Lost in the somewhat fizzled debut of the iPhone 5s (the pricey one) last week was their inclusion of a “motion coprocessor” chip called the M7, which measures data generated by the phone’s accelerometer, gyroscope, and compass. Apple has also created the CoreMotion API for developers to facilitate health tracking apps, including the Nike + Move app. It’s catchup time with Samsung’s S Health surely. Medical Device + Diagnostic Industry This has fueled the expected Apple-ologist divinations on Apple’s ambitions in the wearable computing area, a taste of which you’ll see in GigaOM, though the Trojan Horse analogy is a mite overblown. Hat tip to reader Chris Paton.
Another set of forecasts to not believe in?
A sunny day for approaching Fall (Autumn to our loyal UK readers) and a bon weekend at least in this part of the world, and this Editor has to spoil it by waxing downbeat about an up forecast–way up. This week it is Juniper Research’s Mobile Health and Fitness report straight from Hampshire, UK with the big numbers–98 million by that magic year 2018–but that’s users, not revenue. They also forecast beaucoup cumulative savings of $35 billion over the next five years from remote patient monitoring. Want to know the size of the market versus the research2guidance and MarketsandMarkets forecasts? You’ll just have to scramble in your wallet for £2500 to get the scoop. Healthcare Technology Online, Juniper release, Juniper report overview and pricing. Previously in TTA: The ‘ginormous’ hype around forecasts and our very first ‘Blue Blazes’ feature (by Editor Charles).
Is nothing private in your EHR? Another disturbing trend out of Swampland.
According to a solicitation posted by the Department of Health and Human Services (HHS-Ed.) on Sept. 4, the CMS (Centers for Medicare and Medicaid Services) is commissioning the National Academy of Sciences (NAS) to study how best to add social and behavioral factors to electronic health record reporting. Washington Free Beacon
So a non-profit online publication, which one would site on the conservative or libertarian side (part of the Center for American Freedom), breaks a huge story, way ahead of the mainstream media, which has major implications for privacy, data security, public health, how goes your doctor or hospital visit and the level of care you receive. Is this EHR TMI (too much information)? The Federal inclusion is being linked to Stage 3 of the Meaningful Use program and reimbursement under Medicare, Medicaid and the Children’s Hospital Insurance Program (CHIP). The NAS already is working on this with the Institute of Medicine to draft suggestions for collecting this behavioral data and identifying “core social and behavioral domains to be included in all EHRs.”
With linking the data to outside Nosey Parkers agencies such as public health entities, the possibilities for identified data becoming insecure or compromised increase dramatically. Will it be accessed (abused) by other entities involved in ACA such as the IRS, state Medicaid databases and Social Security? How much of this data will accidentially leak out in non-deidentified files? Will breaches of millions of non-encrypted records become the norm? Another important and oft-overlooked factor is the additional workload on already overworked hospital and clinical staff, who presently struggle to get comprehensive vital data correctly into multiple fields and screens on present EHRs–a major pain point among many speakers and participants at this past week’s iHT2 Health IT Summit. Finally, there’s the patient. He or she will be pressed to answer, due to penalties baked into the ARRA/HITECH MU3 incentives, the most personal questions about their life and behavior particularly if the diagnosis is one of what euphemistically was called a ‘social disease’. Having spoken this week to those in public health both at iHT2 and at Health 2.0 NYC, this Editor can see it as a deterrent to getting the care they need–or choosing evasion rather than truth with their doctor because there are no more confidences. Even the California Healthcare Foundation, hardly on the right wing, sounds an alarm in iHealthBeat.
Worcestershire 3ML Pathfinder procurement canned
It seems that the much-vaunted Worcestershire 3ML pathfinder tender, already the subject of a critical TTA post on 5th July due to delays, has now been cancelled.
Tenderers apparently received letters late last week informing them that no offers had been received that met the combined risk sharing requirements of the original tender. As a result, the telecare part of the tender is to be retendered on a standalone basis (more…)
Jawbone jawbones $100 million in financing
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/09/band1.jpg” thumb_width=”150″ /]Fortune, no usual hangout for health tech news, headlined late last week that Jawbone, which recently relaunched its UP fitness tracker after the earlier version developed glitches, obtained $93 million in debt financing and is rumored to be lining up another $20 million in equity financing from its four largest existing VC backers: Andreessen Horowitz, JPMorgan Digital Growth Fund, Khosla Ventures and Sequoia Capital. Reportedly they are wildly back-ordered for the colorful and stylish UP fitness tracker (now a fashionista item, a sure sign of scarcity). Their founder/CEO Hosain Rahman told Fortune “We’ve been experiencing crazy sell-through demand, particularly since the relaunch of Up. It’s been faster than anything we’d had before, and equity is not the most efficient way to scale all that.” We’ve previously noted Jawbone’s aggressive acquisition warpath with BodyMedia [30 April] and Massive Health [11 Feb]. Competitors have hardly been sleeping: Fitbit just raised an additional $43 million to add to their previous $23 million [15 Aug] and Withings a fresh $30 million [22 July], so fitness trackers are all going one way–up. Exclusive: Jawbone raises more than $100 million (Fortune). Also Mobihealthnews.
Telemedicine in the TIME Swampland
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/blue-blazes.jpg” thumb_width=”175″ /]TIME’s ‘Swampland’ section may be referring to the original siting of Washington, DC on reclaimed swamp land off the Potomac River, but this swampy article ultimately struggles to solid land. You will have to meander through the UVA Center for Telehealth, the Center for Connected Health Policy, WellPoint, the Institute for e-Health Policy and of course Partners Healthcare’s cardiac program [TTA 27 Aug] before addressing the real problem: the desirability of broader telemedicine reimbursement and a consistent policy in US Federal programs such as Medicare and Federally-subsidized Medicaid administered through the states. Currently Medicare reimbursement is restricted to specific rural areas, Native American territories/Indian Health Service, and of course the often-mentioned mess of cross-state physician licensing. However, the Accountable Care Act is not going to be the savior as its implementation is hardly going smoothly. Earlier CMS policies on 30-day same cause readmissions have had far more impact. There is the to-be-expected muddling of telemedicine (virtual consults) and telehealth (monitoring)–and robotics gets a ‘say wot?’ mention. The kicker is the headline and accompanying picture:
“Saving U.S. Health Care With Skype”
Skype, while used in ‘telemental health’ [TTA 11 May], is not HIPAA-compliant for patient privacy. Were TIME’s famed fact-checkers asleep?
Hat tip (and thanks) to reader Bob Pyke.
Ageing Well – how can technology help?
This year’s Telemedicine & eHealth conference, on 25th & 26th November, at the Royal Society of Medicine at 1 Wimpole St, London will focus on how technology can help people to age well. It will cover a wide palette of issues relating to technology and ageing, including both physical & mental conditions, and the importance of social & spiritual considerations too.
Keynote speakers include Jon Rouse (more…)
Medical identity theft hits new highs
August ended with the report of the second highest-ever identity breach traced to a healthcare provider–4 million patient names, addresses, dates of birth, Social Security numbers and clinical information, contained on four unencrypted Advocate Health System (Illinois) office computers. It was a ‘behemoth breach’ in Healthcare IT News‘ words and has led to the filing of a class-action lawsuit (Privacy Rights Clearinghouse). Now security consultant Ponemon Institute’s latest report, released yesterday, increases the breach anxiety level with its 2013 Survey on Medical Identity Theft: (more…)
NY eHealth Collaborative Digital Health Conference 2013
14-15 November 2013, Hilton New York, New York City
This year’s NYeC Digital Health Conference brings together a diverse group of professionals for two days of lively intellectual exchange. Healthcare providers, IT innovators, health leadership, start-ups, hospital officials, group practice managers, investors, and entrepreneurs will gather to hear insights, ideas, and analysis from leaders in the health IT community. Early Bird discount expires 20 September. Information, registration
How startups are being damaged by patent trolls–and turning the tables
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/09/TROLLS-1992-008.jpg” thumb_width=”150″ /]In February and for a few months, this Editor was on a tear about the quaintly dubbed patent trolls–primarily (but not always) non-practicing entities (NPEs) which don’t create or market products, but buy up other people’s/companies’ patents and then seek out opportunities to license them. These NPEs target and challenge vulnerable startups and early-stage companies to defend their patents and systems; the suit for royalties, the financial threat, the papers filed, the attorneys called, the money spent and the eventual settlement (or licensing) is in reality just a form of what’s called in Latin America la mordida. It becomes cheaper to settle than to fight–and the cost can be six or seven figures.
The shots over the bow were in 2012: Bosch’s February lawsuits against Waldo Health, ExpressMD/Authentidate and MedApps (now Alere Connect) [TTA 16 Feb 2012] and then the strange practice of PHR developer/patent accumulator MMRGlobal [TTA 23 Oct 2012] in sending hundreds, perhaps thousands, of letters out to EHR/EMR users to advise them of possible patent violations and demanding licensing. This Editor observed then and during the spring this year that it was only a matter of time that NPEs would pounce on healthcare tech as investment action accelerated. Yet discussions by this Editor with companies in some public venues indicated a certain level of obliviousness to the threat–that there were not enough assets to go after, thus healthcare startups made poor targets–though side conversations with IP specialist attorneys indicated otherwise.
Well, the trolls have reared their fuzzy heads again, uglier than ever, in this drama-laced article in Wired. (more…)
Quantified selfing: elitist and privacy invading
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]The last place you’d expect to see a populist view of Quantified Selfing, outside of the retrograde publications perused by The Gimlet Eye, is Wired. All these Fitbits, Jawbone UPs, Misfit Shines, baby monitors and of course Google Glass cost, cost, cost–upfront and especially for the ongoing subscription services. Even wearables, at this point, are nowhere near cheap and cheerful nor will be for some time. Is QS a luxury of the residents of Elysium? Wired’s Quantified Man, Chris Dancy, toting up his five-sensor/system cost, pays $400-$1,000 per month. The Eye tears up at the effect on the exchequer. But the most painful point for the article’s writer is less elitism than privacy: all the data churned out, existing somewhere to be mined, and all those ad messages waiting to be served up on Glass. PPG–pay per gaze–indeed. Your ‘Quantified-Self’: Are Wearable Technologies Just a Luxury for the Upper-Class?
Is ‘disruption’ the dog that didn’t bark?
Is the disruption in healthcare that we think is going on, have been told is going on, make assumptions on, not really on? This is the contrarian argument posited by Dan Munro:
- Training of doctors, supply and demand is as it was. Training of US doctors is expensive, and doctors tend to go to the better paid specialties in order to pay down education debt faster. And patient demand for acute procedures will always outstrip doctor supply.
- Squeezing down the small stuff doesn’t radically impact demand. In the US we have been pounding down insurers (6 percent) and low-acuity/primary care, but ignoring the heavy spend on hospitals (31 percent) and clinical services (20 percent). Are the big slices of the pie resistant or too controversial to cut?
- Startups aren’t a good source of disruption. (more…)
From ‘Big Data’ to Collective Wisdom – SIHI conference report
This year’s Southern Institute for Health Informatics (SIHI) conference, in Portsmouth on September 11th, was a hugely impressive event featuring a well-chosen array of excellent speakers. As one who has often struggled to get excited about the finer points of coding, this was a revelation: I was converted.
Just what can be achieved in the NHS when technology, culture and organisation are in harmony was breathtaking (more…)
Doro 2.0 smartphone QSs with Withings (EU)
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/09/Doro-Liberto-810.jpg” thumb_width=”100″ /]Doro’s unveiling of their second smartphone, the Doro Liberto 810, along with its ‘privileged access’ to two Withings devices–the Smart Body Analyzer (weight, body fat, heart rate) and Pulse Smart Activity Tracker–continues their moves into older adult-appealing mobile telecare/telehealth offerings, as tracked by founding Editor Steve since at least 2009. Doro’s assertive move into Quantified Selfing as part of what they call ‘the world’s most liberating smartphone’, is more fully featured and was predicted by David Doherty earlier this year [TTA 25 Feb]. It is also not Doro’s first big alliance; late last year, Bosch Healthcare announced that Doro would be the mobile platform for telecare offerings in Germany and Sweden [TTA 16 Nov 2012]. Both the release and Mobihealthnews indicate that this offering will roll out to select European markets initially, but the latter states that a similar offering will debut in the US by early 2014. (For US readers, Doro is equivalent to GreatCall’s Jitterbug line) According to Mobile, the Liberto will be available in the UK in October.
Risky Business 2 (Australia): ‘This time it’s personal….’
26-27 June 2014, Hilton Hotel, Sydney, Australia
This annual international conference on changing the care models around dementia, possibly the only one focused solely on this topic, discusses two questions which telehealth and telecare can answer at least in part: How do we support people with dementia to live their lives well? Are we really delivering care that is personal to the person with dementia and their carer? Call for papers closes 18 October 2013 (video on submitting here) and registration for the conference opens 2 December. Organized by The Dementia Centre, HammondCare-An Independent Christian Charity and the Australian Government Department of Health and Ageing. More information.
The ‘ginormous’ hype around forecasts
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/blue-blazes.jpg” thumb_width=”150″ /]Our readers may have noticed that your Editors of late have skipped the relentless tracking of eHealth/mHealth/digital health/wearables forecasts, save Editor Charles nominating research2guidance’s latest for ‘What in the Blue Blazes’. Yet r2g’s $26 billion by 2017 forecast for the category was but a lagniappe* compared to MarketsandMarkets‘ puffy $59.7 billion by 2018. Laurie Orlov has artfully skewered the relentless forecasting (she is a recovering veteran of Forrester Research) with the sobering comparison of the current D3H**-fed bubble to the fluffy eCommerce forecasts circa 2000. And we all know how that ended. Do not miss her tale of “mythical John and the XLife Preserver” and how it attracts a VC named Head, Clouds, Smoke and Vapor (HCS & V), located down the hill from a Napa winery. (Presumably the product flows downhill?) The Wireless Health market is ginormous — so forecasters say (Aging In Place Technology Watch)
Another factoid from the M&M report: Mobile apps alone by 2018 will be valued at $20.7 billion from $6.3 billion now. Yet 90 percent are currently free and the rest are $1-2, except for medical apps targeted to professionals. The Gimlet Eye is still trying to compute this one in Monopoly® money, and is requesting a large bottle of Panadol (Tylenol). Drug Store News
* Lagniappe: something given or obtained gratuitously or by way of good measure (Merriam-Webster)–American French by way of New Orleans **D3H=Digital Health Hypester Horde
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