Due diligence: the importance of the internal IP audit

November 4, 2013 | by

This is the fourth article of an occasional series on law and intellectual property (IP) as it affects software and systems used in health technology. The topic is the importance on implementing your own audit of your company’s IP and why you should enlist an outside company to do it. More than a list of your copyrights and patents, an independently conducted internal audit will prepare your company for the external due diligence expected when a bank wants to vet a loan or an investor knocks on the door–and it includes things like your website and IT. While Mr. Grossman is writing in the context of US law, our UK and international readers will find his pointers applicable both locally and in dealing with the US. What’s refreshing is his plain writing and lack of ‘legalese’. 

Mark Grossman, JD, has nearly 30 years’ experience in business law and began focusing his practice on technology over 20 years ago. He is an attorney with Tannenbaum Helpern Syracuse & Hirschtritt in New York City and has for ten years been listed in Best Lawyers in America. Mr. Grossman has been Special Counsel for the X-Prize Foundation and SME (subject matter expert) for Florida’s Internet Task Force. More information on Mr. Grossman here and at his blog.

INTELLECTUAL PROPERTY DUE DILIGENCE

Intellectual property may be among the most valuable assets your company owns. The problem with intellectual property (IP) is that by its nature its intangible. You can’t touch it or see it. So how do you know what you have and own?

The starting point is to look to any registrations you may have with the government. For example, you may have registered a copyright or trademark and have paperwork to prove it. However, the registrations are just the starting point. It turns out that getting a handle on your company’s IP assets can be a complex process.  (more…)

Changes at the top at Tunstall

November 3, 2013 | by

EXCLUSIVE

A reliable and informed source has told this Editor (1 Nov) that Gil Baldwin, Group CEO of Tunstall Healthcare Group Ltd. will be stepping down, to be replaced by Paul Stobart, the former CEO of CPPGroup plc. Mr. Baldwin joined Tunstall in March 2010 from major insurer Aviva, where he headed Aviva Health. Prior to CPP, Mr. Stobart held various positions over 15 years at global enterprise software giant Sage Group, concluding as their CEO for Northern Europe.

Charterhouse Capital Partners acquired Tunstall in 2008, with former owner Bridgepoint Capital retaining a minority share. However, a sale/VC exit has long been rumored. The company recently received some unflattering attention on its (fully legal) usage of the Quoted Eurobond Exemption in The Independent [TTA 25 Oct].

This Editor notes that Mr. Stobart became CPPGroup’s CEO to manage the fallout after it was revealed in March 2011 that the FSA (Financial Services Authority) was investigating the company for mis-selling their bank card protection and identity theft products. After two years of struggle and a record £10.5 million FSA fine, four major banks dramatically rescued the company in July with an eleventh-hour £38 million refinancing, but the consequence of restructuring was that Mr. Stobart and the CFO both stepped down in August. [Guardian, Sky News via Orange, CreditToday] This was certainly a trial by fire. It should also be noted that to this Editor’s knowledge, Mr. Stobart has no specific healthcare, telecare/telehealth or health insurance experience, which is unusual for a position of this type.

Update 4 November: Tunstall’s release at 2:20 PM UK time, making this official. Our source indicates that Mr. Stobart’s start date is today (Monday) and it transpired quickly with business staff only being notified internally last Wednesday, which makes this an exceedingly quick change.

Free Medical Apps Event

November 3, 2013 | by

For the past few weeks I have been commissioned by the i3i project, part of the dallas programme, to examine what is necessary to improve clinical and patient confidence in the efficacy of medical apps.  I will shortly publicise my initial draft recommendations to seek reader feedback.

In the meantime, readers might be interested in a free event (more…)

Brief report on the European Telemedicine Conference, Edinburgh 29-30 October 2013

November 1, 2013 | by

The European Telemedicine Conference held in Edinburgh’s historic Assembly Rooms this week exceeded my expectations in many ways.

A vital requirement of all such events is good networking, which Edinburgh promoted most effectively. There was plenty of break time and lots of opportunity to see and meet people. There was a goodly number of stands too, where like-minded people could coalesce. For some there were personalised itineraries that helped as well. Then on the second day, a very deliberate effort was made (more…)

Dick Cheney’s defibrillator and medical device hacking

November 1, 2013 | by

The news this week that former US Vice President Dick Cheney and his cardiologist decided to turn off wireless access to his implanted defibrillator (ICD) in 2007 based on fears of radio-based attacks underlines the increased awareness of security threats to wireless interfacing or programmable devices. The fear of ‘death by malicious hacking’ could very well lessen the sales and acceptance of new wireless-dependent designs in pacemakers, diabetes management/artificial pancreas and even medication ingestion tracking (Proteus). One proposal outlined in medical device supplier blog Qmed is interesting: “Since most proposed attacks would take place from a distance, researchers believe that using a patient’s heartbeat signature as a password could offer an adequate level of security. Using a heartbeat signature password, pacemakers and other devices would only unlock when “fed back” an individual’s heartbeat in real time.”  Yet beyond that, an advanced ‘white hat’ hacker like the late Barnaby Jack envisioned bugs in programming which could negate this to create murdering pacemakers as well as killer insulin pumps. (A look back at Barnaby and his still mysterious death in the Daily Mail) Dick Cheney: Heart implant attack was credible (BBC News) Hat tip to TANN Ireland’s Toni Bunting. Previously in TTA: A ‘mobilized’ artificial pancreas breakthrough included the increased awareness of hack attacks in the medical mainstream and Contributing Editor Charles on compromised smartphone apps.

A real, beneficial, current use for 3D printing in medicine (Belgium)

October 31, 2013 | by

Following our recent Blue Blazes award, along now comes a practical use for 3D printing, to help surgeons reduce theatre time, which both reduces health risk when areas such as the brain are exposed and reduces theatre costs which apparently in round numbers are some $100/minute.   This interesting item from On 3D Printing explains how by making an exact model of a patient’s bone structure, surgeons can prepare beforehand precisely-shaped metal bone inserts that will fit perfectly, so avoiding time-consuming metal shaping when the patient is in theatre.

Patient groups most likely to use mobile phones for health: study

October 30, 2013 | by | 4 Comments

A new Manhattan Research study, which starts off rather pedestrian, contains a surprise. The trend of increased used of smartphones for health is not it, as it follows online use: 95 million Americans now use their mobile phones for health information or tools, up 27 percent from 75 million a year ago, and the Cybercitizen Health US 2013 study of over 8,600 Americans found that 38 percent of online smartphone users consider it “essential”. What sets the study apart from the usual enumeration and semi-puffery is the discovery of which patient groups find smartphones most useful and are most likely to use their phones for health reasons. It is closely linked to medical chronic conditions, but not the ones you think. (more…)

Wellocracy launched to explain fitness tracking, apps

October 30, 2013 | by

Partners HealthCare’s Center for Connected Health has launched Wellocracy, to explain to consumers how you can get the most out of their fitness trackers, health apps and related devices. It won’t be a ‘Consumer Reports’ of devices or apps (though provides a comparison chart), ‘curate’ them as the now seemingly dormant Happtique once intended to do or screech at you on your ‘issues’ as Cigna’s Go You does, but offers sensible advice on how to get the most out of the kit you just bought and the information it provides. Also it addresses the ‘stickiness factor’–staying with a regimen–connects to outside news and adds a large dollop of social engagement with sharing ‘The New Fit Revolution.’ Coincidentally, The Center’s Joseph Kvedar, M.D. just co-authored a book, Wellocracy: Move to a Great Body, with Carol Colman and Justin Mager, MD. Release includes a useful Harris Interactive survey that indicates that fitness and sleep tracking are seen favorably and perceived as valuable but is still large on potential, short on customers.

Luxe workchair becomes telehealth chair

October 30, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/10/Sharp_Telehealth_Chair.jpg” thumb_width=”175″ /]Sit down, relax and let Sharp Electronics‘ Health Care Support Chair do the telehealth work. It will, once you arrange yourself comfortably on the proper sensors, take your body temperature, heart rate, weight, and blood pressure, and put it up there on the big three-part screen to tell you if you’ve been good or bad. The cloud service behind it presumably will store and analyze your information, then send to your doctor if you choose.

Here’s the ‘wow’ view from the chair.[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/10/sharp-health-chair-6.jpg” thumb_width=”175″ /] Telepresence Options noted that Ubergizmo tracked down the chair to the super-luxe MWE Labs‘ Emperor 1510 workstation–an interesting repurposing which demonstrates that health sensors can be incorporated into furniture. It was unveiled at the September CEATEC Japan show and is perhaps designed to address the needs of the rapidly aging but affluent populations of Japan, Taiwan and South Korea who do not want to mess with mobile devices or apps. Also SlashGear.

Fashion? Can wearables simply…work?

October 30, 2013 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]Apple’s hiring of Burberry’s CEO Angela Ahrendts as Senior Vice President of Retail and Online Stores to start in spring 2014 may well be indicative of the importance that Apple is putting on 1) smartwatches (she was honcho of a Burberry watch intro) and 2) wearables (she refreshed and upscaled an iconic brand from stores to merchandise). Chris Matyszczyk in Cnet points out that she is the second hire from the fashion industry (the other’s from YSL). On one hand this seems to reinforce that Apple’s strong suit is design; on the other hand it implies that their retail and online stores need to evolve after some recent missteps–and that they may not feel as confident as in the past of their internal capabilities. However this all seems too haute for the simple everyday buyer who wants stuff that helps you live your life better and more conveniently, and who may find it much easier to go to Verizon or Vodaphone for their mobile needs and that Jawbone UP band to wear. And where are the other wearables, say in a Burberry scarf? The Gimlet Eye is blinking in impatience, and it had better be elegant, or Gloria and Babe’s ghosts will be haunting Cupertino. [TTA 25 Oct]  Apple and the emperor’s new wearable tech (Cnet) Hat tip to TANN Ireland Editor Toni Bunting; New Apple Retail Chief Hired Over Summer, Apple to Hire Burberry CEO (MacRumors).

Much ado about Airo

October 30, 2013 | by

A flurry of publicity has descended like early snow in the Rockies promoting the AIRO fitness band. Developed by three graduates of Canada’s University of Waterloo, it is building pre-delivery excitement (and pre-orders) around the band’s claimed unique capability to analyze post-eating effects and make recommendations. A mini-spectrometer built into the band uses light wavelengths to look into a person’s blood stream and detect the metabolites released during and after eating. Their program then analyzes the information and makes nutritional recommendations on your smartphone without any separate input of foods or calories. As far as this Editor knows, this is a first, along with using heart rate and caloric burn to measure exercise intensity and recovery. The ‘only health tracker you’ll ever need’ cuff also measures and reports on stress and sleep. The company is taking pre-orders at $149 in advance of the full DTC price of $200 (not sure if in Canadian or US dollars), but according to the FAQs delivery will not be until Fall 2014. For iPhones and Android.

Could Fitbit and Jawbone Up be getting the treatment they meted out to Zeo within a year? Will the spectrometer and blood analysis mean that the device will need FDA and Health Canada clearance? Inquiring minds want to know. Website, video, Business Insider article, CBS-TV Cleveland. (Editor Donna note that the pre-sale over a year in advance is essentially a crowdfunding strategy, but standalone it feels ‘take the money and run’ dodgy.)  Hat tip to reader Lois Drapin of The Drapin Group, New York.

Update 31 October: The somewhat sketchy credibility of this device has increased exponentially, in this Editor’s opinion, since the revelation that there is not a working prototype (due in December, according to the founder) and the spectrometer’s capability and accuracy of detecting blood metabolites non-invasively at the wrist may resemble junk science (MedCityNews). Brian Dolan concludes that as of this point, Airo cannot be what it’s cracked up to be in Mobihealthnews.

In smartwatch 2014 deluge news, Google is also nearing its smartwatch launch within months, according to The Wall Street Journal. The watch will incorporate the Google Now personal assistant.

Healthcare.gov’s broken UX guidelines

October 29, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/10/now-panic-and-freak-out.jpg” thumb_width=”150″ /]Given the broken Healthcare.gov website, perhaps a silver lining lesson some of us can take from it, as we (in the US) wait and wonder, is what user experience (UX) usability guidelines it broke. From UX research/consultancy Nielsen Norman group is a ‘count the ways’ to ten. (A difference–the pictures of real people have been removed and replaced with cartoons, with wags bemoaning the loss of the anonymous ‘Obamacare girl’ on the home page, not depicted here.) The contention here is that the account setup is unnecessarily complex and may be contributing to the backend technology failure. HealthCare.gov’s Account Setup: 10 Broken Usability Guidelines  Hat tip to former EIC Steve Hards. (more…)

UCLA telemedicine platform connecting Army medicine and wounded warriors

October 29, 2013 | by

In a joint program instituted by UCLA Health, Brooke Army Medical Center (AMC), a burn and rehab hospital in San Antonio and the Veterans Administration Greater Los Angeles Healthcare System over the past six years, wounded soldiers undergoing major facial or burn reconstruction at UCLA have had access to telemedicine consults between UCLA and Brooke AMC. This is now being expanded to include other major reconstructions, such as orthopedic reconstruction for severely damaged limbs, urologic treatment, otolaryngological care, examination and treatment of reproductive issues, repair of airways and design of new prosthetic ears. In including Fort Irwin in the Mojave Desert, the program is now including TBI and PTSD.  FierceHealthIT on Operation Mend.

Can telehealth kiosks fill the treatment gap?

October 29, 2013 | by | 1 Comment

Telemedicine’s virtual doctor-patient consults have usually been positioned as computer (and now tablet/smartphone over Wi-Fi–American Well’s announcement earlier this month) driven. Kiosks provide an alternate model for a more detailed visit. The relatively new HealthSpot Station has secured a CMS Healthcare Innovation grant of $12.7 million to place kiosks in partnership with three Cleveland, Ohio hospital systems, including University Hospital and for Cuyahoga County employees through a partnership with MetroHealth. One of the UH kiosks is at the Friendly Inn Settlement House, a social services provider in a high-poverty neighborhood on the east side of Cleveland; visits are free for the next three months for kids between 3-18 (accompanied by a parent). (more…)

A highlight from ATA 2013 Fall Meeting: Psychiatric appointments as a ‘data-file’

October 29, 2013 | by

In a conversation at a recent Health 2.0 NYC event, this Editor asked Doug Naegele what was the most surprising topic at the recent American Telemedicine Association conference in Toronto. Doug has graciously contributed this short article. He is the founder of Infield Health, a firm dedicated to increasing health outcomes and reducing total cost of care by putting discharge instructions on mobile phones. 

At the ATA Fall Meeting in Toronto last month, Dr. Peter Yellowlees gave a presentation on his work at University of California-Davis around telepsychiatry. I was struck by a few of his discussion points:

1. It may be helpful to see psychiatric consults as ‘data files’ and not events that require mandatory real-time evaluation.
2. If we accept that these consults can be described as data files, then they can be forwarded to remote psychiatrists for viewing, evaluation, and treatment recommendations much in the same way radiological scans are remotely evaluated. (more…)

Is this Tunstall’s ‘taxgate’? Maybe not.

October 25, 2013 | by | 2 Comments
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/10/taxman_logo.jpg” thumb_width=”170″ /]On Monday, The Independent, one of the UK’s major national papers, turned its attention in a ‘Tax Special Investigation’ to nine healthcare companies which are using a corporation tax reducing scheme, the ‘Quoted Eurobond Exemption’, where they pay loan interest at high rates to their parent companies through a mechanism via the Channel Islands Stock Exchange, rather than their owners further investing by taking additional equity. (How it works–infographic from The Independent)

One of the companies the article focused on was Tunstall and its owners Charterhouse and Bridgepoint. Tunstall’s profits–like the other healthcare companies profiled, Partnerships In Care, Independent Clinical Services, Priory Group, Acorn Care, Lifeways, Healthcare At Home, Spire Healthcare and Care UK–come largely from the public sector and, by using this means to pay less tax, less money is recycled back to the Treasury. The article estimates the amount for each company which would have been paid had this tax exemption not been in place. This Editor notes that a number of the companies profiled have had significant inspection problems and numerous complaints–Tunstall is not one of them, but it is the second largest ‘tax avoider’ (after Spire) listed.

There seem to be three ways to regard this:
1) it’s a commendably clever contrivance
2) it’s a suspiciously shady stratagem
3) it’s a non-story because it is something imposed on Tunstall by its owners

Whatever it may be, we are left wondering if Tunstall’s customers benefit in any way from this tax saving. We will be interested in our readers’ views.

Independent article: Tax Special Investigation: Firms running NHS care services avoiding millions in tax It is equally popular with well known high street (US=Main Street) retailers and restaurant chains: Eurobonds scandal: The high street giants avoiding millions in tax    (more…)