Department of Veterans Affairs IT systems have been breached since 2010 by eight ‘nation-state-sponsored organizations’, affecting records of 20 million veterans, according to recent testimony in hearings held earlier this month by the House Veterans Affairs Oversight and Investigations Subcommittee. While the normal ‘hack’ is due to theft or an inside job for financial gain, these likely have a far more sinister nature. According to former VA Chief Information Security Officer Jerry Davis (now at NASA), the attacks continue from these countries, and according to Subcommittee Chairman Rep. Coffman, may include China and Russia. Testimony and evidence also revealed that those responsible for informing Secretary Shinseki may have understated the problem. The VA has certainly been taking its lumps with a Magic 8 Ball of late, with a derailed joint EHR project with the Department of Defense and wrangling on who’s leading integration [TTA 3 April; iHealthBeat]. VA Systems Hacked From Abroad, Was VA Secretary Misled About Breaches? (HealthcareInfoSecurity)
Patient non-compliance=toxic healthcare system?
Updated 20 June
A decidely contrarian view. Medication and treatment non-compliance is listed as one of the top ‘evils’ that patients inflict on the system which negatively affect outcomes and increase health costs. The doctor/hospital/insurance company laments, Why don’t they do what we tell them to do, exactly? Can’t we punish the patient for this? But what if non-compliance indicates a bigger problem to be solved in the system, comparable to a canary’s silence in the mine when toxic gases are present? Maybe it’s because clinicians don’t take the time to understand the patient’s life and how to fit the treatment. Victor Montori, MD of the Mayo Clinic, at MedCityNews’ ENGAGE conference last week pointed out that patient non-engagement can point to the following:
- The treatment isn’t right for that patient to begin with, and asking him to do more of it is only going to make matters worse.
- The medication and patient options aren’t adequately explained prior to the protocol starting or the prescription–after going home and reading the side effects of the drug, or talking to a friend, the patient opts out. Or the patient doesn’t understand or trust the drug, protocol or doctor.
- The burden of treatment or change is too much (temporarily or permanently) to handle for the sick patient (e.g. additional monitoring, diet)
To Dr. Montori, the best health system is not a ubiquitous, authoritarian one permeating every facet of life, but one that actually shrinks in size, makes it easier for the patient to follow treatment, focuses on treatments that reasonably match a patient’s lifestyle so that the person is ‘able to fully play the role he plays in his life’–in other words, meets the patient ‘job to be done.’ Mayo doc: Stop blaming patients. Healthcare industry’s take on non-compliance is all wrong (MedCityNews) Video excerpt 01:50.
Update 20 June: Full video of Dr. Montori’s talk via YouTube, Patient Centered Care–The Right Thing to Do Right (29:03)
Previously in TTA: Type 1 diabetes self-monitoring as a perpetual Battle of Stalingrad in The diabetic experience: the fly in the Quantified Selfing ointment.
The ultimate in Quantified Selfing?
The Quantified Brain may be the ne plus ultra of QSing. Only a neuroscientist on a Mission from God (and a really good insurance plan) would be getting twice-weekly MRIs and weekly blood tests for hormonal and gene activity levels. Russell Poldrack’s year-long self-study is to correlate his diet and moods, mental state and outdoor time with the scans and blood testing to capture the fluctuations in brain activity and networking–and his physical state. Example: his psoriasis flareups with increases in stress and changes in gene activity. Finally a bit of QSing that doesn’t have a hint of the faddish about it. The Quantified Brain of a Self-Tracking Neuroscientist (MIT Technology Review)
Health tech used more by urban affluent (US)
A report by the US Commerce Department’s National Telecommunications and Information Administration confirms what most of us already have assumed–that telemedicine and telehealth’s early adopters are both urban (8 percent versus 4 percent rural) and with household income above $100,000 (11 percent versus 4 percent with $25,000 or less income). The usage sampled in the study of 53,000 households in July 2011 looked at the 7 percent who go online (via PC or increasingly smartphone) to access medical records, engage in video conferencing with a health care provider (telemedicine) or participate in remote procedures, such as heart rate monitoring (telehealth). Ethnic differences are not great but notable: “Asian-American internet users were significantly more likely to use telemedicine than other ethnics groups, but the differences between whites, blacks and Hispanics is minimal, with white utilization at 7 percent and black and Hispanic participation at 6 percent.” iHealthBeat, Clinical Innovation + Technology overviews; USDOC study (PDF)
MyHomeHelper up for an award (UK)
MyHomeHelper, a product for dementia clients to stay independent in their own homes, beat off competition from over 200 nominations to become one of three products selected as a finalist at this year’s Technology4Good awards. They are up against some big companies such as Barclays Bank and would appreciate votes for them on that page and, as tweets count in addition, they are also hoping for tweets about them using hashtag: #T4GMyHomeHelper.
New book: Technologies for Active Aging
“Technologies for Active Aging offers novel answers to a range of aging issues, from safety and mobility to cognition and continence. Written for the non-technical reader, the book examines the potential of information and communicative technologies such as pervasive computing, smart environments, and robotics to enhance seniors’ quality of life and encourage independent living, better care and self-care, and social participation.” We can’t give a recommendation as we have not read it, but it is edited by two respected people in the field: Andrew Sixsmith of Simon Fraser University, and Gloria Gutman of the Gerontology Research Centre, both based in Vancouver. Technologies for Active Aging (PDF flyer). US Amazon link. UK Amazon link.
UK Community Led Care Conference – TTA reader discount
24 September 2013, Manchester, UK
We were just about to give you, Dear Reader, a heads-up on the Community Led Care – Meeting Needs Closer to Home conference when the organisers came through with a £45 public sector members discount, especially for you. The conference will cover:
- Changing the ‘default setting’ for Healthcare Delivery
- The Challenges of Providing a Truly Integrated Community Health Service
- The Role Technology can play in Supporting Care in the Community
Click here for full details. To receive the Telehealth and Telecare Aware discount, enter TELEPUB in the appropriate box when registering online or mention it if booking by phone: +44 (0)161 831 7111 (Ask for Christopher Sheridan on ext 282)
Piezo-resistive fibers for continuous BP monitoring?
Switzerland-based company STBL Medical Research AG has developed a new ‘blood pressure watch’ that relies on a wristband made from piezo-resistive fibres. These fibres measure the contact pressure of the device on the skin to overcome the problem of the device slipping on the wrist or muscle tension that can affect the measurements. The device is currently undergoing clinical trials. Piezo-resistive fibers enable “blood pressure watch” with continuous monitoring Gizmag – note the comments too.
Stimulating whole system redesign: Organizational lessons from the WSD (UK)
The seventh of 15 expected academic papers arising from the study of the Whole System Demonstrator (WSD) programme has just been published in the Journal of Health Services Research & Policy. The big takeaway is that local ‘ownership’ of new services DID lead to more collaborative practices across the care system BUT that the concept of whole system redesign around remote care is currently unrealistic. With headings such as ‘Misalignment between vision and enactment’, ‘Wider barriers’ and ‘Whole system working: Ambiguity and diversity’ one can see that the underlying analysis is more nuanced than the main conclusion might suggest. Stimulating whole system redesign: Lessons from an organizational analysis of the Whole System Demonstrator programme by Theopisti Chrysanthaki1, Jane Hendy and James Barlow, all of Imperial College, London is also available as a free 10-page PDF download.
A complete list of the WSD papers, updated as they are published, is being maintained here by Mike Clark, to whom thanks for the heads-up on this publication.
Health + Care conference (UK)
A month ago we brought you a preview of some of the telehealth and telecare elements of the Health + Care conference taking place in London today. For readers interested in keeping an eye on what is happening there The Guardian is running a live blog. There is also a press release from Tunstall.
The Guardian now has an extended version of the pre-event video (4 minutes) that demonstrates some of the technologies more thoroughly. How technology can be used in health and social care. Worth watching for its update. Hat tip to Mike Clark.
London Telecare group: new advertising initiative (UK)
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/06/londontelecare-jun13.jpg” thumb_width=”150″ /]The London Telecare group (an association of telecare provider services around the capital) has a long history of generating publicity for telecare via bus shelter spots donated by the advertising industry. [TTA July 2006] Now it is moving into print with an advert to appear on June 23rd in the Mail on Sunday’s ‘Senior Lifestyles’ supplement, covering the London and Carlton TV areas. John Chambers, for London Telecare, says “There are very few companies or organisations creating awareness of the telecare and telehealth services available from local authorities and the private sector. Without advertising, it’s no surprise that the public is still largely unaware…that’s something we have tried to turn around and, with very limited resources, our London and South East members have supported our poster campaigns in the past, which gained over £2m in media value using free unsold sites. Now we have devised a press advertisement designed to make people aware of what’s available. We hope that others will take note and follow our lead with greater resources and, hopefully, government funding. ‘Everyone should know!'”
inHealthcare supports and tele-monitors the health of rowing team (UK)
The gruelling GB ROW 2013 race event, where six crews of four people row 2000 miles around Britain unaided for 26 days in an attempt to break the world record, started on 1 June. One of the teams, The Islanders, is being sponsored by telehealth supplier inHealthcare which is helping team member and medic Alan Morgan to monitor his blood pressure and oxygen saturation readings to see how his body is responding to the challenge. No physical contact with support vessels or the shore is allowed. The race is not just a battle for the world record but a battle against the pain barrier as the four men overcome muscle pain, blisters and exhaustion. More info on inHealthcare’s sponsorship. Hour-by-hour updates on the teams and how they are coping.
Related TTA item: Telefonica sponsors diabetic’s Everest climb.
DocCom now on procurement framework agreement (UK)
DocCom, which we reported in February, has developed hospital-based social networking software and has been awarded a grant of £207,000 by the Technology Strategy Board (TSB) to accelerate its development, has now been put on the UK Government’s latest cloud procurement framework for cloud-based services, G-Cloud iii. Procurement frameworks make it quicker and easier for organisations such as NHS bodies to place orders with preferred providers because they do not have to apply the governance disciplines, or incur the costs, of competitive tendering each time. Press release.
Updated: Specialist housing does not reflect what most older people want (UK)
Please see the update added to the original item: Specialist housing does not reflect what most older people want (UK)
GP Online starts new commissioning website (UK)
GP Online already has a long reach into the consciousness of UK GPs and now the publishers have launched a new website focusing on commissioning matters. For any telehealth companies or organisations that want to win the hearts and minds of GP commissioners, this new site will surely be one to nourish with good information and, possibly, advertising. www.insidecommissioning.co.uk
W/Me tracking wellness and ‘real age’ via stress
The W/Me wristband developed by California-based (where else?) Phyode turns colors based on key physical manifestations of mood, with the goal of helping wearers control them. It translates the data it collects into three scores: mental state, agility, and ANS age readable on a smartphone via Bluetooth. Mental state can be either passive, excitable, pessimistic, anxious, or ideally, balanced somewhere in the middle. Since this Editor can see exceptions in places like NYC and LA, one wonders if they are on a different scale. Perfect for your favorite QS-er along with their Jawbone or FitBit. W/Me is on Kickstarter and oversubscribed for a ship date of August. Articles: PSFK/Boehringer Ingelheim blog, TechCrunch. Hat tip to TANN Ireland’s Toni Bunting.
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