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?
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’
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.
[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…)
700+ cybersquatters on Healthcare.gov, state exchanges
The Washington Examiner estimates that there are 700 or more ‘cyber-squatters’–the dodgy websites that have URLs close to a well-known name–on the Obamacare Healthcare.gov and the 14 state (plus District of Columbia) sites. Identity theft moves to a new and obvious level when it’s no hacking required. All thieves need to is to put up a legitimate-appearing website with the appropriate language and forms that ask for your name, address, income, date of birth and Social Security number, which is apparently what Obama-care.us does. “[Obama-care.us] is so well deceptively designed that I had to research the owner to verify that it wasn’t a government site,” said a retired cybersecurity industry expert.” According to the article, 3,000 people have visited it. What is normal for major sites is to ‘buy around’ the name in multiple domains, alternate search terms and even misspellings and using them to redirect. This is another standard business practice that somehow they neglected to check off the list at HHS. Example: a long-established and legitimate site, Healthcare.com, is so close in name that it alone is capable of siphoning off 30 percent of normal traffic–and they never were approached to sell. Which considering that the real website doesn’t work…. Obamacare launch spawns 700+ cyber-squatters capitalizing on Healthcare.gov, state exchanges And more on the Lucky Men ‘laughing all the way to the bank’ behind Healthcare.com from VentureBeat. Previously in TTA: The sea of security ‘red flags’ that is Healthcare.gov
The Gimlet Eye’s fashion update
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/10/heartbeatdress-260×300.jpg” thumb_width=”200″ /]Enough of this talk of failing health insurance websites and dodgy taxes! Begone! The Babe Paley or Gloria Guinness that The Gimlet Eye aspires to be longs for a dress such as this. And accompanied with its built-in InflataCorset which will calm my excited heart and nervous system when reading the latest outrage, Eye am also assured of maintaining an unblinking countenance (though too much corseting may cause me to fall into a faint.) The Flutter dress is pretty enough to conceal its premise to assist the wearer with hearing loss to ‘feel’ loud sound and respond. And Dahea Sun’s color changing dress depending on the environment–perfection, though the microcontroller may scratch. Does it change to basic black? Rise of the Fashionable Machines (MedCityNews)
Telecare-assisted AL resident monitoring: study
Research on telecare in the US has been rare of late. Thus this qualitative analysis of focus groups with twelve housing managers from twelve different Evangelical Lutheran Good Samaritan Society (GSS) assisted living communities in the LivingWell@Home (LW@H) program should be looked at carefully for both benefits of and issues with sensor-based monitoring of residents’ significant activities of daily living (ADLs). On the ten most prevalent themes, the most positive were:
- Benefits: marketing in bridging home to AL and enhanced quality of care; validation of information helping with resident medical status and overall safety; proactive detection of health events
- Sleep patterns: quality of sleep was perceived as important, and disturbance as an advance indicator of a change in resident health
- Family member assurance: family members understand the value of technology-assisted care in advanced alerting to potential health problems. In fact using the system at home was possibly more attractive to them than in AL.
However, issues with the LW@H program ranged from perceptual ones (resident privacy) (more…)
‘Game changing’ healthcare robots
Healthcare service robots have definitely gone ‘mainstream’ if two are ‘Game Changer’ winners in the industry’s Robotics Business Review. The honors go to the Aethon TUG, a laser and infrared-guided robo-deliverer for medications, lab specimens, food, blood, linens–and remover of trash and waste; and the sumo-like Hstar Technologies RoNA – Robotic Nursing Assistant System to lift extremely heavy patients and minimize nurse/aide injury. Among the finalists were the iRobot Ava using the Cisco TelePresence EX telemedicine platform and (a new one on this Editor) a physician assistant for the delicate work of scalp hair transplantation, Restoration Robotics ARTAS Robotic System. But we could also see healthcare uses for Five Elements Robotics’ Budgee personal transport carrier to assist those who cannot carry heavy loads. RBR’s full list.
mHealth for Behaviour Change
4 December 2013, Holiday Inn Regent’s Park, Central London, UK
SMi’s masterclass hosted by David Doherty of 3G Doctor will cover the following:
• Introduction to how mobile is changing behaviour (positive & negative)
• Overview of available mHealth technologies
• Lessons from previous research efforts
• Ways Healthcare Providers are leveraging Mobile Technology to change behaviour
• Deep dive on world leading program that uses mHealth tech to manage Chronic Disease
• Insights into how to design for sustainable behaviour change
Wireless Health 2013 (US)
1-3 November 2013, Johns Hopkins University-Carey Business School, Baltimore, Maryland
Presented by the San Diego-based Wireless-Life Sciences Alliance (WLSA), the trans-disciplinary focus of the conference, crossing research, development and implementation lines, will bring together members of the medical and health research community, device manufacturers, clinical and health services providers, government leaders and policy makers. Peer-reviewed papers and abstracts, interactive workshops, emerging application demonstrations, and distinguished speakers will be featured. 1 November features pre-conference workshops. Keynoters include Dr. Michael Roizen, Chief Wellness Officer and Wellness Institute Chair at the Cleveland Clinic, Dr. Peter Tippet, Chief Medical Officer and Vice President of the Verizon Innovation Incubator, and computer/healthcare scientist Deborah Estrin of Cornell NYC Tech. Release. Information and registration here.
150 Health 2.0 presentations online
Last month’s Health 2.0 three-day conference in San Francisco appears to be almost totally on video, with presentations ranging from 5 minutes to over 1/2 hour. The 15 pages include demos, keynotes and interviews. Warning–don’t use the categories at the upper right hand corner or the sidebar to try to sort through them, because these group together multiple meetings by topic. Everything you wanted to know about Quantified Selfing, patient communities (PatientsLikeMe, Medivizor), HIT, EMRs, employer wellness programs (Keas), discussing end of life care (Blaine Warkentine’s Vimty) as well as other ‘unmentionables’ like vulnerability, caregiving, social support, death, sex, taxes. Quite a few on the US health insurance exchange which was going to lead Americans to The New Healthcare Jerusalem in a few days. Somehow GetInsured.com manages to calculate possible individual insurance savings in two-three screens, though you have to call about insurance. Tim Kelsey, the NHS National Director for Patients and Information, announces £1 billion in a technology fund here. Health 2.0 San Francisco 2013.
Turn up, tune in but don’t drop out with health monitoring earphones
As part of a recent research project, Microsoft has incorporated health and fitness monitoring into a pair of earphones.
One application being developed for the hardware platform named Septimu, is a smartphone app called Musical Heart. The app enables Septimu to generate tunes based on a person’s mood or activity. So for example, fitness enthusiasts who want to keep the heart rate high can use Musical Heart to automatically up the tempo, helping them keep up the pace. Or for those feeling stressed or angry, Musical Heart could select something more soothing to help bring the heart rate and breathing down to a more relaxed level. Reported in PSFK.
A timely study published online last week in Proceedings of the National Academy of Sciences, demonstrated that ‘musical agency’ (i.e. music chosen by the study participants) greatly decreased perceived exertion during strenuous activity. (more…)
What the Blue Blazes and 3D printing apps
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/10/blue-blazes.jpg” thumb_width=”150″ /] 3D printing and apps are both very topical just now, so surely a 3D printing app has to be the height of popular appeal? Well perhaps not when MakerBot launched their Thingiverse iPhone App for the 3D Printing Community.
Unless I’m missing something critical, it just seems to be a smartphone photo album for keeping (2D) pictures of your favourite 3D printout on. Oh and you can “browse Thingiverse and check out featured, noteworthy, and popular designs, all on your phone”.
Telecare round up: the good, the bad and the future
Telehealth & Telecare Aware has largely moved on from individual reporting of incidents. However once in a while it is perhaps worth sitting back to review the recent past, and look to the future. In telecare, the world of environmental sensing has developed so fast recently that it takes an incident like that reported in Harlow last month where it appears as if (more…)
Practical use of big data in analysing the Mexican pandemic
Further to my write-up of the SIHI big data conference in Portsmouth, Wired has just published an excellent summary of Nuria Oliver’s presentation on how analysing anonymised mobile phone information made a significant contribution to understanding the dynamics of the recent H1N1 flu outbreak in Mexico in 2009.
Worth a read.
UK Comparative Healthcare Costs
OECD have recently updated their useful summary of comparative healthcare costs, with pointers to further detail if required.
It poses a bit of a puzzle by pointing out that the UK’s healthcare expenditure as a proportion of GDP is marginally higher than the OECD average, even though the number of physicians/unit of population is below the OECD average, the number of hospital beds on the same measure is significantly below the OECD average and MRI & CT scanners per million population are both less than half the OECD average. Although it’s not hard to guess the cause, no explanation is offered as to why costs are not therefore lower than the OECD average. (The number of nurses/unit of population is similar to the OECD average.)
Hat tip to Prof Mike Short.
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