Robots in older adult care: a debate

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/05/20disrupt-pic2-tmagArticle.jpg” thumb_width=”150″ /]An article in The New York Times ‘Bits’ tech blog has raised debate on the appropriate role of robots in care for older adults. Illustrated by a picture of two PARO robots being recharged (a strange sight indeed) and a lead about the movie ‘Robot & Frank’ [TTA 23 Aug 12], it discusses the ethics of robots (and robotic pets) in care for the elderly versus humans which continues in the comments. One position is that it is not ethical to entrust your aging loved one’s care to a machine, and that human care is always preferable even if not high quality, because we all need human interaction. The other is that the same loved one might very well prefer having a robot efficiently assist them versus a human helper who talks down to them, doesn’t listen, is incompetent, unable or dishonest. The older person may very well interact with a robot better and demonstrate more directive control. A middle position is that robots for assistive care and robotic pets are quite acceptable as an adjunct to human support. After all, we do tend to anthropomorphize objects, not only cars (ask this Editor about Big Blue, Homer, The Bug and the Cherry Bomb) but also in studies robotic pets such as Sony’s now defunct AIBO. It is also the theory behind the virtual pet-in-a-tablet GeriJoy. And who hasn’t ‘talked’ to their balky PC or printer? Certainly Frank demonstrated ‘greater independence’ when he enlisted his pal Robot in a little heist!  Disruptions: Helper Robots Are Steered, Tentatively, to Care for the Aging

Medical apps largely missing medical expertise: study

A recent Ohio State University study, presented at the American Academy of Pain Medicine (AAPM) conference in April, analyzed 222 pain-related smartphone apps available for Android, iPhone and Blackberry devices. Their findings:

  • One third had no input from a health care professional
  • Professional input could not be determined for an additional one third
  • 27 percent of the apps had obvious input from an MD or DO
  • 8 percent had input from a non-physician health care professional

The OSU study in 2012 was modeled after a UK study in 2011 that examined 111 pain-related apps, with similar findings. As our readers know, in the US Happtique had taken on the role of a health app certifier through its Health App Certification Program (HACP), and presumably despite their internal changes that certifying process will continue and information will be accessible to the public. The FDA is still debating (and debating) app approval processes (along with the FCC, HHS…) while approving a few [TTA 22 Mar]. AAPM has also expressed interest in ‘gatekeeping’ for pain management apps. American Medical News/Amednews.com  Hat tip to reader George Margelis of Australia

FDA goes a bit easier on digital pill classification (US)

Good news for digital pill developers such as Proteus and Carnegie-Mellon’s digestible devices [TTA 15 April]. In FDA’s final order issued 16 May in the Federal Register, ‘ingestible event markers’ (IEM) are now classified as a Class II medical device, which does not require the premarket approval and the longer approval cycle that new devices (‘de novo’) under Class III must have. According to The Hill’s’ regulation blog ‘RegWatch’, “FDA granted the device class 2 status shortly after its approval in 2012, but the legal order sets a permanent standard for the technology.” Proteus’ FDA approval for their IEM was granted in July 2012 [TTA 2 Aug 12] and this now formalizes subsequent IEM classification. iHealthBeat

Management, direction changes at app certifier Happtique

When an entrepreneurial venture, nurtured by a large parent, goes sideways.’

Management and directional changes at Happtique, a subsidiary of the Greater NY Hospital Association (GNYHA), have rocked the still rather insular, and small scale, New York health tech world. Background talk has been in the air for some months. Reading through the exclusive report from Brian Dolan at Mobihealthnews, followed by GNYHA Ventures’ statement, plus your Editor in NYC, several shoes have officially dropped.

  • Well-known co-founder Ben Chodor is no longer CEO, but according to GNYHA remains with the company as co-founder, focused on strategic growth as well as an outside evangelist of sorts. He will continue to host the mHealthZone on BlogTalkRadio and will be at the WLSA Convergence Summit on 29-30 May. Also already departed is Chodor’s leadership team.  (more…)

GSMA mHealth Grand (cycle) Tour – Europe

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/05/mhealth-cycle-tour-route-2013.jpg” thumb_width=”150″ /]The mHealth Grand Tour will be a cycle ride with a difference. Going from Brussels to Barcelona in 13 days (5 – 19 September 2013), it is a 2,100km tour with more than 22,000 meters of climbs. But it is also an opportunity to help demonstrate ways of managing diabetes using mHealth. The ride is “also intended to be fabulous experience, incorporating breathtaking scenery, quiet country roads and the opportunity to sample fabulous food and wine. And, in the spirit of the Grand Tours of old, we have also designed the ride to take in the outstanding cultural sights on the way.” The tour is open to individuals, and sponsoring organisations are putting together some cycling teams too. More information on the tour website.

Med-e-Tel 2013 presentations available

Copies of the presentations at Med-e-Tel 2013 (10-12 April 2013) are now available. Click on the ‘full presentation’ links to access the presentations. The Med-e-Tel Knowledge Resource Center also still contains the presentations from previous events (2002-2012). You can access the Resource Center here.

The Med-e-Tel 2013 proceedings, published as Global Telemedicine and eHealth Updates – Knowledge Resources, Vol. 6, 2013 (610 pages) are now also available for purchase. It contains 133 short papers of presentations that were submitted for the Med-e-Tel 2013 conference program. To order a copy contact info@medetel.eu.

Gloucestershire telehealth: PCT oversold; GPs undersold (UK)

A news item from the BBC (link below) takes the shine off the story of the Gloucestershire ‘big roll out’ of telehealth as it is generally presented (3ML PDF).

Dr Tim Macmorland, a GP in Churchdown, said the systems were ineffective. “I think it’s been handled poorly. It was rolled out to GPs without discussing anything about the system before it was implemented…We already knew it was working in the heart failure service, [see item here, paragraph 5. Ed.] but then we were asked to find patients who had these other chronic diseases for whom the system might work as well, and I don’t think it has to be honest, it’s been an absolute waste of money.”

For many years suppliers – and we – have been calling for an end to small scale pilots and for going straight for mainstream adoption. However, we may be seeing that in reality this is not possible, at least not with the approaches tried so far. Perhaps the ‘not invented here’ effect is stronger than we all supposed and telehealth adoption will only be achieved one doctor at a time.

BBC item: Gloucestershire health monitors investment a ‘waste of money’.

Google Glass ‘hacked’ for hospital facial recognition

Your Editor hid this one from The Gimlet Eye, but according to VentureBeat, Google Glass has been successfully ‘hacked’ for what may be a significant–and useful–medical app. MedRefGlass uses facial recognition to permit doctors  to pull up patient files, and also to create patient folders by voice, take photos, and add voice notes–all hands-free. The development team has posted more here at NeatoCode Techniques on Tumblr. New Google Glass hack gives doctors the power of face recognition. Watch the video demo (04:44).

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

 

The Friday robo-alert: Five ways robots are invading hospitals

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/05/ri-man.png” thumb_width=”150″ /]Having watched the delightful ‘Forbidden Planet’ (1956) on Turner Classic Movies last night, marking the debut of the robot paragon Robby the Robot, this overview of hospital robotics from VentureBeat is on point. No Robbies here (despite our picture, this article does not cover robots that lift or design dresses with options of diamonds, emeralds or star sapphires) but does highlight:

  • Germ and infection reduction (the ultraviolet Xenex)
  • Remote consult robots (iRobot’s RP-VITA, now FDA approved)
  • Prosthetics (BioOM prosthetic ankle)
  • Surgical robots
  • Therapeutic robots for the elderly (PARO, which is a ‘1.0’)

Previously in TTA: RP-VITA’s FDA approval and profile; prosthetic advances, surgical microgripping robots and BriteSeed’s SafeSnips; the debate on the $6,000 PARO; better and more affordable robots and aids for older adults such as GeriJoy (virtual pet) and Clevermind (stimulation); and the vast area of humanoid robots such as Roboy, Hector and Kompaï. (Or just search ‘robots’ in TTA for our wealth of coverage.)

Simpalarm: A venture into within-family telecare has some nice features (UK)

Simpalarm is a new company bravely venturing into the UK telecare market. Accepting the premise that the ability to raise an alert through a press-button device and around-the-home sensors is what is required by many people, Simpalarm uses today’s technology to strip the system back to bare bones. A landline is not necessary because alerts go directly by SMS to friends, neighbours, family, housing provider, etc. and response is not moderated through a call centre (although one assumes it could be). If sensors are added to the system, it is possible for alerts to be triggered when the occupier’s activity deviates from normal patterns. The nicest feature (apart from the hype-free product description) is that the hub is cleverly and semi-permanently attached to the power source, which is a standard UK double electrical socket, so there are no wires that can become unplugged or cut. Download the one-page Simpalarm description (PDF) and visit the website, http://simpalarm.co.uk/ for further information.

O2 mobile care – now with added Tesco (UK)

One of the very striking but curiously underplayed aspects of O2’s launch of Help at Hand two months ago was that O2 had signed up pharmacies in the Sainsbury’s supermarket chain as retail outlets. We now hear that they have also signed up Tesco, the UK’s largest supermarket chain. These are surely steps O2 is making in getting its presence ‘out there’ ready to meet demand for when it unleashes its marketing machine on the consumer market.
Related item: O2’s launch of Health at Home

Telehealth Soapbox: Negotiating a Vendor’s Limitation of Liability Clause

This is the third of an occasional series on US law and intellectual property (IP) as it affects software and systems used in health technology. This article is a ‘how to’ on achieving a more equitable liability arrangement between a company and a vendor. A standard clause a vendor uses to protect their company from liability can cause a great deal of trouble and financial heartache for a contracting company when ‘things go sideways’. Correspondingly, if you are a vendor or partner, this enables you to anticipate issues a skilled negotiator on the other side of the table will present.

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.

When clients come to me to consider suing because of a tech deal that has gone bad, the single worst lawsuit killer is often the “standard” limitation of liability clause found in a vendor’s form agreement. It never ceases to amaze me how people don’t pay attention to these clauses as they blithely sign-off on a one-sided agreement. It’s just one little clause and yet it can cause so much damage.

Here’s an example of the type of provision that you’ll see in tech agreements:

“The liability of vendor to customer for any reason and upon any cause of action related to the performance of the work under this agreement whether in tort or in contract or otherwise shall be limited to the amount paid by the customer to the vendor pursuant to this agreement.”

Yes it’s heavily slanted in favor of the vendor—it’s the vendor’s form. I draft them just as one sided when I’m representing a vendor so that I protect MY client. As I always say, he who drafts sets the agenda. (more…)

Six technologies for aging in place: a review

Analyst and trendspotter Laurie Orlov in Aging in Place Technology Watch reviews six new monitoring and assistive technologies designed to improve safety and independence for older adults in the home environment: for organizations, the Center for Technology and Aging (CTA)’s mHealth Toolkit [TTA 28 Sept 12]; Earl, a free voice driven iPhone & iPad newsreader app; the Lively telecare system [TTA 19 April]; the ConnectMyFolks iPad app for simple news, email, text, photos and videos; BugMe! Stickies for jotting reminder notes by ElectricPocket; and Unfrazzle to assist caregivers in task tracking and connectedness with other caregivers.

Plus: If you are looking for an underserved market in health systems and tech, it is certainly centers, facilities and individuals in dementia care. It has the paradox of being a growth market, highly profitable for senior housing–and largely bereft of care programs that do more than the minimum to help preserve the faculties of the person with dementia. This recent article by Laurie Orlov discusses a different approach linked to the Montessori Method being used at a dementia support center in Toronto. It adapts the widely used teaching method for children pioneered in 1907 to slow decline in brain function and behavior, at different stages. (Globe & Mail article)

Toward a better understanding of US care models

HIMSS’ publishing arm, which has grown to several publications including ones we cite frequently, such as HealthcareITNews and GovernmentITNews, is launching an online site, Future Care, that will focus solely on “new and innovative models of care that improve individual and community well-being, while also reducing healthcare costs.” It has original material plus pickups from HIMSS Media’s other publications, and is supported by IBM’s Smarter Care initiative. (Related to its Smarter Cities initiative and telecare in Bolzano?) The current selection focuses on whether  ACOs are set up to fail (Center for Connected Health’s Dr. Joseph Kvedar rebuts Clayton Christensen and colleagues in the WSJ), outpatient care, readmissions and the utilization of big data. Of note is Merck Vree Health’s mHealth post-discharge care management program, TransitionAdvantage, which represents a change from its initial focus on diabetes management. There’s also the expected helping of IBM-related content including Watson and some IBM white papers. For designers and implementers seeking a better understanding of care and payer models for health tech workflow, this site pulls together a wide scope of information.

Healthcare IT–New York’s Next Big Thing

Sponsored by MIT’s Enterprise Forum and held on 8 May 2013, this event reviewed the efforts of entrepreneurs, investors, public entities and accelerators in changing the New York area from a ‘dead zone’  for health tech to a new hub of innovation–in what this Editor considers a record (two-three year) time. (Was it only July 2011 that 90% of local investment went to internet shopping and mobile?)

Moderator: Steven Krein, founder and CEO of health tech accelerator StartUpHealth (most recently in our news for their joint program with GE Ventures’ Healthymagination)

Panel: Jahan Ali, PhD, Senior Vice President, Partnership Fund for New York City; Serge Loncar, Founding President and CEO, CareSpeak Communications; Philippe Chambon, Managing Director, New Leaf Venture Partners

Steve Krein set the tone with predicting that NYC will be the hub of health IT. It is heading towards its tipping point; that healthcare is not only overdue for its time in investment but also where key factors are converging to make this possible–money, universities and companies within reach. Key factors are investors such as the Partnership Fund for NYC, which helped to fund the NY Digital Health Accelerator with the New York eHealth Collaborative (NYeC), which on the day of the meeting graduated eight startups (see ‘Related’ and video) with $300,000 of funding plus three provider pilots; and VC funds such as New Leaf Venture Partners. Updated 14 May (more…)