Qualcomm Life, which to date has been more involved in device connectivity, interoperability and data management through its 2net Platform, has acquired care coordination platform HealthyCircles. Announced at ATA2013, the HealthyCircles service-as-a-software adds a front end to 2net’s biometric data that will aid in post-discharge and chronic care management from the hospital to home care providers to family caregivers. Qualcomm is clearly going after the hospital ACO (accountable care organization) market in areas such as reductions in 30-day same cause readmissions; the fit with WebMD in integrating 2net biometric data with the former’s reference information, as announced at mHIMSS, is a little less apparent [TTA 5 March]. MedCityNews, HealthcareITNews, Qualcomm’s (jargon-laden, nearly unreadable) release.
Reducing dementia patient anti-psychotic drug usage via telemedicine
A largely hidden problem in US skilled nursing facilities (SNFs) has been the inappropriate and over-use of multiple psychotropic drugs in dementia patients. A two-year old telemedicine (telepsychiatry) company, Forefront TeleCare, is targeting SNFs and clinics in rural counties across 18 states. Rural areas have sparse behavioral health coverage; medications to mitigate the effects of dementia and other mental illnesses are often prescribed by non-psychiatrists who have a limited knowledge of their effects over time, particularly in older adults. Forefront’s virtual consults weekly can keep track of these patients and reduce, adjust or update their medications. Video (from ATA). MedCityNews.
Microgripping and touching robots
Need that tissue sample, doctor? You may be laying aside your scalpel and forceps for a swarm of microgripping robots that you place and retrieve. David H. Gracias, PhD. and his Johns Hopkins team has developed star-shaped nickel metal discs of only 300 micrometers in size which snip bits of tissue. Using a magnetic catheter, the microgrippers are then gathered and removed–hopefully. Gizmag; study in Gastroenterology.
Last week, the TakkTile, this week, piezotronic transistors. Thousands of them arrayed, and designed to give robots–and touchscreens–that extra and almost human edge in touch sensitivity. The transistors in thin, flat material can sense changes in their own polarity when pressure is applied due to their zinc oxide composition. Initial use will probably be in touchscreens, but the Georgia Tech project’s supporters–the Defense Advanced Research Projects Agency (DARPA), the National Science Foundation (NSF), the US Air Force (USAF), the Department of Energy (DOE), and the Knowledge Innovation Program of the Chinese Academy of Sciences–are also considering its use in prosthetic skin or limbs. Gizmag.
Where the real remote care innovations are
Another report by James Barlow from the ATA Conference.
More evidence that the really innovative thinking in the remote care world is coming from lower income countries. Dr Sikder Zakir from the Telemedicine Reference Centre (TRC – www.trclcare.com) in Bangladesh reported on the use of mHealth to improve access to underserved populations. Usually this would involve telemedicine – in its m- or non-mHealth guises – bringing healthcare to remotely located rural populations. Bangladesh is no exception, with 40,000 doctors and 25,000 nurses for 160 million people. But as is only too obvious to anyone who has been to countries in the Gulf there is a huge population of migrant workers living there. The 5 million expats from Bangladesh have 20 million dependents back home dependent on remittances, but neither side is well served for healthcare. The TRC is using mHealth to provide expats with access to doctors in Bangladesh via SMS messaging and voice calls, and extends the service – free – to up to five of their family members. Funding is via a $3 a month subscription paid via the migrant worker’s mobile phone network. The scheme is being tried out with 80,000 migrant workers in Singapore, before moving to Saudi Arabia and the UAE.
We also heard from Dr Zakir about AMCARE (www.amcare24.com), an example of mHealth being used to extend diabetes care from hospitals to villages. This uses microinsurance payments (50 US cents / month) to cover the costs, a business model that is now gathering momentum in developing countries’ health systems.
Continua Alliance launches presence in Latin America
Brazil, to be precise. Wondered when they’d get round to it. Continua Alliance launches presence in Latin America (mHIMSS)
Avatars to help close the doctor-patient communication gap?
An interesting concept and some interesting stats lurk under the pedestrian title of an article by Willie D Jones in the biomedical section of IEEE Spectrum’s risk analysis blog: Can Avatars Help Close the Doctor-Patient Communication Gap? The idea is that an electronic entity that can be interrogated by a patient and which has access to his or her electronic health record could act as a non-threatening intermediary between doctors and their patients…’someone’ who can be asked those stupid questions one might feel to powerless to ask the doctor in person. Heads-up thanks to Toni Bunting.
Plus ça change – this appears to be a modern take on the centuries-old Chinese practice for women to use small statuettes called ‘doctor’s models‘ to indicate to the doctor what was ailing them when face-to-face contact was embarrassing. (Although experts at Christie’s now believe these figures had a ‘more erotic intention’.)
NHS telemedicine system for strokes hailed a success
A few weeks late in the posting, but relevant to the telemedicine collaboration issues raised by Professor James Barlow’s report from the ATA 2013: Over the last 18 months a telemedicine system set up to help stroke patients by the NHS Cumbria & Lancashire Cardiac and Stroke Network (CSNLC) has provided 24-hour access to thrombolysis treatment from remote specialists. The telestroke network serves eight hospitals that serve a population of 2.2 million. NHS telemedicine system for strokes hailed as a success (ComputerWorld) Heads-up thanks to Alistair Hodgson.
Surgical telemonitoring – the next milestone for telemedicine?
The first in a series of real-time reports from American Telemedicine Association annual conference in Austin, Texas, by James Barlow, Imperial College London.
The ATA conference has just included an interesting session on surgery as the next milestone for telemedicine. While telesurgey has long been an area of interest in remote care, pressures in the health system and developments in technology are combining to create new opportunities for supporting surgeons in their work. But many of the familiar implementation challenges are also looming large. So what were the reflections from the panel and discussion?
The consensus was that we need to shift the state of the art in operating room practices from considering volume and quality to broader notions of ‘value’ embracing cost, quality and access. Hospitals will be increasingly rewarded on outcomes and patient satisfaction, and telesurgery potentially helps improve both.
Two kinds of broad telesurgery model are envisaged – the expert surgeon ‘broadcast’ their operations to a wide audience and a more 1:1 relationship where the expert is remotely located and provides support for a specific operation. The ‘new telesurgery’ will involve three things.
- Just phoning another surgeon for advice in the middle of an operation is no longer good enough. There will be much more collaboration between surgeons, using new collaborative tools for bringing people together at a distance. The possibility of virtual environments around the operating room is already here and should be widely embraced.
- Large peer-supported integrated surgery networks will emerge with surgeons paid for the time they spend providing advice or moderating discussions. Spending 10% of your time mentoring other surgeons – perhaps around the world – will become part of the norm.
- A pool of recognised expert mentors will develop. Mentors can be ‘in the room’ virtually during the procedure. Or they can be invited to participate in situations where there is an ‘index case’ – a rarely encountered procedure – where the pool of knowledge is spread thinly.
All this is going to clash with the inherent conservatism of surgeons and their unwillingness to change tried and trusted approaches and technologies. The big challenges for moving forward in telesurgery are:
- ‘Network effects’ need to kick in – there has to be a critical mass of users and installed technology to generate the biggest benefits.
- Inevitably there are incompatibilities in technical standards for data transfer.
- The focus so far has been on audio and video, but integrating patient data into telesurgery and back into patient record systems is also essential.
- Tools for virtual collaboration are rapidly developing, allowing crystal clear video, remote access to laparoscopic images, virtual laser pointers, and doing all this on tablets. These need to be made widely available.
- Reimbursement and business models – who pays for what? Can we find ways of reimbursing hospitals / surgeons providing experts? How do we schedule expert mentor time and build this into their contracts?
- Medico-legal. There are cross border (or cross state issues here in the US) licensing issues and big problems of responsibilities in the event of problems arising in a telesurgery procedure.
Northamptonshire NHS contracts for video consultation service (UK)
The Saypage Telehealth Platform looks like an interesting addition to the number of companies providing video conferencing services to health services in the UK but the company’s announcement would get a warmer welcome from us if were not for its classic hype-it-up press release. Just because one NHS Trust has contracted for the service does not justify the implied claim that the whole NHS is rolling it out. NHS Launches Online Video Consultations Service Using Saypage Telehealth Platform. The lesson for all suppliers is to keep it real if you do not want to undermine readers’ respect.
Wales: telehealth research participants sought
The Institute of Rural Health and Aberdeen University are to research the effect of technology on patients interactions with their home carers, and are seeking input from patients using telehealth in the Powys and Betsi Cadwaladr health board areas. Recruitment is open until the end of June and seeks patients aged 60-79 years, who are visited by a nurse or other professional carer at least once a week and are using some sort of telehealth technology to help them to manage chronic pain or another medical condition. ‘Technology’ might include the use of internet forums, phone ‘apps’, or Skype links to carers. For further information please contact Sophie Corbett at the IRH on 01686 629480. (Info via Dispensing Doctors’ Association)
eDevice M2M company growing strongly (France)
According to its pre-ATA press release, eDevice “has 100k connected patients” but, as the release rambles, it is hard to identify just where these are. However, it is clear that the company has grown strongly and anticipates further strong growth.
US top 10 iPhone mHealth apps generate 5.5 million lifetime downloads on average
According to a reasearch2guidance blog post publicising a new report, the most successful free health and fitness apps accumulated 5.5 million downloads on average since their first appearance in the Apple App Store. However, there are significant performance gaps that highlight the importance of choosing the right platform, app category and device choice for mHealth publishers.
Police use GPS trackers to find people with dementia (UK)
According to a BBC TV report (may not be viewable outside the UK), Sussex Police has become the first force in Britain to pay for GPS tracking to help people with dementia. They are using the £27/month Mindme device.
UPDATE 2 May: Mike Clark on the 3millionlives LinkedIn group has pulled together links to items that are appearing in response to the above BBC report. For readers without access to the group they are from the Guardian; the Telegraph, the BBC and the Alzheimer’s Society. Judging by the comments on the Guardian article, the National Pensioners Convention badly misjudged the public mood on this one, and their press release muddles the issues of service funding, who should be responsible for people with dementia, and social isolation.
Curl me up
Phones have rung or buzzed since Alexander Graham Bell’s time. What if it simply…curled? That is perhaps the Phone In Your Pfuture, or something like the MorePhone. The prototype “can curl its entire body to indicate a call, or curl up to three individual corners to indicate a particular message” –phone, text or email. The thin, flexible electrophoretic display is manufactured by Plastic Logic, a UK company. Developed by a team from Queen’s University (Toronto, Canada) Human Media Lab, it will be presented at the ACM CHI 2013 (Computer-Human Interaction) conference in Paris this week. But don’t hold off on getting that Galaxy 4G…this is estimated to take another 5-10 years to market. The possibility of course is that some of its underlying technology and Plastic Logic display will find its way into other devices. GizMag, Human Media Lab press release, main page with short video.
Jawbone definitely ‘up’ with BodyMedia acquisition
BodyMedia, mentioned earlier today in context with wireless expansion into telehealth M2M (in this case, T-Mobile) is being acquired by Jawbone (of the UP bracelet). BodyMedia’s wearable (on the upper arm), wireless syncing body monitors, developed over 14 years and with FDA Class II approval, have primarily targeted the ‘serious’ dieter with chronic weight problems and/or a diabetes prevention need, not the occasional exerciser. Their partnerships with Jenny Craig, Apex Gyms and a trial with Cigna employees have been tailored to this objective. In contrast, Jawbone has consistently targeted the more casual user with fashionable wrist-worn bracelets plus a wider variety of features such as mood, sleep, activity and food tracking. It appears the two products will be kept separate for now. The bonuses: BodyMedia’s deep technical expertise (indicated by the unusual announcement of BodyMedia’s employees joining Jawbone, badly needed by the latter in light of their product development stumbles), 87 (!) patents, a massive database of human sensor data and the Vue Patch disposable sensor developed in conjunction with Avery Dennison announced at CES. Jawbone release, Mobihealthnews article.
Related: Jawbone UP’s iOS version now can incorporate data from other devices and platforms via partnerships with IFTTT, LoseIt!, Maxwell Health, MapMyFitness, MyFitnessPal, Notch, RunKeeper, Sleepio, Wello and Withings. Wired
Previously in TTA re Jawbone: Is it Hope? Hype? Or just the Same Old Struggle?, Quantified Self fail: nighty-night for Zeo, Quantified Selfing as…Show & Tell?
In-car health monitoring: a Quantum of Dismay
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /]The simple pleasure of a drive, with the cheerful sound of a quiet engine purring and the pleasures of early Spring, are rapidly becoming as obsolete as no cell phone zones. Eye realized it this Sunday whilst driving in Big Blue (left, Cadillac,1955) with Waldo Lydecker to a scenic overlook on the New Jersey Palisades, where other like-minded vintage Cadillac owners unusually take pleasure in parking, eyeballing paint, chrome and upholstery, telling Cadillac tales and generally not doing very much for a few Sunday hours. But it was the drive to and from the garage that gave one pause. Blue must share the road [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/04/04281312541.jpg” thumb_width=”150″ /]with fellow vehicles of all sorts, piloted by–to be kind–distracted drivers minding their GPS, smartphones and MP3 players. Now Blue, being a mature lady, has rather a leisurely pace in gliding her 4,500 lbs both forward and to a stop, so she will mind you if you mind her with a little more room and consideration than a nippy Mercedes hussy coupe.
Thus yesterday’s article from the Telegraph (UK) adds to the Quantum of Dismay. The Gimlet Eye has already turned a very dim eye on the phenomenon of the Automotive Dashboard as mHealthy Monitor. Ford’s SYNC apps alerting you to pollen, pollution and your chances of having an asthma attack at the wheel–useful when used before travel, but blinking and beeping at 70 mph in four-lane traffic? A driver’s seat for hypochondriacs that measures blood pressure, pulse, stress and…blood glucose? (don’t ask)…may work well in the lab, but any New York, Washington, LA or London Metropolitan Area Rush Hour will produce a sound arrangement straight from the Raymond Scott book. A BMW steering wheel that measures perspiration? Ah, the Eye thought that driving your Beemer was supposed to make you glow with excitement. Is it TMBD (too much busy dashboard)? Is it TMI (information), especially if the signs are recorded? Would you then would be ‘asked’ to ‘volunteer’ said information to your insurance company and state DOT due to medical causes? Privacy concerns abound. Cars that can monitor your health–are in-car health monitors the way of the future or a step too far? (Telegraph)
Previously in TTA: Eye’s earlier dismay in More cars that will monitor your BP…and brain waves, Ford SYNCs up with Allergy Alert; Editor Donna not much more pleased in Ford’s ‘car that cares’ visits CES, Syncs up Healthrageously; Your car as mHealth platform.
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