So many apps, so little time

August 27, 2013 | by

Over the past few days there seems to have been a particularly rich set of alerts related to mHealth apps (there’s even been an update to the mHealth Grand Tour website with a nice video to promote the tour that starts on 5th September). Adding to them a couple that others have kindly alerted me to, here are a few that might interest:

Let’s begin with an infographic on the rising popularity of mHealth apps that puts it all into context. However, in some countries mHealth is being held back by outdated privacy laws, and in the US lack of final FDA guidance is considered a check on progress.  If you ever wondered how much data your DNA, or your most recent scan contained, (more…)

Samsung gets jump on 2014 smartwatch rush

August 27, 2013 | by

Breaking news

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/galaxy_gear_mockup.jpg” thumb_width=”175″ /]Word via Mashable is that Samsung’s shot over the bow in the smartwatch wars comes on 4 September when it introduces its smartwatch, the Galaxy Gear, just ahead of the IFA consumer electronics trade show in Berlin. Rumor has it that it will be in five colors (white, orange, gray, black and the newest trend, white gold). This couples with their recent introduction of the massive phablet, the Galaxy Mega. No word yet on health applications, but what comes in the smartwatch will be an indicator of Samsung’s seriousness about extending S Health.  (Photo is mockup) Samsung’s Galaxy Gear Coming Sept. 4, Samsung’s Smart Watch Rumored to Come in Five Colors

Previously in TTA: Smartwatches as the 2014 tablet, redux; Apple-ologists discern ‘new’ interest in health tech and telehealth

Owlet baby monitor sock moving to market

August 27, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/product_sock-Owlet.png” thumb_width=”150″ /]About nine months ago [TTA 6 Dec 12], the Owlet baby monitor in prototype won a student competition at Brigham Young University. It definitely ‘socked it” to this Editor at the time as an elegant way to monitor baby vital signs or signs of distress; it is a sensor-rich sock transmitting to a smartphone. While it still had pending patents, needed further prototyping and of course no FDA approval, I recommended “if you’re an angel looking for a highly marketable telehealth item–and with adult uses in hospitals and nursing homes–a trip to Utah may be in order.” Owlet is now seeking $100,000 in crowdfunding directly via its website and Amazon checkout (it was rejected by Kickstarter for being a baby product!) and will ship the device at an early bird rate of $159 once the funding is achieved. (more…)

It’s that word again, and a new association (take your pick III) (UK)

August 27, 2013 | by | 1 Comment

First it was two cohort studies of the same project, then two reviews of reviews, and now two new organisations have recently emerged in the telemonitoring world.

So, to that word.  London Telecare has just announced it is planning to change it’s name to UK Telehealthcare and go nationwide.  No ®, no ™: true independence. This follows on from the recent emergence of (more…)

Gamification in the US; any great examples closer to home?

August 27, 2013 | by

In spite of gamification being at the peak of inflated expectations in the 2013 Gartner Hype Cycle, here’s a great example from the US journal Pediatrics of its use to encourage young people with cancer to improve their medication adherence.  The subject was also covered in the BBC’s Click (starts 13.55 into the programme), and the Hope Labs website is here…

…which prompts the question as to where the best examples of gamification use to improve health & wellbeing are on this side of the Atlantic. (more…)

At last a supportive article on telehealth! (UK)

August 27, 2013 | by

Richard Vize has written a highly-recommended article in the Guardian today entitled “GPs continue to do battle with government over telehealth”. This gives some valuable context to why publications such as Pulse continue to dredge up the historic Whole System Demonstrator (WSD) cost/QALY statistics as it did on Wednesday and  Thursday last week.

TTA readers will of course be aware of the reasons why those figures are so unrepresentative of the technology from our recent post on why it’s time to bid farewell to the WSD.

Particularly pleasing is to see recognition of the role of telehealth as a means of promoting wider improvement in the way care is delivered:

“Eventually, other costs will start to fall as telehealth becomes a catalyst for wider system change. At present it is a bolt-on to a care system poorly integrated and not adapted for telehealth. It will require clinicians to work together in new ways, particularly in more effective joint working between community and hospital staff.”

Saving a life with Google Glass

August 27, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/screen-shot-2013-07-05-at-9-10-08-pm.jpg” thumb_width=”200″ /]Further to Contributing Editor Toni’s posting on Google Glass being used during cardiothoracic surgery [TTA 26 August] is this report of a Glass app, CPRGLASS, coaching the user through CPR and developed by . The camera utilizes an algorithm which can detect a human pulse; the coaching provides music to do compressions by (at 100 per minute), uses the gyroscope to determine their adequacy, tracks time, number and calls 911 with the proper location as well as contacting nearest hospital. Even The Gimlet Eye likes this app as part of the proper potential in healthcare–as long as it isn’t mixed with the MTV Video Music Awards which would spell Cardiac Doom. ‘OK Glass, Save A Life.’  The Application Of Google Glass In Sudden Cardiac Death John Nosta in Forbes

Medtronic confirms forecast direction change, the market reacts, and brains are stimulated

August 27, 2013 | by

The ‘reasons why’ we (and others like David Shaywitz in Forbes) proposed back on 12 August for Medtronic’s purchase of Cardiocom were fully confirmed by their CEO Omar Ishrak in Bloomberg (21 August) and an analysis in Forbes (24 August). However, the Forbes article continues on to dump a bucket of cold water on Mr. Ishrak’s  ‘solutions provider’ strategem (so reminiscent of 2008-9 with different companies), positing that telehealth belongs with wireless/mobile companies (Qualcomm), companies further downstream (Allscripts, a major US pharmacy benefits manager) or other technology/monitoring companies. Mr. Market held the roses though (Deutsche Bank’s reiterated hold rating in Benzinga reflecting the consensus in Yahoo Finance).

What is interesting are their advances in brain stimulation to relieve pain in two areas. (more…)

Signs of a home monitoring bubble?

August 27, 2013 | by | 3 Comments
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/08/Ambio-health.jpg” thumb_width=”175″ /]Suddenly home-based remote monitoring is very warm, if not hot. The news of investments at all levels–from Medtronic’s purchase of Cardiocom [TTA 12 Aug] to a $525,000 third angel round investment in AmbioHealth (which this Editor doubts would have been on MedCityNews’ radar a year ago)–sounds like home telehealth is finally, finally gaining traction with investors, which have been more attracted to hospital-based and fitness monitoring. But is it the right type of traction based on reasonable expectations? We were among the first to point out in 2010 in positing the FBQs* that where the data goes, how it’s being used and who’s taking action on it was critical. Now Robert Pearl MD in Forbes is also examining the new song of home RPM and finding a few off notes (or to mix metaphors, finding a pan of fool’s gold):

That’s because some promoters of home monitoring technology believe doctors will carefully scrutinize each EKG or blood sugar reading and use the information to tailor perfect regimens for their patients. This is not how medicine works.

and

Looking at thousands of EKG tracings won’t add much value either. In fact, putting all that information into an electronic medical record (EMR) only makes it more difficult for doctors to identify other, more vital pieces of information. Instead, doctors need to understand which of a few possible patterns are happening to determine the appropriate course of action.

Dr. Pearl’s prescription is for smartphones to embed telehealth monitoring capabilities at a price point slightly above the current cost, but less expensive than stand-alone devices (more…)

Humanising healthcare…or doctor making a ‘glasshole’ of you?

August 26, 2013 | by

dont-be-scared-your-surgeon-may-soon-wear-google-glass-in-the-operating-roomA cardiothoracic surgeon at the University of California, San Francisco recently performed surgery wearing Google’s wearable computer, Google Glass.

Dr. Pierre Theodore described his experience at the recent Rock Health Innovation Summit. During the surgery he used the glasses to compare the patient’s CAT scan images with what was in front of him. “There was a cognitive integration between what I saw in front of me and the radiographs. It was extraordinarily helpful,” he explained, likening it to driving a car and glancing in the rear-view mirror (as opposed to having to turn around to see what’s behind).

Also speaking at the event was Ian Shakil, Co-founder and CEO of Augmedix, a start-up company which is building applications for healthcare on Google Glass. According to Mr Shakil, one aim of the technology is to re-humanize healthcare so that physicians can focus on the doctor-patient encounter and cut down on the non-patient facing tasks, like taking notes and looking up medical records. 

While it’s arguable whether or not companies such as Augmedix will succeed in further humanising healthcare (picture your doctor, one eye staring at you as you explain your latest woe, the other twitching around, viewing who knows what in a Google Glass eye-piece), various applications for Google Glass do seem to have real potential for being of benefit in certain healthcare settings.

Indeed, for better or worse, there’s little doubt that Google Glass (or a similar device) will be used in many professions in the not too distant future. And according to research carried out by Augmedix, most of us are fine with that. The company asked 200 patients before a visit if they minded seeing a doctor wearing Google’s head-worn gadget, and only 3 demurred!

However, as highlighted previously by the discerning gaze of TTA’s Gimlet Eye, we might be best served not to disregard the potential for misuse and abuse with wearable ‘cybernetic headbands’ such as Google Glass, not least in a clinical setting!

Read more: Fast Company / MIT Technology Review

 

Related TTA articles: Google Glass ‘hacked’ for hospital facial recognition / Google Glass through a doctor’s eyes / Google Glass: a proper potential in healthcare

Don’t be put off by the title…take II (and take your pick II)

August 26, 2013 | by

Following on from yesterday’s post entitled “Don’t be put off by the title, or the conclusion, of this review of reviews“, Mike Clark has kindly pointed me towards another recent review of telehealth reviews entitled “Telehealth – the effects on clinical outcomes, cost effectiveness and the patient experience: a systematic overview of the literature”, this time from Salford University, authored by Dr Alison Brettle, Tamara Brown, Professor Nicolas Hardiker, Jon Radcliffe and Christine Smith.

This paper provides an intriguing contrast to the paper reviewed yesterday in a couple of, doubtless unrelated, ways. Firstly, whilst the word that was the subject of yesterday’s post does not appear in the title (it does appear in the text), the paper was funded by an educational grant from the organisation most often associated with that word. Secondly, the review is noticeably more positive, for example:

“There is more evidence for some conditions than others, but on the whole the trends are largely positive suggesting that telehealth is effective in:

  • Reducing patient mortality and hospital admissions for chronic heart failure
  • Reducing hospital admissions for COPD
  • Reducing blood pressure in hypertension, improving glycaemic control in diabetes and reducing symptoms in asthma”

As with our two recent posts on Birmingham OwnHealth, it looks like it’s take your pick time again.

It is perhaps just worth adding that there are also significant similarities between some of the observations made in both papers, most notably about the small size of many trials, inconsistent collection of outcome measures and the weaknesses of the methodologies currently used for assessing the effectiveness of trials of medical devices.

Don’t be put off by the title, or the conclusion, of this review of reviews

August 25, 2013 | by

Whenever I see the word “telehealthcare” I feel there should be an ® or perhaps a ™ after it as it so often appears in connection with a particular organisation. However no such connection is evident is this paper entitled “The Impact of Telehealthcare on the Quality and Safety of Care: A Systematic Overview” (published on the PLOS ONE site), especially as the overall conclusion is far from that often found in articles toting that word:

“Policymakers and planners need to be aware that investment in telehealthcare will not inevitably yield clinical or economic benefits. It is likely that the greatest gains will be achieved for patients at highest risk of serious outcomes. There is a need for longer-term studies in order to determine whether the benefits demonstrated in time limited trials are sustained.”

If you stop there though, you miss some very important points (more…)

Medivizor patient info site goes public with additional information

August 24, 2013 | by

Medivizor, which was one of the better discoveries of our CE Week (NYC) coverage and the H20NYC/Healthcare Pioneers evening back in July [TTA 3 July], has moved out of what was a largely private beta to what they interestingly term a ‘public beta’. The site provides individualized content, understandable by the layman, for subscribers on a larger group of diseases which were on track for this fall: lung, colorectal, breast, and prostate cancer, as well as melanoma, diabetes, coronary artery disease, hypertension and stroke. The goal is to improve doctor-patient communications by better patient education. Another important feature is a “personalized system for matching individuals with specific clinical trials available worldwide.” Company release, Xconomy article.

A related New York Times article is an appreciation of how physicians are overwhelmed by information and that “doctors also need a skilled docent to help walk them through all that curated data.”  Healing the Overwhelmed Physician

Journal of the International Society for Telemedicine and eHealth (South Africa)

August 24, 2013 | by

A heads-up to our readers: a new peer reviewed journal out of South Africa’s University of KwaZulu-Natal’s Department of TeleHealth is the Journal of the International Society for Telemedicine and eHealth. On its second edition, their content (in PDF or HTML formats) seems to be of general interest:

  • Editorial: Would a Rose By Any Other Name – Cause Such Confusion? (defining eHealth)
  • Original Research:
    • TalkMeHome: an in situ evaluation of a service to guide a lost person with dementia home safely
    • Assessing the development process of the eHealth strategy for South Africa against the recommendations of the WHO/ITU National eHealth Strategy Toolkit.
  • Invited Commentary: Telerehabilitation: Current Challenges to Deployment in the United States

The Editors are certainly an international mix: Prof. Maurice Mars, University of KwaZulu-Natal, South Africa; Prof Richard E Scott, University of of KwaZulu-Natal Director, NT Consulting, Canada; Dr Malina Jordanova, Bulgarian Academy of Sciences, Institute for Space and Solar-Terrestrial Research, Bulgaria.

Addicted to mobile health? Telepsychiatry to the rescue!

August 23, 2013 | by

Dr. Joseph Kvedar of Boston’s Center for Connected Health counted himself in this Editor’s camp as annoyed by the mHealth hype (inflicted by those we’ve dubbed the D3H—Digital Health Hypester Horde), and far more of a believer in SMS for health programs. His blog post is a ‘kind of edge’ towards thinking that mHealth can be habit-forming. In the CCH’s own clinical trials, more participants have smartphones (tracking the general population’s adoption) even with the lag among those with chronic disease (maybe a question of affordability?) and want apps. And then he sees the pattern of people checking their smartphone obsessively, like budgies with bells and mirrors….along with a study that indicates that patients with a passive sensor to upload blood glucose measurement, rather than pushing a button, were “significantly more adherent to their plan and had better health outcomes.” Not having to do something in the Diabetic’s Perpetual Battle of Stalingrad is addictive? Well, this is edging towards a nomination for ‘What in the Blue Blazes?” Could mobile health become addictive? (CHealth Blog) Hat tip to reader Bob Pyke via Twitter

Well, we can send Dr. K to a connected psychiatrist for a session of e-therapy.  (more…)

Eye diagnostics a hot mHealth area

August 23, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”150″ /] The Gimlet Eye spied earlier this week that California startup iCheck Health Connection, which has a series of mobile app patents around eye diseases, has raised $750,816 of a $3.6 million offering (SEC filing) in what is presumably an angel round of funding. What was surprising in the Mobihealthnews article were their five patents around eye diagnostics: video games meant to monitor retinal diseases and visual field loss in glaucoma,  as well as “eccentric photorefraction, pupillary light reflex and the corneal light reflex eye screening tests in infants and young children.” The Eyes seem to have it lately with MIT Media Lab’s EyeNetra spinoff in July filing with the SEC their raise of $2 million of a $2.5 million round for their Netra-G app and attachment, which measures nearsightedness, farsightedness and astigmatism [TTA 9 July], Sensormed Triggerfish’s diagnostic contact lenses [TTA 31 July] and eye tracking as a stroke diagnostic [TTA 18 March]. Only last night Editor Donna at Health 2.0 NYC’s ‘Killer Apps for Healthy Living’ (KA4HL) saw Joshua Weiss, CEO of app developer TeliApp present his latest project, a mobile slit lamp sleeve that would fit over a standard smartphone and view the inside of the eye in clinical quality. (The office slit lamp is distinctly not mobile and costs between $2,500 and $5,000.)  The app would also enable a non-opthamologist/optometrist to flag eye issues as well as permit remote diagnosis in a home visit, in emergency response or by combat medics. It just went on crowdfunder MedStartr for a $16,000 funding towards an anticipated $160,000 raise for a prototype. (See Josh’s presentation at KA4HL here–registration required–at 01:50:57)

Contributing Editor Charles adds: there’s also an impressive mHealth app just announced in the UK that was developed by doctors in London and Glasgow to help diagnose serious eye conditions in the developing world called the Portable Eye Examination Kit (PEEK).  Around 39 million people around the globe are blind, 90% of them in low income countries; 80% of cases could apparently be avoided if health workers could reach them with affordable equipment.  PEEK is set to replace standard ophthalmology kit costing more than £100,000 with a £300 smartphone producing equally good results.

Trained health workers first assess a patient’s vision by flashing progressively smaller letters onto the screen.  Then they use the camera to check the lens of the eye for cloudy cataracts.  Finally, by attaching a special clip to the camera and switching on the flash, they are able to check the retina at the back of the eye for diseases such as diabetic retinopathy.  The images can be sent back to a hospital for assessment, along with the precise GPS coordinates of the patient’s location so they can be found later and treated.