‘Green Houses’: a better model for senior living (US)

July 30, 2013 | by

“Let’s abolish the nursing home”–Dr. Bill Thomas

In the US, the ‘Green House Project’ model has made tremendous progress in developing homes for older adults as an alternative to nursing homes. A ‘design for living’ for 10-12 residents, a Green House is a home-like model built from the ground up with private rooms, bathrooms and community living. Currently 260 homes are open or under development across 32 states. From their website, the intent is for “Those who live in, work in, and care about a Green House [home] share the duty to foster the emergence of late-life development within the daily life they create together.” The care ratio is also much higher; care teams are organized on self-managed work teams to care for the mostly high acuity residents (including dementia). Yet costs, according to NPR, are about the same as the median for nursing homes nationally (many residents are on Medicaid) and in quality of life, it respects residents habits, privacy with the outcome that it supports residents longer in a level of independence.

The Green House concept came from the work of Bill Thomas MD, a geriatrician who also developed the Eden Alternative and frequently writes on ChangingAging.org. The news is the backing of the Green House Project by the prestigious and well-funded Robert Wood Johnson Foundation and NCB Capital Partners. The Project provides the model and guidance to independent organizations for organization, implementation and certification of these homes. MedCityNews was wowed by it (Wall Street Journal link does not work, however). See the video from RWJF on what they saw as ‘a catalyst for significant social change’.  Green House Project website   RWJF page on their support of this ‘force multiplier’.

What if you added non-intrusive health tech to these homes? The opportunities could be as varied as the ELSI Smart Floors and alert system for safety (Charles)…fitness bracelets/wearables to monitor basic vitals and ADL/activity (Jawbone, Misfit, AFrame)…biosensor ‘tattoos’ (Toni). Tablet/PC based socialization/brain stimulation (GeriJoy, GrandCare, It’s Never 2 Late). Could this humane environment move to a higher level with a touch of tech?

[This video is no longer available on this site but may be findable via an internet search]

Telecare LIN July newsletter is out

July 29, 2013 | by

The July Telecare LIN newsletter has been published and is available for download here. This month Mike has two short items on the Kings Fund congress earlier in the month and the transfer of 3ML from DH to NHS England plus the usual monthly round up of news with the top item being O2’s pull out from telecare and telehealth.

Biosensor tattoo helps avoid extreme fatigue in athletes

July 29, 2013 | by | 1 Comment
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/07/biosensor-tattoo.jpg” thumb_width=”150″ /]A new biosensor, worn on the skin like a temporary tattoo, provides an early warning to athletes that energy stores in their muscles are running low. The device works by measuring lactate levels in sweat, which allows athletes to evaluate their workouts and adjust the level of intensity.

Reported in the current issue of Analytical Chemistry (subscription required), tests on 10 human volunteers have shown that the sensor can continuously measure real-time lactate levels in sweat during exercise. This method of monitoring has clear benefits, as lactate is usually measured using blood samples which are not only invasive but also require frequent breaks in a workout session to collect.

Research on the biosensor tattoo began in the Laboratory for Nanobioelectronics at the University of California, San Diego (UCSD) – see previous TTA item ‘A tattoo sensor to delight or scare kiddies’ covered by TTA’s Editor In Chief, Donna Cusano. Since then the venture has expanded into a commercial company, Electrozyme, which hopes to begin offering the technology to consumers by 2015.

As UCSD nanoengineer Joseph Wang explained in this LA Times article, scientists could also adapt the sensor technology to measure other physiological indicators, such as glucose levels for diabetes and cortisol levels for stress.  Or as Donna Cusano noted in her previous TTA item, “…there’s great potential for this not only in sports, but also in assisted living and rehabs where one of the most serious conditions is gradual, invisible dehydration of residents.”

This development has got quite a bit of coverage and you can read more at Mashable, The Engineer, MobiHealthNews, New Scientist and the Los Angeles Times.

Alpha version of Open Health Data Platform produces impressive data analysis graphics (UK)

July 29, 2013 | by

The alpha version of the CDEC Open Health Data Platform offers a tantalising glimpse into what big data can do to improve healthcare. This site uses data from sources like the Health and Social Care Information Centre (HSCIC) and shows how it can be turned into visualisations and analysis to answer specific health-related questions.

The initial release, which focuses on a small number of datasets including data about GP prescriptions and diabetes prevalence to show the extent of diabetes treatment in the UK, is a request for comment from the UK  innovator community. Specifically sought are views on functionality to include and the future data sets to incorporate.

The outline business case for developing the tool suggests potentially many profitable opportunities particularly for micro-enterprises and SMEs.

An extremely exciting venture, much to be encouraged.

Apple’s ‘tarnished luster’, Round 2

July 29, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/07/headeriwatchfinal.jpg” thumb_width=”200″ /]Today’s disclosure provides Apple-ologists with a major ‘what does this mean’ field day. The exec on the right no longer is on the executive team of the man on the left. On the right, Bob Mansfield, former SVP Technologies; on the left, CEO Tim Cook. AllThingsD last night (US Pacific Time) reported and confirmed that the early Sunday removal of Mr. Mansfield from the website, uncovered by the appropriately named MacRumors, meant precisely that. The ‘special projects’ assignment is usually a face-saver until the contract runs out.

We’ve gleaned some trouble in AppleLand on the odd reiteration of their eHealthy moves but slow progress on the iWatch [TTA 20 July]. It turns out that Mr. Mansfield had already announced his retirement from Apple in last year, but after some internal controversy was persuaded to return in October 2012 with a major title and compensation as head of Technologies until 2014. In this Editor’s experience, these lurebacks never turn out well even when beaucoup bucks are in the mix. We will leave it to the Apple-ologists to figure out the permutations and emanations.

Related: Will this add to the tarnish on the former Appleshine as Dave Logan had it just last week? [TTA 26 July]

Photo credit: 9to5Mac

Nurses using social media for health tech collaboration

July 29, 2013 | by

Interesting article and longish (26:04) video on how nurses are using Google Hangout for collaboration, especially on using technology as part of their practice and getting involved in tech development. The four onscreen are located in Canada, Australia and Hawaii. The author is herself an RN and health care advisor for the US Strategic Perspective Institute, a think tank whose main job is advocating ‘saving jobs’, a Sisyphean task if there ever was one. (Don’t bother to look at the healthcare blog–the last entry there was 2010.)  This is from ZDNet. Nurses use Google Hangouts to collaborate on technology

Internet training for older people vs works-out-of-the-box mobiles

July 29, 2013 | by | 8 Comments

Echoing last week’s “the world has moved on” post on the WSD, the 3G Doctor (David Doherty) has an excellent opinion piece on how AGE UK should spend the money given to it by Google for making it to the final six in the Global Impact Challenge that supports British non-profits using technology to tackle tough problems.

In discussing Age UK’s current plans to use the money to teach older people about the internet he says: “For the £500,000 AGE UK would spend on training 16,000 seniors they could give away (at retail price!) 10,000 of the latest designed for senior 3G CameraPhones from Doro. Works straight out of the box. No training required.”

Elsewhere on his site he has an interesting take too on the reasons behind O2’s announcement last week.

Smart flooring that can simplify alerting

July 28, 2013 | by | 2 Comments

The ELSI Smart Floor underfloor sensing laminate is a thin laminated copper based sensor that offers some potentially very valuable benefits. According to the website, the capacitative sensing technology can be used to trigger alerts created by patient movements. Examples given are:

  • Falling/slumping on the floor
  • Getting out of bed
  • Triggering lighting when getting out of bed
  • Going to the toilet
  • Leaving the room at night time
  • Staying anywhere where someone shouldn’t stay for any length of time such as the toilet, or on a balcony in wintertime

There’s no indication of price or the difficulty of installation; one presumes it would be best suited for hospitals and residential care establishments as a permanent installation.  There’s also no indication of sensitivity and the danger of false alerts – it’s clearly got to be pretty sensitive to pickup changes in the capacitance of a floor so false alerts is a topic I’d want to explore before making an investment.

That said, it looks to be a very exciting development, that does not require users to wear devices, cannot be fiddled with or switched off by users and, sadly equally important, cannot easily be tampered with by cleaning staff or require regular replacement (as opposed for example to bed sensors).

There would also seem to be the benefit that the output could be used for ADL (activities of daily living) monitoring too (though there is no mention of equipment that this Finnish company provides that could do that).

Clearly this will potentially have other applications in addition to monitoring frail people – the website, under ‘ongoing developments’ also mentions:

  • gaming solutions
  • elevator systems
  • pedestrian counting systems
  • energy optimisation systems
  • prisons
  • intruder and flood detection systems.

This seems a most exciting addition to the array of sensors available, particularly because it requires nothing to be worn and cannot easily be disabled or wear out.

Pondering the squandering of taxpayer money on IT projects (US)

July 27, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]The Gimlet Eye has been in Observation Mode this week. But this handful of Dust-In-Eye necessitates a Benny Goodman-style Ray on another US governmental ‘fail’. When it comes to IT, the government admits…

Agencies Have Spent Billions on Failed and Poorly Performing Investments

Exhibit #1: FierceHealthIT summarizes five big ones out of a 51-page Government Accountability Office (GAO) report focusing on the inefficiency of agency IT initiatives–just in healthcare.

  1. Veterans Affairs (VA) VistA EHR system transitioning to a new architecture: terminated October 2010 at a cost of $1.9 billion
  2. VA-Department of Defense (DOD) iEHR integration: as previously written about, it collapsed under its own weight for another $1 billion [TTA 8 March]

  3. DoD-VA’s Federal Health Care Center (FHCC). Opened in 2010 as a joint facility under a single authority line, but somehow none of the IT capabilities were up and running when the doors opened. ‘Jake, it’s ChiTown.’ Only $122 million.

  4. DoD’s own EHR, AHLTA (no VistA–that’s VA’s) still doesn’t work right; speed, usability and availability all problematic. A mere $2 billion over 13 years.
  5. VA’s outpatient system is 25 years old. Modernization failed after $127 million over 9 years before the plug was pulled in September 2009

You’ll need Iron Eyes to slog through the detail, but it is a remarkable and damning document. PDF (link)

but…there’s more. Excruciating, hair-hurting, and would be amusing if not so painfully, and expensively, inept. Malware Removal Gone Wild at Commerce… (more…)

A question for our readers: what does it take for health tech to cross borders well?

July 26, 2013 | by | 1 Comment

In considering the culture gap surrounding Telefónica’s stumble down the pit with O2–and other projects they had that didn’t cross borders well–this Editor thought it worthwhile to ask our readers, particularly our new ones, to kick off a conversation in Comments about this observation. There seem to be national barriers in health tech. Why?

What are the factors that enable health tech companies to cross borders and be successful?

This is not a comprehensive survey by any means, but in your Editor’s experience, it appears that most health tech innovation by smaller companies stays in the country of design. When it is purchased by a multi-national organization, cautiousness takes hold. Much of the liveliness of PERS market leader Lifeline has dimmed since Philips acquired it about 2008, (more…)

Apple’s tarnished luster predicted, interestingly

July 26, 2013 | by

At the point where doctors and their children use iPhones routinely, iPad is the elite tablet and Apple’s balance sheet is deep in cash, University of Southern California business professor and management consultant Dave Logan is warning that the magic is waning. He uses a bit of communication analysis called ‘wordmapping’ that he’s developed to parse the remarks of Apple’s management, notably CEO Tim Cook, and concludes that Apple is losing its way. There is no longer a revolutionary-in-residence imagining something from nothing…none on the horizon, either. Apple-ologists have been tap dancing around this for awhile, but the protracted development of the Apple smartwatch is pinging all sorts of alarms, despite the flurry of activity in and around health ‘n’ fitness [TTA 20 July] We’ve been to this movie before when Blackberry was a must-have and dubbed ‘Crackberry.’ A rather cheeky headline that’s made a few AppleFans upset. Why Apple is a dead company walking (CBS MoneyWatch)

Related: Want to try wordmapping for yourself as a tool for ‘instant rapport’? Mr. Logan dishes on the fascinating pointers here.

Qualcomm Life, Palomar Health pair up to check out Glass-wear

July 26, 2013 | by

The pairing up of Qualcomm Life and California health system Palomar Health in Glassomics is certainly a novel move. It’s termed an ‘incubator’ to explore wearable computing in medicine, but it is more like a test bed for the partners. Heading it are two recognized health tech honchos–Don Jones, VP of Qualcomm Life and Orlando Portale, Palomar’s Chief Innovation Officer. Innovation and development is not new for Palomar and Portale–they trialled AirStrip, Mr. Portale’s mobile platform for it (eventually sold to them), and were key in the three-year ramp-up of Sotera Wireless’ Visi Mobile patient vital sign monitor [TTA 23 Aug 12]. Much has been made of the Glass connection and testing its healthcare chops, but their mission is not limited to ‘glassware’ (and not for your weekend drinks party, either.) It’s also a home to test out Qualcomm’s 2net connection platform and Healthy Circles Care Orchestration tools and services. Glassomics website. Gigaom article

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/07/specs.jpg” thumb_width=”170″ /]And for your weekend drinks party, here’s a cooler, lighter and less geeky take on Glass: GlassUp. It reports incoming e-mails, text messages, tweets, Facebook updates and other messages. Italian design for Augmented Reality (the new cool term for the category) of course. Yours for $299-399 on crowdfunder Indiegogo, where they are less than halfway to their goal with 11 days left (better hustle!). The Indiegogo video here.

No more lying through your teeth?

July 26, 2013 | by | 3 Comments

A sensor embedded in your tooth could tell doctors if you have defied medical advice to give up smoking or to eat less!

Built into a tiny circuit board, the sensor includes an accelerometer that transmits data to a smartphone. So from each tell-tale jaw motion pattern, the software can work out how much chewing, teeth grinding, smoking, coughing, talking or (…okay I’ll stop there!) that you are doing.

The device can be fitted into dentures or a dental brace, and the team at the National Taiwan University in Taipei plan to miniaturise it further to fit into a cavity or crown. Results so far look promising, with the system having recognised ‘oral activities’ correctly 94 per cent of the time in tests to date. New Scientist and IEEE Spectrum have both covered the story.

It kind of takes ‘wearables’ into a whole new sphere! Don’t you think?

Pressure-sensitive electronic ‘skin’

July 26, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/07/skin-monitor-130513.jpg” thumb_width=”175″ /]A thin pressure sensor under development by a team at Stanford University has the potential to impact robotics, health tech devices, smartwatches and prosthetics. A transistor made of a flexible polymer semiconductor is actually more sensitive than skin, detecting temperature, pressure and humidity, and works even when curved. At a pulse point, it not only detected pulse but also “a second, weaker wave of blood being bounced back from the extremities, and a third wave that can provide a measurement of the stiffness of the artery. Stiff arteries can be a sign of damage from diabetes, or cholesterol buildup.” LiveScience. Published in Nature Communications in May and somehow winding up in the NY Post this week.

Related:

  • the TakkTile sensor developed at Harvard which is also centered on a digital barometer [TTA 23 April].
  • another pressure-sensitive thin skin from researchers Martin Kaltenbrunner and Takao Someya at the University of Tokyo, oddly attractive on its own. Engadget

The doctor’s dilemma: I hate my EHR, but is it worth the ‘rip and replace’? (US)

July 26, 2013 | by | 1 Comment
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/07/doctor_pulling_hair.jpg” thumb_width=”150″ /]Will this doctor be able to replace his hair? Confirming EHR misery for doctors, this article in Healthcare Technology Online gives more details on the Black Book Rankings’ 2013 State of the Ambulatory EHR Market report that we presented back in February when early findings were released. Out of their 17,000 users from solo practitioners to 100+ doctor practices, 31 percent of respondents were dissatisfied enough with their EHR to consider making a change with 18% seeking to change systems within the next year. Poor usability led the reasons why. But there’s 84 percent plus queasiness about vendor viability, reasonable when there are 600+ vendors and a number have already gone out of business leaving their practices stranded. The basics aren’t enough–must-haves are support for mobile devices (80 percent), data sharing and integration (83 percent)  and patient portal (58 percent). And it has to be Web-based/SaaS  based (70 percent). One detail: confirmation of the anecdotal ‘we jumped too fast to get the Meaningful Use money’.  #EHRbacklash, indeed.