Terminology: do we need another contribution?

January 28, 2014 | by | 1 Comment

Although I suspect most readers have now got used to the variability in definitions in our field, to the point where it has, thankfully, dropped from being the regular debating point it used to be on TTA (eg here, here and here), valiant souls occasionally pop up to continue seeking to impose uniformity. The most recent is this paper from the European Connected Health Alliance and Wragge & Co, which has an excellent justification for its publication:

In our legal opinion, a more important distinction with these definitions is whether the products and/or services involved are regulated by telecommunication and technology laws and/or health laws. To answer these legal issues comprehensively you need clear legal definitions which do not exist either in the UK or on a pan European (EU) basis.

…which seems a very good point that I suspect many of us had missed. (Perhaps more important for many readers, I guess standardisation would make it easier for recruiters to find the best people to invite for interview from LinkedIn, too, now that that database has become the recognised database for professionals in many fields).

It is certainly a good collation of views on many of the terms we often use. There is much good stuff in here too (more…)

Videolink telehealth continues expanding in Yorkshire (UK)

January 28, 2014 | by

The video-link/ videoconferencing system used by Airedale NHS Foundation Trust in Yorkshire, [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/Airedale-digital-healthcare-centre.jpg” thumb_width=”150″ /]England, to provide remote medical assistance is being rolled out to additoinal care home sites. The service is staffed by a specialist nurse at Airedale General Hospital who uses the system, known as the Telehealth Hub, to assess patients and support staff at the homes.

According to the Keighley News the service was installed in a Bradford nursing home with the first use on New Year’s Eve. Staff at Ashville Care Home are quoted as saying that the service allows their residents to receive medical care without having to call a GP out or take them into hospital. A hospital visit would mean having to get extra cover as a member of staff needs to go as well.

Meanwhile the Telegraph & Argus reports (more…)

South Korea to push Telehealth – good for Samsung

January 27, 2014 | by

Returning from the World Economic Forum in Davos, Switzerland, where she met with several company CEOs, [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/Park-Geun-hye.jpg” thumb_width=”150″ /]South Korean President Park Geun-hye has decided to promote telehealth as a new growth engine for South Korea according to the Shanghai Daily. The president wants to see the country become a global leader in telehealth with a strong domestic use of the technology.

This is particularly fortunate for Samsung, the country’s largest group of companies, which is also said to be planning biomedicine and medical equipment to be among its growth sectors with a reported 10-year total of $22 bn (US) of investment across all its growth sectors. Samsung already produces major hospital equipment such as ultrasound and digital radiography systems, currently operates a massive hospital and cancer center in Seoul and is, (more…)

An essential link to mHealth devices and apps?

January 27, 2014 | by

Guest columnist Lois Drapin thinks so. She shares her insights on Validic, an emerging company in data integration for payers, providers, preventive wellness companies and pharma;how it evolved from its original concept in consumer health engagement, along with a few pointers its founders have for fellow entrepreneurs.

One of the keystone aspects of “ecosystems” is interoperability and this also applies to the data pipeline that flows from health apps and devices to the appropriate segment of the healthcare delivery system, and eventually, to the users—patients, consumers and/or medical professionals such as physicians and nurses or other clinicians. By now, we all know that the capture and analytics for both “big” and “small” health data are business imperatives for healthcare in the US. With data of this nature, we can embrace our understanding of behavioral change at the individual and population levels. The anticipated outcomes of behavioral change may power operational and cost efficiencies in the healthcare industry.

But data will no longer come from just inside the healthcare delivery system. In addition to the changing technology enablement within the health system, as we all know, data will flow from many things—in fact, The Internet of Things (IoT). This means that data that relates to our lifestyle, wellness and health will pour from the many types of wearable devices not now connected to the heath delivery system. In addition to our computers, tablets, phablets and smartphones, are the many sensors paired with tech innovations such as the wearables— from wristbands, smartwatches, clothing (from shoes to headbands), glasses, contacts, and pendants — to things such as refrigerators, clocks, mattresses, scales, coffee pots, cars, and even, toilets…all of which are predicted to become an important market in the coming years.

Validic, based in Durham, NC, has put itself smack in the middle of that market (more…)

Telepsychiatry: a new practitioner’s experience

January 27, 2014 | by

Daniel W. Knoedler, MD in Psychiatric News chronicles his first week as a full-time telepsychiatrist, working for the Green Bay VA Hospital in Green Bay, Wisconsin. He is definitely a bit stressed as he adjusts to working alone in a cold basement, his image in the video system and the Loneliness of the Long-Distance Psychiatrist who doesn’t have face-to-face contact with patients–and his own socialization. Yet he thinks telemedicine is useful in addressing the lack of access to care for patients and that the technology is not much of a barrier. He does worry about the consequences of not shaving, leading to some musings on Howard Hughes.  Telepsychiatry: First Week in the Trenches

Telepsychiatry pilot success in the Bronx

January 27, 2014 | by

More on telepsychiatry: a pilot at Lincoln Hospital in The Bronx (borough of NYC) for adolescent telepsychiatry consultations reported success with only one in 10 patients being hospitalized after the telehealth consultation, according to Louis Capponi, M.D., chief medical informatics officer for New York Health & Hospitals Corporation, the parent of Lincoln Hospital. “The impact was very profound in terms of the number of patients that were able to (be) discharged safely.” HHC is considering expanding the pilot to patients who come in through the prison system. What is puzzling is that in the exclusive interview with Dr. Capponi in FierceHealthIT, there is no information on the duration of the pilot, the number of patients in the program, or details that would give our readers some framework beyond ‘engaging patients through technology’.

Telehealth counselling program expands in Texas

January 27, 2014 | by

Following on from our article on the school telehealth scheme in Michigan  (Smaller scale telehealth and telecare sucesses, [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/videoconf-Texas.jpg” thumb_width=”150″ /]TTA Jan 4), we report now how a remote counselling clinic started by Texas A&M to provide psychological counselling to rural population has expanded. The Telehealth Counselling Clinic in Centerville, Leon County, was started from a grant in 2007 to the Center of Community Health Development (Texas A&M) and Leon County, and provides counselling using Texas A&M faculty and graduate students in the counselling psychology program, supervised by licensed psychologists.

The service has now been expanded to Madison and Washington counties based on the success seen in Leon County. Two more sites are planned for opening  in 2014. (more…)

US, UK agreement on HIT

January 25, 2014 | by

Edited from the HHS release. US Health & Human Services (HHS) Secretary Kathleen Sebelius and UK Secretary of State for Health Jeremy Hunt on Thursday 23 January signed a bi-lateral agreement for the use and sharing of health IT information and tools. The agreement strengthens efforts to cultivate and increase the use of health IT tools and information designed to help improve the quality and efficiency of the delivery of health care in both countries.  The two Secretaries signed the agreement at the Annual Meeting of the HHS Office of the National Coordinator (ONC) for Health Information Technology. It concentrates on four key areas identified at the joint June 2013 summit:

  • Sharing Quality Indicators
  • Liberating Data and Putting It to Work
  • Adopting Digital Health Record Systems
  • Priming the Health IT Market

Collaboration efforts will be showcased at the Health Innovation Expo conference at Manchester Central 3-4 March (two weeks before HC2014) and the Health Datapalooza on 1-3 June in Washington, DC. A possible good sign for telehealth as there’s a great deal of mention of ‘preventive interventions’, ‘accessing and sharing data’ and the ‘health IT marketplace’.

Full memorandum of understanding text here. Also iHealthBeat.

HC2014

January 24, 2014 | by

19-20 March 2014, Manchester Central, Petersfield, UK

For over 30 years, HC has delivered thought leadership; informing and educating its audience on the how the latest innovations in technology support the increasing demands within healthcare. HC2014 will address all the current healthcare reforms with a number of themes referring to the call for paperless NHS by 2018. Key sessions will demonstrate technology to support Patient Engagement, Safer Hospitals and Integrated Care. Conference and exhibition presented by the BCS, The Chartered Institute for IT, in partnership with HIMSS. Conference keynoters include Tim Kelsey, NHS England; Andrea Sutcliffe, Care Quality Commission; Mike Pringle, Royal College of GPs; Kingsley Manning, HSCIC. Information and registration. Hat tip to reader Louise Sinclair. If there are TTA readers planning to attend, we are once again inviting you to contribute an article or a compilation of impressions. This can be filed within 72 hours of the close of event; alternatively, during or at day’s end/start. If you are interested, please email EIC Donna here (donna.cusano@telecareaware.com). It is expected that you can be selective and interesting rather than comprehensive. You will be credited of course but expenses and article will not be covered. 

 

Advanced haptics advancing behavioral mHealth

January 23, 2014 | by

Haptics is the feedback you receive through a sense of touch–think of the slight vibration you receive on a mobile touchscreen when you touch a ‘button’. Marry haptics to behavioral health and remote monitoring, and you have some interesting devices from MIT’s Touch Lab (formally the Laboratory for Human and Machine Haptics) which have reached clinical testing stage. The four are Touch Me, Squeeze Me, Hurt Me, and Cool Me Down. Touch Me is an array of sensors that vibrate at the caregiver’s remote command to simulate touch. The related Squeeze Me is a vest that inflates, also remotely controlled, to simulate holding, similar to the T.Ware T-Jacket vest [TTA 22 Mar]. Both are for autistic children or those with sensory processing disorders. The touch is to calm and reassure them. Hurt Me is not for the local “dungeon” or Client #9–it’s to assist in the therapy of those who deliberately harm themselves such as ‘cutters’ by simulating the feeling of being bitten on the arm. The pins against the skin deliver controlled pain without breaking the skin. (more…)

HealthSpot Station kiosks add telepharmacy

January 23, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/booth-with_new_attendant.jpg” thumb_width=”180″ /]’Virtual consult’/staffed kiosk HealthSpot Station [TTA 29 Oct], most recently adding behavioral health EHR Netsmart and telemedicine provider Teladoc [TTA 5 Sept], as well as several health system providers, is expanding into telepharmacy through a strategic alliance with Canada-based MedAvail. MedAvail’s kiosks fill prescriptions in clinics, hospitals and office locations, including live assistance from a pharmacist, though the website video doesn’t explain how drugs not in stock in the kiosk are handled. What’s notable? Large kiosks are moving towards full-scope onsite clinics. HealthSpot in its three years of existence has quietly accumulated over $15 million in funding, $10 million in 2013 alone–a fact that is not included in Rock Health’s Digital Health 2013 report, unless this Editor overlooked it. Is this not digital health delivered? Correct me if I’m wrong. HealthSpot/MedAvail press release. Also see Editor Charles’ post on ‘The Future of Doctors’ below for more on this trend and its consequences.

The future of doctors

January 23, 2014 | by

The Economist this week has an important leader and report on the future of work that has key implications for technology adoption by clinicians.  It is well worth reading in full. For those who cannot, the very basic issue raised is that technology is again replacing labour with capital. In the past this has always resulted in higher value jobs being created. This time though, there are many suggesting that it might just be different: some people will run out of road.

The Economist article does not go into the detail of many individual professions, however the description of the types of work most suited to this next wave of automation does cover much of the field of medicine (as, coincidentally I argued recently in my predictions for 2014). A particularly relevant section in the article is:

The machines are not just cleverer, they also have access to far more data. The combination of big data and smart machines will take over some occupations wholesale;

…which supports my contention:

And just think too, what correlations a single system overseeing the treatment of tens of thousands of people, with access to regular vital signs and other information on progress for each one of them, might be able to spot to enable it to improve patient care, that elude the best of GPs treating far fewer. Doubtless increasing genomic analysis & knowledge will enhance this too. –

So how should doctors react? Clearly one view, which seems still to be the minority approach (and that Telehealth & Telecare Aware is really all about trying to encourage) is to use existing technology, like telehealth and mHealth, to improve healthcare and reduce its cost. Automation is expensive so investors will look for those professions where the expected returns are highest; with this approach, the greatest benefits from automation will lie in other professions, so the greatest impact of automation on the medical profession will be delayed.

The alternative, which still seems to be the majority view, is to argue for the continuation of current practice and ignore the benefits of technology (and ignore the evidence that demographic changes will mean that the ratio of careworkers to those requiring care will render the current system infeasible anyway). That way will keep the cost of care relatively high and promote a crisis in the delivery of healthcare relatively soon, making early profound medical automation particularly attractive.

Of the two, from a patient point of view, earlier rapid automation looks superficially attractive although the chaos of rapid change will likely create many challenges that make it less attractive – let’s hope that the leaders in the medical profession, and those who appoint them, read the Economist this week and recognise the benefits to them (as well as to patients) of early technology adoption.

Rock Health opens new HQ to wonder, sums up 2013

January 23, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/RockHealth_Photo©BruceDamonte_02.jpg” thumb_width=”175″ /]As seems to be the way in the West Coast Digital Health scene, the opening of accelerator/funder Rock Health’s new HQ in the Mission Bay district of San Francisco gained more heavy-breathing hype than its mostly positive 2013 digital health investment report. The soireé during last week’s JP Morgan Healthcare Conference, glowingly reported in Xconomy with plenty of pics of the achingly trendy interior design and Health Digerati/D3Hers (Digital Health Hypester/Hipster Horde) at play also was a demo of a different type–how insular interests interlock and circle in Fog City. Star guest San Francisco Mayor Ed Lee spearheaded the remaking of the district into a life sciences/tech center; the Xconomy-moderated panel discussion paired him with Rock Health founder/CEO Halle Tecco and Alexandria Real Estate CEO Joel Marcus;  Alexandria underwrites Xconomy and has a huge investment in life sciences real estate; the new Rock Health HQ is on the ground floor of an Alexandria-owned building. Of course Mission Bay is now hyped as the ‘US Digital Health Hub’ for all those Rock Health-accelerated, funded startups. It does give one pause: how much of this is substance, or is it the peak of style before tipping into The Trough of Disillusionment? The tartest takedown on this is courtesy of Neil Versel’s Meaningful HIT News column. Pointed pokes abound: at Silicon Valley for its health tech failures (Google Health among them), the odd duplications (Google-funded telemedicine provider Doctor On Demand sounds like American Well, Ameridoc, etc.) and the even odder lack of considering integration with payer/provider systems and workflows.  Keep wasting your money, Silicon Valley venture capitalists (Note to Neil: the circular swings seem to be a feature of Alexandria’s properties–they’re present at Alexandria Center NYC too. Image © Bruce Damonte/Studios Architecture)

With that aside, the highlights of the Rock Health Digital Health Funding Year In Review were generally positive, but some of them, looked at critically, weren’t, even when depicted in attractive charts and graphs: (more…)

Certifying medical apps (contd.)

January 21, 2014 | by

No sooner had I given my keyboard the final tap to publish the conclusions of my work yesterday on medical apps than the first item hit my inbox that suggest that certification is a flawed proposition.

The suggestion of this iMedicalApps article is that the Happtique saga has shown certification to be impossible. Instead it is suggested that people make up their own minds based on peer review on sites (you’ve guessed it) such as theirs, and a greater understanding of apps.  The key paragraph for me is (more…)

Net neutrality’s end and effect on telehealth (US)

January 21, 2014 | by

With its recent decision in ending ‘net neutrality’ as directed in the FCC‘s 2010 Open Internet Order, the (Washington) DC Circuit Court of Appeals has changed the playing field for mHealth. The FCC regulation treated internet service providers (ISPs) like telecommunications companies by enforcing telecom ‘common carriage’ requirements that prevented ISPs from blocking or discriminating against types or providers of internet traffic. The current situation is now a double-edged sword for the ISPs: on one edge, ISPs such as Verizon, Comcast or Charter won, because they now can charge fees to, slow down or demand revenue sharing of high-demand content originators (Netflix) which also use a lot of bandwidth; the other edge is that the court affirmed that the FCC regulates the relationship between the two.

The meaning for mHealth? The amount of health data carried over the internet is growing exponentially and dependent on speed. If internet carriage can be held up for small providers to make way for high-paying content, it can and will change the revenue model for mHealth. From clinicians to fitness buffs, everyone wants their data right now. It may impact lower-income people and home health which uses internet tracking for healthcare. But it may also have a stimulative effect on ISPs–more bandwidth and speed means more revenue. How does this compare to UK/Europe/Asia/Oceania regulation? What do you see as the outcome?

More here: mHealth after net neutrality: Innovation drain or gain? (GovernmentHealthIT); Three Dangers of Losing Net Neutrality That Nobody’s Talking About (Wired), Net Neutrality is Dead! Long Live Net Neutrality! (Wall Street Journal)  And an advocate of Congress getting involved (!) is Greg Slabodkin in FierceMobileHealthcare. Hat tip to Editor Charles Lowe for pointing out the potential effect on mHealth.