Is Silicon Valley-style thinking right for healthcare?

June 5, 2013 | by

The always thoughtful David Shaywitz writes about coming out on the other side of the Gartner hype curve (ever so familiar to this Editor) into the ‘plateau of productivity’.  He provides some anecdotal evidence from his Silicon Valley experience that you could possibly take the good parts of Hope and Hype and make them work for Health. His qualifiers lead this Editor to the following takeaways, with which Dr. Shaywitz might not necessarily agree:

  • You the entrepreneur may well be thinking about changing the world with your service or device, but you might be better off focusing on solving a specific problem (or in Clayton Christensen’s terms ‘a job to be done’) and then being gratified when you do, actually, find a way to change the world and yes, you make some money for your investors. The Epic EHR started quite modestly.
  • Silicon Valley observers are onto the hype cycle there– “the contrast between grandiose ambitions and disappointing delivery.” You should be too. If you’re in health tech, steer clear of the hypesters and the cocktail parties. In fact, be more like Dr. Shaywitz’s colleagues at MIT, understanding “the limitations of your work and the enormity of the unanswered questions remaining.”
  • Aim for more than tweaking something existing–the incessant efficiency innovations so attractive to VCs in this ‘stuck on stupid’ economy–and “learn how to develop profoundly improved therapies, that cure – or better yet, prevent – disease and disability. ” Break out of what Dr. Christensen’s ‘broken circle.’ [TTA 9 Nov 12]
  • Most startups fail, and to date there are far fewer successful exits in healthcare than in social media, which is why VCs like them ever so much more and they get the billion-dollar exits. More realistic is a modest return and a long development curve. So when seeking funding, be conservative and find alternate means.

Hope, Hype, And Health In Silicon Valley (Forbes)

QS’ing, Google Glass and other wearable tech on BBC’s Newsnight (UK)

June 4, 2013 | by

Here’s one for UK-residents only owing to tech restrictions – unless other readers know how to access it via a UK proxy server – it’s an item on the BBC’s Newsnight programme yesterday (available via the BBC iPlayer for six more days) and it covers various forms of wearable technology. The 15 minute slot beginning at 34 minutes includes a report to demonstrate forms of the technology and a discussion about the associated ethics. The staggering conclusion is that it is awesome technology but we should worry about how the companies that collect data from it will use the information. Newsnight 3 June 2013. Heads up thanks to Mike Clark.

Saypage Telehealth introduced at West Suffolk Hospital (UK)

June 4, 2013 | by

When this editor worked for the NHS in West Suffolk – long, long ago – my colleagues and I always denied the saying that West Suffolk was ‘the graveyard of ambition’, and we pointed to numerous innovations that we introduced without fanfare into our various fields. So it is pleasing to see that the tradition appears to be continuing. The following press release describes the introduction of a hospital-to-home internet-based video link system to reduce the need for some orthopaedic patients to attend hospital to receive post-operative follow-up consultations. Significantly, it appears to be a development championed by an enthusiastic hospital consultant. We have seen over and over again that technological solutions to care pathway problems work best when they are adopted from the ground up. West Suffolk NHS Foundation Trust Launches Virtual Orthopaedics Outpatients Clinic Built On Saypage Telemedicine Platform. (Saypage press release) [Will the people who use the system be counted towards the 3millionlives (3ML) target? Oh! Silly me! No one is counting anything, and it’s an aspiration, not a target!]

Related links: What is Saypage Telehealth? and Saypage User Guide.

Instead of pharmaceuticals, electroceuticals?

June 4, 2013 | by

Electroceuticals–using electrical impulses to modulate the body’s neural circuits as an alternative to drugs–are gaining momentum, and probably a lot closer to being realized than say, genomics. According to the article, if you can map how a disease affects the neural circuitry, then ‘remapping’ through stimulating or inhibiting the malfunctioning pathways via tiny electrodes may show a way to health without biological drugs. For instance, stimulating the vagus nerve seems to reduce the production of cytokines — immune system mediators — and blocks inflammation through boosting the immune system. It has been successfully used on a preliminary basis in treating inflammatory disease with rheumatoid arthritis. Multiple research teams have experimented with additional conditions such as respiratory diseases, asthma and diabetes–and possibly neuro-psychiatric disorders like Parkinson’s and epilepsy. It’s been successful enough to date to warrant a small investment from pharma giant Glaxo Smith Kline (GSK). Wired.co.uk

Health tech growing fast in Brazil and Asia-Pacific

June 4, 2013 | by

Brazil’s strong growth in mHealth and medical apps is detailed in three recent studies from PwC, PwC-GSMA, Research2Guidance and the New Cities Foundation. PwC is pegging mobile health apps at $46.6 million by 2015, with PwC-GSMA projecting that 43.9 million additional patients could be treated with mobile health technology in Brazil and Mexico by 2017. Research2Guidance confirms that Brazil’s an Android market, outselling iOS in the 10 most downloaded health and fitness apps by 17 times. The Geneva/Paris-based New Cities Foundation equipped doctors and nurses at a family clinic in Santa Marta, Rio de Janiero, Brazil with a $42,000 ‘backpack’ for home care, containing a GE Vscan portable ultrasound, a TuffSat pulse oximeter, an Accutrend blood monitor, an EKG machine, a blood pressure monitor, a weight scale, a digital thermometer, tape measure and stethoscope. Savings were about $200,000 per 100 patients/year. Mobihealthnews.

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”100″ /] The Gimlet Eye, having read this, just sent a message to your Editor. Could it be The Eye’s undisclosed location?  Perhaps we should be… ‘Flying Down to Rio’?

In Asia-Pacific, the $55 billion APAC medical devices market–nearly 25 percent of the world market– is expected to grow over 10 percent per year over the next three years, outstripping rest-of-world growth by 4 points. Growth in China and India is especially striking, with India’s medical device growth at 16 percent per year for three years. Healthcare is improving in less developed areas, and the age 65+ population in greater developed countries is increasing as a proportion of the population as birth rates fall (in Japan, 24 percent–with Japan also the overwhelming leader in patents). While much broader than mobile health or telehealth, the overall category serves as a pointer to growth opportunities in the very near future. MD+DI  Hat tip to reader George Margelis, MD via LinkedIn, who advocates Australia take a greater leadership position in developing ‘medtech’. 

Avatars to help schizophrenics cope with ‘the voices’

June 4, 2013 | by

One of the most common features of schizophrenia is the inability to control the voices that tell you what to do–at minimum annoying, but sometimes urge you to harm yourself or another. Anti-psychotic drugs do not silence them in 25 percent of cases. This approach from University College London researchers puts faces to the voices–and, by letting the patient create them, gives the patient control. With a therapist, each of the 16 patients in the study created an avatar with a computer-generated face and voice ‘matching’ the ‘voice in the head’.

In up to seven 30-minute sessions, each subject interacted with their entity’s avatar, and were encouraged to oppose its threats and orders. Not only did this allow the subjects to get comfortable with the idea of standing up to the “actual” entities themselves, but because they had taken part in creating the avatars, it helped them realize that the entities actually originated within their own mind. Additionally, each subject received an MP3 recording of their sessions, which they could listen to whenever they started hearing voices again.

Almost all participants experienced a reduction in the frequency and severity of their episodes–and three of the subjects, who had been experiencing hallucinations for 16, 13 and 3.5 years, stopped hearing voices completely. The research team just received a £1.3 million (US$1.98 million) grant from the Wellcome Trust to expand the research starting in July.  Avatars help schizophrenics gain control of voices in their heads (Gizmag)

Sensory feedback adds to prosthetics and situational awareness

June 4, 2013 | by

There have been a number of prosthetics developed in recent years that directly connect with nerves, but their drawbacks have included deterioration of the nerve-prosthetic connection over time and lack of reliability in acting like a natural limb. With over 2,000 American military personnel suffering major amputations since 2000,  the US Department of Defense’s DARPA (Defense Advanced Research Projects Agency) is working to advance better nerve-connected prosthetics through the RE-NET–Reliable Neural-Interface Technology–program. DARPA uses nerve/muscle interfaces to give amputees feedback and improve control (Gizmag) For the sight-impaired, the Russian company Oriense is extending its technology that assists robots to avoid objects to a human-worn camera/sensor combination. It combines a Primesense sensor (akin to Microsoft’s Kinect camera) with Oriense’s software which scans data from the sensor and gives voice notifications about where objects are and if they are directly in your path. The prototype would not be out of place on a robot (camera on chest, computer in hand, earbud) but second generation promises to be more streamlined. From robot tech to humans: hardware to “see” the world around you (MedCityNews).

AdhereTech wins Healthcare Innovation World Cup

June 4, 2013 | by

AdhereTech, a med reminder startup from the Summer 2012 Blueprint Health class, recently won the $50,000 Healthcare Innovation World Cup sponsored by Boehringer Ingelheim and organized by NYC-based independent healthcare research organization HITLAB (Healthcare Innovation Technology Lab). The annual competition challenges innovators in healthcare and IT to help solve global health issues; this year’s focus was diabetes prevention and management. AdhereTech is nearly to market with an M2M-connected compact bottle for pills or liquids that not only reminds, but also provides a measurement of pills/liquids remaining in the bottle [TTA 28 March]. Second place with a prize of $10,000 went to Indian company Team IITKgp which is developing a non-invasive blood glucose measurement device. Runners-up: in third place with an award of $5,000 was India’s Team SmartSense, developing a multianalyte sensing device for diabetic ketoacidosis (DKA) and Ohio’s Team EndoGoal, a mobile and web-based social rewards program for people with insulin-dependent diabetes who track daily glucose levels. All four teams had previously received $2,500 for reaching the final rounds as semi-finalists in the US and India. The awards were hosted by the German Center for Research and Innovation (GCRI). Congratulations to all. Release.  Website

Telecare: A waste of time or the future of health and social care? (UK)

June 3, 2013 | by

A longish article on the Building Better Healthcare website (for the building industry) gives a fairly comprehensive overview of the current state of telecare in the UK. It ranges from ‘pendant or chord’ [sic] to ‘buddi’ via the TSA Code of Practice and a number of council examples. It’s probably a reasonable response to ‘What is Telecare?’ for industry outsiders: Special report: Telecare: A waste of time or the future of health and social care?

The Eye has it (UK)

June 3, 2013 | by | 1 Comment

It is not TTA’s own Gimlet Eye that features in this item, but Private Eye “a fortnightly British satirical and current affairs magazine” (Wikipedia) which, in the current issue (1341), picks up again [TTA Nov. 2010] the matter of the North Yorkshire and York (NYY) procurement of Tunstall telehealth equipment and the subsequent writing off of its capital value. The page 31 item does not make it into the highly cut-down online version of the magazine and there is nothing in it with which readers of the Yorkshire Post newspaper or of TTA’s own coverage [March 2013] will be unfamiliar.

Rather surprisingly, Private Eye does not pick up on what should be the matter of most concern for taxpayers – the status of the funds paid to Tunstall under the terms of the contract but for which no goods or services have been called off by the health services. We have not had any indication that these funds have been or will be returned to the public purse and, indeed, we speculate that there may not be a contractual requirement or mechanism to do so any more. However, Tunstall’s directors, being ethical people, surely cannot be comfortable with this situation and it will be interesting to see how they resolve it.

Telehealth makes front page in UK newspaper

May 31, 2013 | by | 1 Comment

Rather to many people’s surprise the popular Daily Express newspaper featured a telehealth story on its front page on Wednesday. It appears to be an extension of the UK’s media’s current interest in the woes of hospital emergency departments and the simplistic ‘blame the GPs’ theme that has been fuelled by recent comments from the Secretary of State for Health. However, the article is positive about telehealth blood pressure monitoring: DIY test will save your life: gadget sends blood pressure results direct to your GP (online version). Interestingly, the article contains no reference to the 3ML initiative. One wag Tweeted “Oh no! I’m rubbish at DIY. I’ll surely fail the test”. Here’s a link to a picture of the front page so that readers can gauge the weight that the item received.

Android app for dementia research and therapy (UK)

May 31, 2013 | by

Steinkrug, a UK based research and development company has developed an Android app for tablet-based devices that monitors users’ responses to sound and images. The technology has been designed for use in dementia research but has potential for wider applications within and beyond the healthcare sector. Whereas Google Glass looks outwards into the wearer’s environment, Steinkrug’s application tracks the user’s response to media displayed on the device. Press release: Android App For Dementia Research and Therapy.

May Telecare LIN newsletter published (UK)

May 31, 2013 | by

This edition concentrates on the changing telehealth and telecare context: the publication of the Care Bill in England along with plans to integrate health and social care services over the next five years and the NHS Mandate’s extensive programme of NHS changes until March 2015. Pressures continue on health and care services. These will all have an impact on telecare, telehealth and digital health implementation. In the meantime, Scotland is just getting on with its programme… May newsletter (PDF) News listings/links supplement (PDF).

FDA regulation of mobile health: a study in ambiguity

May 31, 2013 | by

The signs are not good when FDA continues to delay on issuing its draft guidance on mHealth devices (now tagged for the close of FY 2013), yet sends a notice to India’s Biosense Technologies Pvt Ltd, developer of the uChek Urine analyzer app, that it immediately needs to seek 510(k) Class II clearance. Biosense claims Class I clearance; FDA claims that it has no record. Letters fly, yet the app remains in the iPhone AppStore. How can there be a crackdown on mobile health apps, as FierceMobileHealthcare’s Greg Slabodkin projects, when developers legitimately say there’s no rules of the road? Magic 8 Ball says: ‘In The Fog’.  Also Mobihealthnews.

Previously in TTA: FDA regulating medical apps–or not? The Hearings. If not FDA to regulate mHealth, then who? An ‘Office of mHealth’ a solution for FDA gridlock?

‘The new era of connected aging’

May 31, 2013 | by

The Center for Technology and Aging’s latest white paper posits their vision on how online and mobile technologies will increasingly be used to support older adults in living independently longer and in better health, as well as assisting caregivers. Use of mobile phones, social networking and tablets have all been on a gradual growth curve, with phones well above 60 percent in the over-65 age bracket. The technology is also moving away from single-purpose devices to those that integrate with phones and tablets. The New Era of Connected Aging: A Framework for Understanding Technologies that Support Older Adults in Aging in Place