker Botts has kindly confirmed their agreement to be long term sponsors. This meeting will be in their premises close to Bank Tube so easily accessible.
Speakers will be:
- Neil Daly, founder of Skin Analytics on “Our story – how we got started”
- James Semple from Appcelerator on how to get apps to market quickly
- Rupert Tebb from Paper on “MeHab – how we developed an alcohol reduction programme for the under 30s”
- Neil Foster, Partner, Baker Botts on “the IPO of Cambridge Cognition, the leading British developer of computerised neuropsychological tests”
As this is our first meetup at Baker Botts, attendance by as many as possible would be greatly appreciated, to show our sponsors how much their generosity is appreciated. Your views on who you’d most like to get to speak at future events would be greatly welcome, too. The format of the evening will be as previously, with doors open at 6.30, aiming to start at 6.45 with four 15-20 minute presentations followed by questions ending in time to begin networking drinks (which will be a very high standard) at 8pm.
For security reasons only those who have indicated in advance that they will be attending will be able to attend – more details, and how to book are here.
NHS futures – more encouraging signs of change (UK)
Monitor has now released the output from the NHS Futures summit held on 21 November 2013, hosted by NHS England, Monitor and the NHS Trust Development Authority. The summit was designed to spark debate about how the landscape of health and care providers could evolve over the next decade to better meet the challenges outlined in the Call to Action. Over 100 senior health leaders took part including commissioners, providers (including GPs), health policy experts, and patient and charity representatives.
The summary Call to Action document makes encouraging reading for those who believe technology can help the NHS to improve patient outcomes at lower cost. Contrary to the consultation exercise held by NHS England last August when we pointed out that remote consultation was not even mentioned, this features prominently in the Monitor summary (see especially Appendix 3, on pages 19-21), together with many other uses of technology such as smart homes, encouraging self-care, telemedicine, single patient record, interoperability, etc.
There are also some great videos – in particular (more…)
Apple-ologizing Healthbook
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/03/healthbook-book.jpg” thumb_width=”300″ /]With the same obsession that Kremlinologists had during the Cold War, the Apple-ologists at 9to5Mac observe emanations and permutations emitting from Cupertino. Based on their inside sources, they have the lowdown on how Apple will Go Big into healthcare monitoring and fitness tracking.
- ‘Cards’ in the Healthbook allowing entry for vital signs such as blood pressure, blood glucose, breathing rate, weight, hydration and oxygen saturation (O2). (photo at left above a ‘recreation of screenshots’ by 9to5Mac)
- Sleep tracking. Apple in February hired Roy J.E.M. Raymann, one of the world’s experts in sleep tracking including wearables and sensors, out of Philips.
- Emergency Card with customer’s name, birthdate, medication information, weight, eye color, blood type, organ donor status, and location.
The rumors tie it to the introduction of iOS 8, the iWatch or both. But beyond the sensors on the phone and/or the iWatch–there’s no information on how telehealth apps, devices or sensors would wirelessly transmit the information. “While Healthbook is capable of tracking, sorting, and managing various types of health and fitness-related data, it is currently uncertain where this data will actually be sourced from.” But Editor Toni noted in February (link below) that Apple just patented headphones which are capable of monitoring temperature, heart rate and perspiration levels. This is Healthbook, Apple’s major first step into health & fitness tracking (9to5Mac). And Wired thinks Apple’s Upcoming Health App Is the Start of Something Huge (Wonder if South Korea’s Ministry of Food and Drug Safety will impound it as an unapproved medical device!)
Previously in TTA: Apple-ologists discern ‘new’ interest in health tech and telehealth [20 July 13], Apple’s tarnished luster, Round 2 [29 July 13], Apple purchasing 3D gesture control developer PrimeSense [19 Nov 13], Apple patents health monitoring headphones with ‘head gesture’ control [19 Feb]
Vodafone and AstraZeneca sign global m-health partnership
Vodafone has signed a global partnership with AstraZeneca in order to develop m-health services to improve the outcome for patients with cardiovascular conditions. The collaboration will create new mobile and internet-based services to support patients through their treatment journey, improving medication adherence and giving patients confidence to manage their condition more effectively, according to the press release.
AstraZeneca’s Intelligent Pharmaceutical Group will lead the project with Vodafone charged with providing the technology, infrastructure and expertise for the new services.
The UK-based operator said it will also look to capture data from a variety of sources to improve overall engagement between patients and healthcare professionals. All the new services will be designed to work across geographies.
“Bringing together the best in connectivity with the best in treatment and education will create powerful and compelling outcomes for patients,” according to a comment attributed to Vodafone M2M Director Erik Brennais. But there is little in the way of details of what the two companies may develop or the timescales.
University of Mississippi awarded telemedicine Emergency and Specialty Care grant
More details have emerged of one of the projects funded by the $16 million USDA investment announced in February (see TTA 7 February 2014).
The United States Department of Agriculture grant of $378,360 to the University of Mississippi Medical Center will be enhanced by $200,000 from Appalachian Regional Commission [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/03/TESCAN_map.jpg” thumb_width=”150″ /] providing $578,360 for a three-year distance-learning and telemedicine service project “Telemedicine Emergency and Specialty Care for Appalachia in North Mississippi (TESCAN)”, according to UMMC. UMMC is also the primary site for the Diabetes Telehealth Network we reported in January.
The sites, considered “medically underserved areas” and “health-professional-shortage areas” by the U.S. Department of Health and Human Services, include:
• Calhoun County Medical Clinic, Calhoun City;
• Trace Regional Hospital, Houston;
• Kemper County Medical Center, De Kalb;
• Tishomingo Health Services, Inc., Iuka;
• Webster General Hospital, Eupora;
• Yalobusha General Hospital, Water Valley;
• North Mississippi Medical Center-Pontotoc, Pontotoc;
• Kilmichael Hospital, Kilmichael; and
• Holmes County Hospital, Lexington.
Representatives from the USDA and UMMC announced the grant agreement at a joint press conference at the UBS Building in Jackson.
The grant will expand the number of (more…)
Sony to launch new telehealth camera at Australian Healthcare Week
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/03/Sony-telehealth-camera.jpg” thumb_width=”150″ /]
Sony Australia and New Zealand today announced it will officially launch its new Patient Monitor telehealth camera system at Australian Healthcare Week. Sony’s IP Patient Monitor, NCSRS46P, has been developed in Australia to meet the specific needs of regional healthcare, according to Sony.
The solution enables two-way audio and one-way video communication over IP, typically a broadband internet connection. It has been created in an environment where privacy, ease of installation, simplicity of use and reliability are key concerns. The camera has a powerful 36x optical zoom that allows the healthcare professional or specialist to easily and efficiently view the area of interest and effectively assist with diagnosis.
Although the official launch is next week, there are over 200 IP Patient Monitors in use across Australia, say Sony, including in New South Wales where they are used as part of the Greater Western Clinical Outreach Project.
The Australian Healthcare Week will be from 25-27 March at the Australian Technology Park in Eveleigh, New South Wales.
The King’s Fund: Self-Care in the Digital Age
24 June 2014, 11 – 13 Cavendish Square, London
Morning session: 9.00am – 12.30pm
Afternoon session: 1.00pm – 4.30pm
How can the UK manage its health and social care needs, now and in the future? How can new technology aid in the evolution of our perceptions of health and care? And how is self-care being adopted across the UK? Sponsors dallas (Delivering Assisted Living Lifestyles At Scale) and The King’s Fund will explore and expand that debate with an audience including government ministers, health care practitioners and patients themselves. This free half-day conference is running twice on the same day; once you register on Eventbrite, you will be asked whether you want to attend either the morning or the afternoon session. The organizers will then contact you to confirm your place (subject to availability). Registration, information.
Short, ‘springy’ takes for Friday
IBM Watson crunches the genomics for glioblastoma. A clinical trial at seven locations is being developed in partnership with the NY Genome Center to identify potential treatment options for the most common type of brain tumor–one where diagnosis and treatment time is of the essence. iHealthBeat, Modern Healthcare….Also in NY, Montefiore Medical Center in The Bronx is evaluating several mobile initiatives including a current pilot for texts/care management to support diabetic teenagers, as well as evaluating interacting with diabetics on fitness and biosensor monitoring. FierceMobileHealthcare….Yecco’s social media platform for families caring for older adults [TTA 13 Mar] adds insurance. Allianz Global Assistance UK announced Yecco Home Care insurance, providing up to six weeks of assistance at home following an accident, injury or hospitalization. Release….Six US Senators seek clarification on FDA mobile health regulations. The letter to FDA Commissioner Margaret Hamburg inquired on FDA plans and asked if legislative assistance might be required. The FDA/ONC-HIT framework report originally due in January now has a deadline of 31 March. iHealthBeat. The Hill ‘Healthwatch’….The Samsung Galaxy S5 won’t be considered a medical device by South Korea’s Ministry of Food and Drug Safety. According to Engadget, it was the heart-rate sensor that subjected it to stricter regulations under current South Korean laws. Oy….And it took a while, but finally the Tunstall Americas management page lists new CEO Casey Pittock at the top! (No release yet though.)
Telehealth & telemetry to push US monitoring market to $5.1 bn by 2020
New market research predicts that the health monitoring market in the US will exceed $5 billion by 2020. The research by iData Research covers devices and equipment for both hospital based telemetry and home based telehealth markets.
According to the report, the US patient monitoring market was valued at over $3.5 billion in 2013 and will grow to over $5.1 billion by 2020 due most notably to the expansion of multi-parameter vital sign monitors, electroencephalograms (EEG), electromyograms (EMG), cerebral oximeters and pulse oximetry devices. The pulse oximetry monitoring market alone is expected to exceed a billion dollars by 2020. Players leading this growth are Medtronic, Bosch Healthcare, St. Jude Medical, Honeywell, Boston Scientific, Philips Healthcare and Biotronik.
Interestingly, the report notes that the Veterans Health Administration (VHA) represents the largest example of telehealth success within the U.S. and that they serve over half a million patients who receive telehealth-based solutions.
New products which feature smartphone integration and Bluetooth capabilities entering the market will further drive sales, say iData; other remote monitoring devices such as modern pacemakers, implantable cardioverter defibrillators (ICDs) and hemodynamic monitors are paving the way for substantial growth in this market. So it is not all telehealth by any means.
Box.com’s odd swerve into healthcare cloud storage and PHRs
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /] Both The Gimlet Eye (filing from a remote island) and Editor Donna have been pleased users of the Box.com file storage site for storing all sorts of files in the ‘cloud’ (a/k/a Somewhere Out There On A Whole Bunch Of Internet Servers), sharing and collaboration. It’s simple to use, it works and, for our needs, actually free. However founders Aaron Levie and Dylan Smith, who look barely old enough to shave (but smartly have A Touch of Grey in their management team), have their eyes set on far bigger prizes than our mediocre needs. Now they have added ‘special advisers’ Aneesh Chopra, first US CTO, and Glen Tullman, former CEO of Allscripts. Mr. Tullman certainly does add major luster (and connections) and Mr. Chopra, despite the Eye’s consideration of him as hyperbolic and politically, not technically, qualified for his previous positions in the Government and the state of Virginia, adds the inevitable political ones. Having them on the roster also adds heft to their imminently rumored IPO (TechCrunch; update, filed 24 March) and ultimately acing out other file sharers Dropbox in the enterprise area. Expectations are high; Box has $414 million in funding from a roster of investors (including Telefónica and Australia’s Telstra) through a Series F (CrunchBase) with a valuation of $2 billion (TechCrunch) and undoubtedly they’d like some of it back. Soon. (The completely overheated Castlight Health IPO only whets the appetite.)
Healthcare one key to a rich IPO. Box’s healthcare moves point in the enterprise direction. (more…)
A useful note on telehealth & telecare (UK)
If like me you are frequently asked for a summary of what has happened recently in the world of telehealth & telecare and are forced either to sit down and cut & paste/write one or politely turn down the request, you’ll be pleased to know of the recent four-page summary produced by the Parliamentary Office of Science and Technology (POST). Written by Peter Border, it is a competent summary of recent developments in remote monitoring in the UK, including 3millionlives & ALIP, extending to mention of the regulation of medical apps.
Of course there are bits I’d have written differently. For example (more…)
MHRA guidance on medical device stand-alone software, including apps (UK)
The MHRA has today provided guidance on medical device software, which includes medical apps. The guidance can be found here.
Briefly, this guidance aims to:
- outline the current regulatory position
- explain what defines a medical device
- help with decisions on whether your stand -alone software or app is a medical device and give examples
- give information about the rules on classification of medical devices and how to meet the regulations
- give links to other useful websites and relevant documents.
This guidance is aimed at those working in healthcare and people who are developing devices.
Readers might wish to refer to our previous recommendations regarding medical apps.
New market research on telehealth in US
A new market research report has been released on the telehealth market in the US. Telehealth services in the US is produced by IBIS World (not a market research firm I am familiar with) and, according to the press release, over the next five years, the industry will continue to benefit from the demographic and structural factors affecting the healthcare industry as telehealth will emerge as a cost-effective solution to meeting the medical needs of an expanding and aging population. That didn’t exactly knock my socks off. There is very little in the press release to tempt me to part with the $1600 needed to read the full text.
On the other hand if you are interested, visit IBIS World to purchase membership. (Also see this article in FierceHealthIT for a bit more, free)
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