Ann Collins is the Assistive Technology Project Manager for Brandon Trust (website) which provides homes for people with learning disabilities. She has a particular situation to deal with and would appreciate suggestions from readers. She says: “I am working on the reconfiguration of a property and am ideally looking for an integrated telecare solution for the people living there that will also accommodate the specific needs of an individual living in an adjoining self contained flat supported by the same team.

The individual needs an incontinence sensor that can be integrated into a chair. It cannot be placed under a cushion as it will be removed. It would need to be accessible so that the sensor(s) can be removed and cleaned. All wires and transmitters will also need to be hidden or remote as, if visible, they would be damaged. If the individual becomes distressed the first indication of this is that they start to tip over furniture. Is anyone aware of ways that we could use sensors (accelerometers, I assume) that would be able to detect if the furniture is turned over? Any ideas about standalone, integrated solutions or possible suppliers would be very welcome.” Leave suggestions in comments or email Ann.

In Editor Donna’s ‘in box’:

• Much hype around Misfit Wearables, which incorporates in its bracelet and pocket clip (necklace to come) a metallic activity/aerobics tracker called the Shine, which is the size of a quarter, uploads on both iPhone 4/5 and most Android devices via Wi-Fi, and will retail in the $79-199 range when released sometime in mid-2013. It’s raised more than $500,000 on crowdfunding site Indiegogo.com, plus developer Sonny Vu is backed by partner John Sculley (remember him a century ago at Apple?), Founders Fund and the ubiquitous Khosla Ventures. Activity-Tracking Tech Moves From Wrist to Neck, With Sculley’s New Shine Necklace (AllThingsD) (This is the only mention where Sculley gets the lead!)
• Researchers at the University of Pittsburgh have successfully developed a prosthetic hand controlled by the thoughts of a quadriplegic patient detected via electrode implants in the motor cortex part of the brain. According to The Scientist, it “rivals the way an unimpaired brain directs limb movement.” Published 16 December in The Lancet. Thoughts control robotic hand (The Scientist)
• A health texting provider, Televox, claims that 34% of Americans say they are more honest discussing their health problems through automatic calls, email, or text messaging, than in a face to face conversation with a doctor, and a similar percentage felt that receiving emails, texts and voicemails from their doctor increased trust. Despite the relatively large N of the study (over 1,000), the self-reporting online poll recruited via email and the sponsorship by Televox leaves one wondering how honest or objective the study is. Mobihealthnews.

The Avera Health Network provides remote telemedicine critical care to a Midwest slice of the 10% of US doctors currently serving the 25% of Americans who live in rural areas. Avera’s services–eConsult, eICU Care, eEmergency, ePharm and eLongTermCare for nursing homes–originate in a Sioux Falls, South Dakota ‘hospital-without-patients’ which utilize telemedicine and telehealth tools. It connects to rural doctors, nurses, clinics and hospitals in South Dakota, North Dakota, Minnesota, Iowa, Wyoming, and Nebraska where the doctors are few, the distances are far and the population is aging. Avera, according to the article, is the only eICU operation of this kind in the US and possibly the world. This Atlantic article is another good news story in that you see, in relatively few words, how distance care can be truly effective and secure–as of October, they reported an 18% decrease in ambulance and helicopter transfers to major hospitals, equating to $6.6 million saved. Where ER Doctors Work Entirely Via Webcam (Using a dedicated network, not Skype!)

The year should not conclude without at least one last look at data breaches. This article from HealthWorks Collective samples three but they are ‘doozys’–in the millions and all hacking. Over at Privacy Rights Clearinghouse, if you select only healthcare and tick all breaches save payment card fraud, there are 207–with the most serious belonging to Alere [TA 30 Nov], Gulf Coast Healthcare Services and the California Department of Healthcare Services all with breaches including SSI and over 10,000 records. Not a good leading indicator for 2013.

Watford New Hope Trust receives CommunityPod courtesy Telehealth Solutions is an item in a local newspaper. It should have been a really positive news story for the company Telehealth Solutions and the WNHT charity but the journalist’s failure to explain what the technology does, or its benefits, has spawned a series of uninformed comments. What a pity. Heads-up thanks to Mike Burton.

Because epilepsy is such a distressing condition there will surely be a crock of gold waiting for whoever can produce a device that can reliably monitor the brain activity of people with epilepsy when at home, especially when asleep. Here is the latest effort from researchers in The Netherlands which, they say, has a (good) 90% success rate: Tele-Epilepsy and Remote Seizure Monitoring in the Netherlands Shimmer Research. (Whoever coined the term ‘tele-epilepsy’ should be sent to the naughty step until they say sorry!) Heads-up thanks to Toni Bunting.

The Chain of Trust Project is a two-year pan-European collaboration between researchers in six countries, Greece, Latvia, The Netherlands, Poland, and Portugal and led by the Norwegian Centre for Integrated Care and Telemedicine. (Website). It began in 2011 with a literature review (PDF), a survey involving patients and professionals, and country-based workshops. Its 45-page interim report Understanding patients’ and health professionals’ perspective on telehealth and building confidence and acceptance (PDF) was published in November. Unfortunately, it is not until Section 3 (page 10) that the authors who, in the previous pages frequently and consistently refer to ‘telehealth’, define the term. “Telehealth refers to the delivery of healthcare across a distance, using information and telecommunications technology and specially adapted equipment. It allows health professionals to diagnose, treat, care, assess and monitor patients without requiring both individuals to be physically in the same location” which, in our book, is mostly ‘telemedicine’. This is confirmed in the footnote to the definition which states “Telehealth is in turn an expansion of the term telemedicine”.

This lack of up-front clarity doesn’t invalidate any of the findings, of course, but it may alienate readers who feel that they have wasted half an hour trying to figure out the particular context when, with a little thought, the definition could have been placed in a box at the beginning. Grrr… [Related TA item from 4 years ago]

“FDA approval of this innovative study design is a significant milestone. Pharmaceutical companies have been worried that the FDA would not accept telemonitoring in place of costly clinic visits,” said John Holland, senior vice president for research and business development at AMC Health. U.S. Food and Drug Administration Approves Remote Monitoring for Drug Trial. ThirdAge.com (3 pages)

Something other than wine for device suppliers to be mulling over the Christmas holiday season: the MHRA’s consultation about proposed changes to the European medical device directives closes on 21 January 2013. The MHRA “has been engaging with the Commission to influence its proposals as they have been developed over the last four years. We are pleased to see that they include measures that will improve the transparency, traceability, vigilance, and governance of the system, as well as the performance of notified bodies. However there are also areas of concern in the proposed regulations, notably those provisions which place additional burdens on industry and healthcare systems without a credible evidence base of the public health benefit.” For more information start here, then go here.