Harvard Business School + Harvard Medical School = Forum on Healthcare Innovation

July 26, 2013 | by

Definitely for your weekend perusal, the report issued earlier this month from the first collaboration between HBS and HMS, the Forum on Healthcare Innovation, is derived from the five-panel, two-day conference, ‘Healing Ourselves: Addressing Healthcare’s Innovation Challenge’, held last November at HBS. It centered on ‘Five Imperatives’ :

1. Making Value The Central Objective
2. Promoting Novel Approaches to Process Improvement
3. Making Consumerism Really Work
4. Decentralizing Approaches to Problem Solving
5. Integrating New Approaches Into Established Organizations

Dan Munro’s Forbes article is an excellent summary of a 26 page report. Additional content and videos are available on the Forum’s website. The one certainly worth watching is Clayton Christensen’s as moderator of Panel 4 – Improving the Patient Experience (link) which focused on decentralizing care–pushing care out to consumers via clinics and decentralizing the innovation process. (The Innovator’s Prescription discusses this at length.) What is notable from the initial reading is that no one is discussing ‘technology’, HIT or mobile health specifically or as a panacea–but it is shadowing everything : effectively using patient data, the quality of that data, and ways patients can use information to guide their choices. This doesn’t seem like a single shot effort, so we’ll be watching for Round 2.

When mHealth and telehealth become ‘just healthcare’ (US)

July 25, 2013 | by

GovernmentHealthIT reports that, speaking yesterday during the first day of the World Congress on mHealth and Telehealth in Boston, US, Jonah J. Czerwinski said Veterans Affairs (VA) had managed the health of some 500,000 people using telehealth in 2012.  He expects this to rise to over 600,000 this year.  He is senior advisor to the Secretary of the U.S. Department of Veterans Affairs, where he leads the VA Center for Innovation.  That’s some endorsement for telehealth!

“It’s connected healthcare – no ‘tele-,’ no ‘m-,'” he is reported to have told the audience: “This is just healthcare.”

Picking up on the topic of automating telehealth monitoring, he also described how the VitaLink home monitoring system, one of the VA’s more promising telehealth projects, has been developed by the VA from algorithms used in the mining industry to detect when drill bits embedded deep in the earth were stressed out and ready to fail.

Soapbox: Further thoughts on CarelineUK, O2 & WSD

July 25, 2013 | by

The many, excellent, comments on O2’s withdrawal of their current telecare & telehealth offerings in the UK market, most notably from my fellow editor Alasdair Morrison, have prompted further thoughts on the post about CarelineUK’s 25th anniversary earlier today: what will CarelineUK,  and other organisations like it, look like in 25 years’ time?

Perhaps the most significant change that appears to be coming in the area of telemonitoring is  (more…)

CarelineUK celebrates 25th Anniversary

July 25, 2013 | by

Congratulations to CarelineUK on the 25th anniversary of the receipt of their first emergency call.  According to the announcement on their website they are now the largest monitoring centre in the UK, covering over 110,000 service users across the country.  Over 120 people work at their New Forest call centre which has the ability to integrate telecare & telehealth monitoring. and is compatible with digital networks.

Gestational Diabetes Telehealth trial at John Radcliffe Hospital, Oxford (UK)

July 24, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/07/John-Radcliffe-Hospital.jpg” thumb_width=”150″ /]Diabetes in pregnant women, known as gestational diabetes, is said to have significantly increased over the past 20 years and affects 1 in 20 pregnant women in the UK. This  is probably caused by an excess intake of carbohydrates, says Dr Lucy Mackillop of John Radcliffe Hospital, in an interview in Inside Health on BBC Radio 4, broadcast on 23 July 2013.

A foetus growing in a high sugar environment can lead to an overweight baby resulting in birth difficulties. Such babies may also develop problems such as diabetes in later life. Gestational diabetes also carries all the usual dangers of diabetes for mother.

If a pregnant woman has one of 5 risk factors she will be fully tested for diabetes and if she is diabetic, she will be monitored during preganancy. Monitoring typically may be a fortnightly hospital visit, but at the John Radcliffe there is a trial of 50 mothers who have been given special blood sugar meters which connect to smart phones via Bluetooth.

A daily blood sugar test result is transmitted to the hospital where software picks out patients that may need attention by a midwife, and changes to the treatment regime can be implemented if necessary. This saves many unnecessary hospital visits while giving a much more frequent review of the state of the patients.

Download the full programme from the BBC Radio 4 podcast page.

Telehealth – the RSM guide

July 24, 2013 | by | 2 Comments

Some while back a suggestion was made that the Royal Society of Medicine produced a short guide to telehealth that gave an unbiased a view as possible of the topic.

Well it’s now been published on the website and will also be available in print at selected conferences and similar gatherings.  The intention is that it can be given to clinicians, patients and other interested parties that want to know more.  It is also unashamed publicity for the RSM’s (unbiased) telehealth-related events, for those that want to know even more – the website version will be refreshed as events come & go.

I should immediately declare an interest as one of the authors – the others are Prof Brian McKinstry, Dr Richard Williams and Helen Lyndon.

Special thanks to inHealthcare and medvivo for their kind sponsorship.

Hope you like it!

Leicester City CCG sets impressive standard for COPD telehealth savings

July 24, 2013 | by

EHI describes what looks to be a hugely impressive COPD project being run by NHS Leicester City CCG.  Using a “definition of saved admissions that identifies when a clinical intervention has been made that stops a patient being admitted to hospital within 14 days” they reckon they have prevented 107 hospital admissions over the past 30 weeks and they are currently up to only 47 patients.  As these 30 weeks referred to will have spanned the winter months (usually the worst time for COPD exacerbations) even if there are no avoided hospitalisations at all in the remaining 22 weeks to the first anniversary of the project, on these figures they are preventing upwards of (more…)

Cambridge Wireless Healthcare Special Interest Group

July 24, 2013 | by

Queens College, Fitzpatrick Hall, Silver Street, Cambridge.  Thursday 26th September 2013

The Cambridge Wireless Healthcare Special Interest Group (SIG) in association with IET, Cambridge Biomedical Campus and EAHSN present  ‘Management of long term, chronic conditions – Technology innovation in patient pathways’.

This half-day topical event will highlight the challenges and opportunities technological innovations present to the health service now and in the future. It will follow the patient pathway; from initial contact with an NHS member of staff (such as their GP), through to referral, primary treatment and support from social care services. Speakers will address the issues surrounding the remote monitoring of carers and how that maps onto the technical world with a focus on clinical improvement and patient support, safety and confidentiality.Confirmed speakers: Keith Swinburne of Papworth Hospital, Dr Afzal Chaudhry of CUH, Dr Andrew Grace of University of Cambridge, Dr Rachel Morris of University of Cambridge School of Clinical Medicine and Charles Lowe of The Royal Society of Medicine.

To find out more information and register, please visit their website. Agenda. Registration.

Editor’s note: our Contributing Editor Charles Lowe will be the kickoff speaker.

O2 to stop selling telecare & telehealth in the UK

July 23, 2013 | by | 41 Comments

To quote from the O2 website: “We would like to let you know that O2 Health has taken the difficult decision to stop selling our telecare (Help at Hand) and telehealth (Health at Home) in the UK. We will cease providing the Help at Hand and Health at Home services to existing customers.”

There are more details on the website – the reason given for the decision is that the uptake of mobile telecare and telehealth in the UK marketplace has been slower than anticipated.

As someone who attended the launch of Help at Hand in March, and who has been really excited about O2’s decision to move into the end-consumer market as the harbinger of the development of a consumer telemonitoring service market, this has left me in a state of shock.

There are of course now apps that can make a standard smartphone or tablet behave in a similar manner to the dedicated kit that O2 has provided.  However the principal challenge with retail sales of telecare and telehealth has always been the monitoring/response end, which O2 will now presumably be withdrawing.

A sad day!

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/07/o2-on-sale-after-withdrawl-26jul13.jpg” thumb_width=”200″ /]Update 26 July: A reader has sent us a snap of the O2 display taken today at their local (Hertfordshire) Tesco pharmacy counter. That person spoke with the pharmacist who said they hadn’t been told it had been withdrawn! This Editor (Donna) notes that the display is jammed in adjacent to the £5 Cholesterol Check and flyers for ‘Are You At Risk For Diabetes?’ Aside from its unattractiveness and medicalization, whatever happened to what presumably was the marketing takeaway message–freedom to live life out of the home in safety for the first time, delivered simply? Looks like the POS (point of sale) missed that all-important mark.

Stats on medical apps on Apple & Android

July 23, 2013 | by

iMedicalApps reports on the latest stats on medical apps on Apple & Android.  Overall figures show Apple with more than twice as many as Android.  It would be interesting to know how that split would be for apps aimed at patients – notwithstanding the previous post, I get the impression that the balance between the two is evening up.

There is a stark contrast between these numbers (over 19,000 for Apple, just over 8,000 on Google Play) and the small number of medical apps approved by the FDA (just over 100 according to a comment on the report) and on the NHS Choices health apps library.  Even making a very generous allowance for clinician-focused apps, this still emphasises the importance of the work underway just now on ordering the market to give users greater confidence in the safety and efficacy of what they download.

Clever use of augmented reality in patient education medical app (iOS)

July 23, 2013 | by

iMedicalApps reports the first example it has seen of the use of augmented reality in an app aimed at educating customers – in this case about eye problems.  The iTunes link for EyeDecide is here.  The app is produced by Orca MD.

Looks an impressive app.  The example shown is of the effect of age-related macular degeneration: anything that can encourage people to have their eyes regularly checked by showing them what happens if they don’t has to be good.

Health tech funding reshapes, diversifies

July 22, 2013 | by

In thinking how funding for health tech startups has changed since this Editor’s early days (2006) when VCs had a lock on the Letter Series (A, B, C) and your real goal was to ‘please, Lord, won’t you find me a strategic investor?’ (are there any of those left?), some more pointers to the future, both in EU and US:

Withings, known for its pioneering Bluetooth scale circa 2009, and more recently other Bluetooth monitors, nimbly moves to wearables with a fitness tracker about the size of a USB drive and priced at an affordable $99. It also has raised $30 million led by Bpifrance with $15 million, with participation from Idinvest Partners, 360 Capital Partners, and Ventech. (Most of us have forgotten that Withings is a French company.) A French challenge to Fitbit, Nike, Jawbone and a whole raft of smartwatches coming 2013-2014 including Sony, Pebble and Apple? VentureBeat

Angel funding diversifies geographically. No longer do the coasts have a lock on the action. Silicon Valley has had some problems [TTA 18 July], Silicon Alley (NY) is still finding its way and Boston/Cambridge is, well, Boston/Cambridge. We recently covered angel groups in Ohio (LaunchHouse), Texas (Wildcatters) and Arizona (SeedSpot). Now Delaware joins the list with FP Angels. And where are most of the companies? According to the Halo Report, in the US Southwest. Angel investing groups show love for the Southwest and healthcare in Q1 (MedCityNews)

And the rise of crowdfunding. As mentioned previously, angels and ‘FFF’ funding has been supplemented and market tested by crowdfunders such as Kickstarter, IndieGogo, MedStartr and Health Tech Hatch. Two kitchen-table entrepreneurs can market test their idea almost immediately. The problem is failure to deliver on time, on budget and as promised, as witnessed by the overwhelmingly successful Misfit Shine. The math of Hardware+Crowdfunding=Success has more than a few caveats in the formula. The hardware revolution will be crowdfunded (VentureBeat)

And a little-noticed change in Securities & Exchange Commission (SEC) regulations lifted the ban on ‘General Solicitation’ which according to this Forbes article will allow entrepreneurs seeking funding to cast a net beyond their network of ‘pre-existing relationships’–but they have to be accredited investors. It makes the reach to non-accredited investor interest just a little bit closer–for good or ill. The SEC’s Removal of General Solicitation Changes Everything

For our readers, health tech appears ‘siloed’ by region and country. What does it take to move beyond borders?:

  • If your startup is based in the UK or EU, have you thought about reaching out to US funding through a US base?
  • If you’ve considered and rejected it, why? (Health tech
  • Why are we not seeing more activity by UK/EU companies in the US (or Americas) markets?
  • What do you perceive as the differences between developing health tech ex US–and translating it to the US market?
  • Has anyone had experience extending in non-US/UK/EU markets?

News ‘shorts’ for shorts weather

July 22, 2013 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/07/00114031.gif” thumb_width=”150″ /]It’s summer on both sides of the Atlantic–and shorts were spotted at the British Open! Thus a ‘short’ roundup of three items of interest–but this is after you read Charles Lowe’s superb Soapbox on bidding the WSD farewell, and TANN England’s Chrys Meewella’s latest on rural telemedicine.

An update on the US Department of Defense’s and Veterans Affairs’ efforts to combat PTSD. “Every VA facility is now required to provide evidence-based treatments for PTSD, including prolonged exposure” (PE). PE asks the patient in session to revisit, in their minds, the traumatic event. A study published in JAMA Psychiatry in July examined treatment by relatively novice therapists using PE with over 1,900 patients for PTSD and depression, and found that PE was effective in reducing both comparable to previous trials, plus “The proportion of patients screening positive for PTSD on the PTSD Checklist decreased from 87.6% to 46.2%.” The Reuters Health article reprinted in MedCityNews is an overview; link to JAMA abstract is here (subscription or library access required for full content.) TTA related: PE smartphone app coach 6 Aug 12.

Adding teddy bears to wearables, from Croatia…IDerma has developed Teddy the Guardian, a stuffed bear that according to a PSFK report records a child’s heart rate, body temperature, blood pressure and oxygen saturation, then sends the data to the parent’s smartphone. All the child does is to put their finger on Teddy’s paw or the paw on their forehead. According to the article, the sensors are CE/FDA approved, but reading this over, the system is not FDA approved nor is it in production. Note the IDerma engagement with Croatia’s bid for entry in the EU and the young entrepreneurs behind it. Hat tip to Toni Bunting, our new Contributing Editor and TANN Ireland editor.

Pointer to the future. Webnapperon form factors PCs into everyday objects. This Belgian based company reimagines a simplified PC as everyday, familiar objects on a side table–a picture frame is the screen, a doily interacts with the computer and through its RFID reader, reads a tagged item from family and friends that looks conventional, but has an RFID chip that delivers additional content  Apparently very little capability beyond this from the article but but perhaps serviceable for the oldest–and a pointer to the future in accessorizing objects with RFID chips. Springwise.com, and another hat tip to Toni Bunting. Website (in French)

Establishing high-level evidence for the safety and efficacy of medical devices and systems

July 22, 2013 | by

I have recently been made aware of an excellent publication jointly by the Royal Academy of Engineering and the Academy of Medical Sciences entitled Establishing high-level evidence for the safety and efficacy of medical devices and systems, so this post is to reach out to those like me who were previously unaware.

It is a major step forward in applying engineering methodology to evaluating the effectiveness of medical devices & systems and, even more important, ensuring their ongoing safety.  Those of us who have participated in a substantial randomised control trial such as the Whole System Demonstrator (see earlier post today) will take great interest at what follows the quote: “For pharmaceutical innovation, the randomised controlled trial is the acknowledged gold standard for creating a body of high-quality evidence. But designing clinical trials to establish the evidence for medical devices has proven more problematic.”

(Included in the paper is the observation  that the ultimate health improvement device when you leave an aeroplane that is in the air – the parachute – has never been proven by an RCT.)

Finally just to return to an earlier comment, the report makes the point that because medical devices can be changed far more often than the composition of a drug, the importance of appropriate safety monitoring is absolutely critical, an issue that is becoming increasingly relevant as penetration of telehealth (in particular) and telecare increases.  Whilst  we might choose to ignore the different nature of medical devices when assessing a trial, we cannot ignore the different nature of medical devices when designing and putting in place appropriate safety systems.

Digital economy twice the size the government thought it was (General interest)

July 22, 2013 | by

The FT reports that the National Institute of Economic and Social Research conservatively estimates that there are 270,000 digital companies compared to less than half that estimated by the government.

The report, just out, supported by Google, is entitled Measuring the UK’s Digital Economy With Big Data.  As the title suggests, it makes a strong case for the use of extensive data analysis in determining that the digital economy  has spread into every sector of the economy.

Hal Varian, Chief Economist of Google, wrote the foreword which includes the only reference to ‘biotech’ specifically in the report: “The UK is one of the world’s strongest internet economies yet the myth persists that it consists largely of tiny dotcom or biotech startups in a few high technology clusters that quickly bubble up and often go bust.”