Health tech growing in Brazil

August 15, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/Saude.jpg” thumb_width=”150″ /]We hear relatively little about health tech developments in Latin America–and in a region with huge healthcare needs and population at all income levels, it has great potential. EmpreenderSaúde (roughly ‘to undertake health’) is looking to change that with events (including Meetups, Twitter @EmpreenderSaude and a Facebook page) that present local healthcare entrepreneurs and help to educate them on both business and healthcare. This report on their 6 August meeting features diagnostic medicine company Grupo Fleury and Projeto Dom, an initiative supporting not-for profit healthcare organizations; Saútil, a online information site providing information on Brazil’s public healthcare system; healthy food company Natue; and Medicinia which is a secure website for physicians to follow-up with their patients. The face of the rising stars on the EmpreenderSaúde website

So 9 out of 10 people haven’t heard of ‘telehealth’…and your point is?

August 14, 2013 | by | 3 Comments

Apparently echoing the comments about health technology awareness made in our post last week about O2 (who are, by the way, to be congratulated for their parent company’s announcement today that they are preferred bidders for two of the three smart meter regions), the HSJ has reported the results of a YouGov poll that nine out of ten adults in the UK have never heard of telehealth.  Of those over 55, the age above which use of telehealth is more likely, 92% hadn’t heard of it. (Note that the HSJ article is behind a paywall, however via a Google search on “National Telehealth Forum”, the commissioner of the survey, you can currently go past it). The National Telehealth Forum press release is .  EHI also covers the story, .

So is this a matter of serious concern?  (more…)

The pill spot – Proteus’s first trial and FDA approval for the next generation PillCam (US)

August 14, 2013 | by

One of the greatest misconceptions I had when I first got involved in telecare was that the main reason that people don’t adhere to their medication regime is that they forget to take their medicine – therefore all they need is an automated pill dispenser or perhaps even an alerting system and all will be well.  If only it was so simple!

In reality there are all sorts of reasons, such as (more…)

Well someone thinks telehealth is good news!

August 12, 2013 | by | 2 Comments

Medtronic has just announced a $200m takeover of Cardiocom, the telehealth device maker.  If you can get through the paywall, the WSJ article is here (updated link not paywalled–Ed. Donna). FierceMedical quotes Medtronic as saying that “At-home monitoring is a proven method of reducing the rates of hospital readmission…and that translates to savings for payers, providers and governments.” First area of joint working is expected to be heart failure. Recent US regulations on Medicare, and increasingly insurance payers, penalize hospitals for 30-day same-cause repeat admissions. Medtronic press release.

Editor Donna: The announcement of Medtronic’s (#4 in worldwide revenue) acquisition of Cardiocom (both Minnesota-based companies) created quite a stir in the US as Medtronic is a ‘traditional medical device’ company best known for its implantables: cardiac shunts, stents, heart valves, pacemakers, insulin pumps and interestingly, a wide range of neurostimulators for different conditions. Now with the acquisition of Cardiocom, Medtronic moves into the post-implant/post-discharge/post-diagnosis chronic condition management continuum– not only into telehealth via Cardiocom’s devices and hubs, but also their clinical and care management systems. $200 million in cold cash is a fair bet even though Medtronic’s market cap is north of $55 billion. Medtronic has to see the opportunity to make a bottom line difference to providers and payers. It is also reacting to a narrowing in its profitable core market–medical devices are now taxed, there have been recent product defect-related ‘scandals’ tarring the industry, and there is pressure to reduce pricey device costs to fit a cost-constrained environment, driven by the new healthcare ‘scheme’ (in both the British and American English senses!) Forbes‘ David Shaywitz has a smart take on it today (though he won’t hold his breath for the pharmas to follow), as well as VC TripleTree’s Chris Hoffman ‘connecting the dots’ and coming up with what we’ve been talking about for some time–integration making sense. It is also most definitely a shot over the bow for major competitors such as Alere, Bosch and Philips plus a raft of smaller companies which have been working with a scattering of hospital discharge areas, integrated delivery systems, ACOs and home health agencies, looking nervously over their shoulder–and other leading medical device companies such as Stryker, BD, Baxter and yes….GE. (Bosch also sued Cardiocom on patent infringement this time last year [TTA 7 Aug 2012]; presumably as this suit was not announced as settled or decided, Bosch is now dealing with a company its own size!)

It also should be noted that Medtronic’s CEO, Omar Ishrak, is well acquainted with home health. Mr. Ishrak was formerly the CEO and president of GE Healthcare through mid-2011–and the driver behind making what was an ultimately failed bet in getting GEHC into home health. That was in 2008-9 with a tiny company called Living Independently Group, developer of a telecare system called QuietCare, which ultimately went to the Care Innovations JV with Intel. (Disclosure: I was head of marketing at the time of the acquisition.) Like GEHC, Medtronic is acquiring a closely-held company in a very different line of business with drivers quite unlike its own; they are retaining the former CEO as a general manager of the division but whether other management or the brand name will survive is not disclosed.

Whilst on the subject of telehealth devices, Heartwire reports a meta-analysis of 52 studies that shows that just measuring your blood pressure regularly results in a significant reduction in both systolic and diastolic levels after six months. Sadly the paper itself in the latest issue of the Annals of Internal Medicine is behind a paywall so it’s not possible to try to understand how the final comment in the synopsis of the paper on the Annals website that: “Additional support enhances the BP-lowering effect.” fits with the comment in Heartwire that “Low-strength” evidence from 13 studies comparing self-monitoring plus additional support vs self-monitoring alone “failed to support a difference” between the two strategies.”

Meanwhile back in the UK, Medvivo has become the first company to be accredited to the telehealth elements of the TSA’s Integrated Code of Practice. Sadly the TSA website will only release the Code to members (TTA isn’t one) or those aspiring to achieve accreditation (TTA fails on that one too) so it’s not possible to make meaningful comment. However the prospect of a Battle of the Codes is looking up with word from Malcolm Fisk that the final version of the European Code of Practice for Telehealth Services will be available for all to read and download on the TeleSCoPE website within a month. There has been talk of a third code being developed too…

ITALIA Project Launch Event (UK)

August 12, 2013 | by

18th September 2013, The Oculus, The Gateway, Gatehouse Road, Aylesbury   10am to 5pm

Unfortunately not a Ferrari in your driveway, the ITALIA (Innovative Telehealth and Assisted Living Ideas and Applications) Project initiated by Buckinghamshire New University’s institute, the Centre of Excellence for Telehealth and Assisted Living (CETAL),  is a public/private year-long initiative to develop the telehealth applications of the future. The kickoff event will bring together companies with products, ideas or technologies, clinicians and commissioners from organizations such as Buckinghamshire Business First (BBF) and Buckinghamshire Healthcare NHS Trust. More information here (PDF download) and Bucks New University News. Admittance is free but registration on Eventbrite is requested. Our Contributing Editor Charles Lowe is scheduled to be a speaker. Hat tip to reader Stephanie Carrington of BBF.

‘Wired for health’, making case for mHealth

August 12, 2013 | by

STSI (Scripps Translational Science Institute), directed by the famous Eric Topol, MD,  is undertaking a 200-person six-month research study to determine the results of telehealth monitoring for three conditions (diabetes, heart arrhythmia and high blood pressure) coupled with an active disease management program. Half of the survey group will receive a Withings Blood Pressure Monitor, an AliveCor Heart Monitor and an iBGStar Blood Glucose Meter delivered via Qualcomm Life’s 2net Hub and Platform to a web portal or mobile device; the remainder will not but will be part of the disease management program. Subjects will be drawn from Scripps Health employees and family, which to this Editor may be stacking the deck–most employees of a health system presumably are health-conscious.  Participants also include Scripps Health, HealthComp (third-party healthcare administrator which will monitor health status), Accenture and Sanofi Diabetes. Though the release promises ‘social networks’, the only reference this Editor could find is interactivity between the person and the health care team.  Scripps press release. MedCityNews  Hat tip to former QuietCare colleague José Molina (via LinkedIn)

Analysis of the Birmingham OwnHealth service – not the bad news it seems?

August 9, 2013 | by | 3 Comments

The BMJ has just published an open access paper entitled “Effect of telephone health coaching (Birmingham OwnHealth) on hospital use and associated costs: cohort study with matched controls” (BMJ2013;347:f4585, Steventon et Al).  It reaches the rather depressing headline conclusion that telephone coaching did not reduce unplanned hospitalisations and if anything increased them.

This looks to fly in the face of the apparently less academically rigorous recent claims by the Leicester City CCG and Totally Health, that they reduced hospitalisations significantly, saving some £353,000 over a 30 week period with a cohort of between 47 & 50 patients that we reported recently.

However reading on, perhaps a key passage, in the conclusion, is (more…)

O2 – a retrospective

August 8, 2013 | by | 2 Comments
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/O2.jpg” thumb_width=”100″ /]With 1734 hits (and counting) the Telecareaware post on O2 Health’s telecare & telehealth withdrawal and associated comments was one of our most popular. It therefore seems appropriate to try to crystallise some important lessons from all those brilliant comments, so here’s my starter – please feel free to add your thoughts. (Almost all the comments are related to the retail telecare offering so unless specifically stated otherwise, all the following relates only to this side.)

Overall there was a huge sense of sadness that came through from many comments – many had seen the move into retail sales a confirmation that telecare had finally arrived as a mainstream technology in the UK, so a withdrawal so soon afterwards caused much grief.  It was touching to see the concern for the staff too, who have worked so hard to get this venture airborne.

Although there were few comments specifically about the retail telecare kit, none were complimentary; it was seen as being single purpose, limited and hard to use. The ability to replicate the hardware functionality on a standard smartphone, (more…)

FDA publishes medical device interoperability standards (US)

August 8, 2013 | by | 1 Comment

While FDA is still dithering about issuing draft guidance on mHealth, it looks like medical device manufacturers can break out the champs, because FDA has now recognized 25 standards on medical device interoperability and cybersecurity. According to Bakul Patel of the Center for Devices and Radiological Health at FDA, “Making sure devices are interoperable requires the creation, validation, and recognition of standards that help manufacturers develop products that are harmonious and can “plug and play.” It’s an alphabet soup of industry standard abbreviations–IEEE, ANSI, AAMI, ISO, IEC and ASTM–and it’s purely voluntary, but various groups such as Continua and AAMI (Association for the Advancement of Medical Instrumentation) have praised this ‘first step’, and being published, it is now open for comment.

According to the Continua LinkedIn group announcement from Executive Director Chuck Parker, the 25 standards can be grouped into three categories:

  1. Risk management standards for a connected and networked environment
  2. Interoperability standards that establish nomenclature, frameworks and medical device specific communications and including system and software lifecycle processes
  3. Cyber security standards from the industrial control area most relevant to medical devices.

As the FierceHealthIT article cited, interoperability failure is a top 10 health technology hazard according to the ECRI Institute.  One can hope the new standards can be applied retroactively to current devices which are not being patched and updated because manufacturers fear running afoul of FDA clearance regulations and counter that ‘discouragement’. [TTA 8 Aug] AAMI News, Federal Register 6 August, FDA Voice (blog article by Bakul Patel)

The five-point digital health checkup meets the FBQs

August 8, 2013 | by

Checking up on some of the issues that the D3H crowd (Digital Health Hypester Horde) tends to skip merrily by, Dan Munro’s analysis hits several nails on the head and then some, with his points touching on our FBQs–the Five Big Questions*–we first outlined exactly three years ago (integration was added last year).

  1. Who has the rights to your data? You or only your doctor? (#3) And why not you?
  2. Need drastically improved standards of safety and security in devices. From those black hatted device hackers to the lack of updates by manufacturers and FDA‘s apparent discouragement–it may not be an an FBQ, but it impacts #5, data integration.
  3. Accuracy. Are these devices accurate or only ‘kinda’? How do you play off accuracy versus convenience?
  4. Privacy–what about it? Business models call for sale of ‘de-identified’ data which can be tracked back and re-identified. (#1) And what does your activity say about you-ooooo? (#3)
  5. The business model. Aside from who’s paying for the device and how much (#1, #2), #3 is still there–who’s looking at the data if you purchased the kit? And who’s liable for interpretation–and errors?

5 Point Digital Health Checkup (Forbes)

* 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. 

FDA’s discouraging role in medical device security

August 8, 2013 | by

According to a Wall Street Journal report (unfortunately firewalled), hospitals are pointing a very long finger at medical device manufacturers for not updating software and leaving devices open to breaches. Yet the manufacturers readily cite FDA’s most recent guidance as prohibiting software updates and security patches without resubmitting their devices for approval–something a spokesperson for the FDA denies as long as the update is for cybersecurity only. If the draft guidance issued in June is actually finalized, it will go the distance in helping manufacturers and hospitals. Hospitals Say Device Manufacturers Resist Boosting Cybersecurity (iHealthBeat)

Big data in healthcare’s Tower of Babel: interview with Eric Topol

August 8, 2013 | by

A short interview in iHealthBeat with Eric Topol, MD, Lydon Newmann of Impact Advisors and Lee Pierce from Intermountain Healthcare shows the bright side of business intel/’big data’. All that structured and unstructured data collected on individuals can be put to good use by data warehousing and analysis–a success story is Intermountain’s reduction of induced births from 30 percent to 5 percent. Yet the wins outlined are single system. Eric Topol agrees with this Editor that “The problem that exists is they lack any ability to transfer information from one to the next. There’s no interoperability. So we have a Tower of Babel.” Audio (and a dissenting comment) here, PDF transcript here.

Microsoft Kinect now as sign language translator

August 8, 2013 | by

The versatility of Microsoft Kinect continues to astound, with uses ranging from human rehab/physical therapy to equipping robots with anticipatory powers for your drink to Ellie the Virtual Analyst. Add sign language translation to this list. The latest is Chinese sign language simultaneous translation via Kinect that will permit deaf and hearing individuals to understand each other. Sign languages are their own entity with grammar and rules that make the spoken/written language nearly foreign to the user. The system developed by Chinese Academy of Sciences’ Institute of Computing Technology and Microsoft Research Asia joins the one developed for American Sign Language last year. Wired.co.uk  Hat tip to Toni Bunting, TTA and TANN Ireland.

Digital Health Days (Sweden)

August 8, 2013 | by

21-22 August 2013, Stockholmsmässan, Stockholm, Sweden

If you prefer to cool off from summer’s heat in Stockholm, the first annual Digital Health Days is “designed to provide the perfect mix of visionary expert panels, learning workshops and demonstrations of real solutions.” It is both a conference and exhibition–and looks to be diverse based on the program (in English). Speakers include Don Jones of Qualcomm, IBM hosting a presentation on Watson and certainly a different mix of companies. Events include a health hackathon and the Digital Health B2B meeting sponsored by the Stockholm Business Region Development; pre-organized one-to-one meetings bring together partners and investors for European companies. (Registration for this only is here and free).  Website, registration

23andMe advertising nationally in the US (sign of the times)

August 7, 2013 | by | 1 Comment

23andMe, the US personal genetics company, launched Portraits of  Health, the company’s first (US) television advertising campaign on 5th August.

Anyone unaware of the company and its ambitions could do worse than watch the excellent video of Anne Wojcicki’s presentation at a recent RSM innovations summit.

Whilst the NHS talks about building a 100,000 person genomic database, and the RCGP sees the most advanced medical development in the life of the average GP by 2022 will be remote delivery of test results, it seems that 23and Me is powering toward’s Anne’s goal of one million genomes sequenced.

It’s not a totally fair comparison of course as the NHS ambition is full sequencing, whereas, as she explains in the video, 23andMe focuses on what they consider the key areas; nevertheless it’s impressive stuff and an indication of just how quickly technology is changing healthcare.