BATDOK monitor jumps into action on the battlefield medic arm (USAF)

September 6, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/09/BATDOK-on-Wrist-586×350.jpg” thumb_width=”200″ /]US Air Force researchers have developed software with the long handle Battlefield Assisted Trauma Distributed Observation Kit (BATDOK). It runs on a smartphone or other mobile devices, which (suitably ruggedized) can jump into action with medical pararescue and combat rescue Airmen. Equipped with medical sensors, “BATDOK is a multi-patient, point of injury, casualty tool that assists our human operators and improves care. It can be a real-time health status monitoring for multiple patients, a documentation tool, a user-definable medical library, a portal to integrate patient data into their electronic health records, and finally it is interoperable with battlefield digital situation awareness maps, which helps identify the exact location of casualties.” said the head manager, Dr. Gregory Burnett, of the Airman Systems Directorate in the Warfighter Interface Division of the 711th Human Performance Wing. Aside from the technology, the intriguing point of the story is how the development team literally jumped with USAF teams into hot landing zones, returned back to the lab, yet everything was validated through the design, integration and testing process by the Airmen in the field–a tip that our health tech software and hardware developers would be well advised to follow. This Editor hopes that this technology will quickly be commercialized for use by civilian paramedics. Armed With Science (DoD Science Blog)  (USAF photo)

Tender Alert: NHS England–IAPT, Arden & GEM, Yorkshire and The Humber

September 6, 2017 | by

Susanne Woodman, our Eye on Tenders, has three that cover a major initiative of NHS England, plus two regional telecare projects.

  • NHS England–IAPT (Improving Access to Psychological Therapies). NHS Shared Business Services is procuring ‘Digital Therapies for IAPT Assessment: Project Management Organisation’. The aim of the programme is to find good quality, evidence-based digital therapy packages for use in IAPT services. Up to 14 digital therapy products will be assessed for IAPT by 2020. This will help expand provision of psychological therapies, as well as improving access to digital services, both goals set out in the Five Year Forward View for Mental Health. Clarification questions are due by Wednesday 13 September at 10am. Bid deadline is Monday 18 September at noon. More information and contact here on Gov.UK Contracts Finder. Additional programme information on NICE and IAPT here.
  • Arden & Greater East Midlands: Bravo reference Project 851 is an Innovation and Technology Tariff. There are three parts (2-4): the closest related to health tech is #4, web-based applications for the self-management of COPD. Deadline is 2 October 2017 at 5pm. More information and application links on the Arden-GEM website here.
  • Yorkshire and The Humber: Kirklees Council is seeking a provider of assistive technology and telecare solutions aimed at supporting vulnerable people to live safely and independently in their own home. This also includes support for existing and future social care applications, lone workers, and building security. Value of the contract is £210,000. Deadline is 2 October 2017. There’s not a lot of information on the Gov.UK page and it directs questions to the Kirklees coordinator.

PillCam in Dublin hospital test for small bowel diagnosis (IE)

September 6, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/09/Pillcam.jpg” thumb_width=”150″ /]Medtronic’s PillCam is being tested by Bon Secours Hospital in Dublin, Ireland for small bowel and colon diseases. The test group is only 50 patients, which is striking as the PillCam is in wide use in the US for diagnosis of Crohn’s Disease. The PillCam SB is 1.02″ wide and in an eight-hour test can take up to 55,000 pictures (two pictures per second). After the test, it is expelled naturally but in about 3 percent of cases, it is not, so a test capsule is used in many cases, according to their US website. Images from the camera are sent to a belt-worn data recorder, which from RTÉ Health Correspondent Fergal Bowers’ personal test, you’d want to avoid train stations and airports. Images are downloaded after the test. The prep is similar to that for colonoscopy, with one extra–that you have to wait at least eight hours after! It is also in use at Tallaght Hospital. The articles imply that it may be used instead of standard endoscopy, which in the US is a prerequisite. RTÉ on the Bon Secours test. Hat tip to our Northern Ireland correspondent and former TTA Ireland editor, Toni Bunting

Robot roundup: doctor cars, teleworkers, robogiggers, errant NAO robots

August 30, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/Overrun-by-Robots1-183×108.jpg” thumb_width=”200″ /]This month your Editor’s been ‘overrun by robots’ in the news! Here’s the roundup for your end of August reading, with an emphasis on how humans interact with robot helpers, especially at work:

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/08/7-who-needs-a-hospital-when-this-self-driving-doctor-comes.jpg” thumb_width=”150″ /]The doctor’s car has been around since the 1904 Buick, but the Seattle firm Artefact takes it one step further by combining the self-driving car with a fully automated clinic on wheels that arrives at your home, minus the doctor. Step in and it takes your weight, BMI, posture, respiration, and other sensor-based measurements guided through augmented reality instructions. It has a telemedicine interface in case you need a live virtual doctor. Medication? It’s a dispensary on wheels. Treatments? It will take you to a real doctor or provides AI-driven comparative information on treatment options. Artefact’s concept is part of their endless health monitoring continuum of care, which far more than the Doc Car is a little…creepy. FastCompany Design

Many of us are remote workers, but what if you could be in the office via a telepresence robot? A writer for Wired adopted an EmBot from Double Robotics so she could ‘be in the office’ in San Francisco while living in Boston. Her adventures with human-robot office interactions, developing relationship protocols, self-identification with it, and its many foibles (technical and otherwise) are a hoot. Hat tip to TTA Founder Steve Hards

Clark Kent would activate a robot to take his place at the Daily Planet while dashing off as Superman. Could a robot be your cyberself, working to provide you with an income stream in retirement? Or could you invest in robots working in the short-term robo-gig economy? Joseph Coughlin of MIT’s AgeLab in Forbes is quite certain that we’ll be hiring robot helpers around the house (including serving drinks) and some of us will become robopreneurs, sending out our robots to work. Far fetched? Froyo franchise kiosks (already promoted on radio in the US) serve up robot-prepared and sold frozen yogurt.

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/08/Nao.jpg” thumb_width=”170″ /]For your weekend reading (with coffee and a snack) is a study examining human reactions to a purposely programmed error-ridden NAO humanoid robot versus a behaving NAO in performing interactive tasks. The surprise is that people liked the faulty robot more than the perfect one. The study also gauged the human cues to errant behavior (sidelong gazes, laughter)–cues that could tell the robot it’s in error. To Err Is Robot: How Humans Assess and Act toward an Erroneous Social Robot (Frontiers in Robotics and AI) Second tipped hat to Steve More on SoftBank Robotics’ NAO here.

Tender Alert: Luton, Coventry and Warwickshire, EU mHealth

August 30, 2017 | by

Susanne Woodman, our Eye on Tenders, has three for September–one for a major EU initiative.

  • Luton: Luton Borough Council is seeking tender submissions for Call Monitoring & Response Services for Assistive Technology Solutions (Telecare). It is currently being operated 24/7 by Wellbeing staff using Tunstall systems and services. Over 25,800 of Luton residents are over the age of 65 in this highly multi-ethnic area. Bid applications for this five-year contract valued at £210k are due by 21 September. Start date is 9 October. More information at Gov.UK. 
  • Coventry and Warwickshire: The Innovative Coventry and Warwickshire Test Bed Project funded by ERDF is seeking quotations to form a framework agreement to provide consultancy services for workshops in community healthcare services, e-health sectors, and assistive technology. The value of this contract is £8,000. Closing is 10 September. More information at Gov.UK.
  • EU mHealth Hub: The joint WHO and International Telecommunication Union (ITU) initiative, ‘’Be Healthy, Be Mobile’’ is seeking a host for the EU mHealth Hub (‘’the Hub’’) as part of a Horizon 2020 funded project. They are pre-qualifying non-commercial EU institutions/organizations. Closing is 29 September at 1500 hours Geneva time. More information (including an eight-page solicitation guide) at the UN Global Marketplace. Requests for Expressions of Interest presentation (PDF)

‘Serving with heart’: two glimpses of innovation in Singapore and Thailand

August 30, 2017 | by

Probably a first for this Editor is news from Singapore on the healthcare technology and innovation front. The first report comes from Today where Deputy Prime Minister Teo Chee Hean advocates for the interesting combination of embracing innovation and ‘serving patients with heart.’ Speaking at the opening of the Lee Kong Chian School of Medicine’s Clinical Sciences Building in Novena, Mr. Teo talked not only about pathogens and biomedical research but also about remote patient monitoring, tele-consulting, and home-care robots.

From Thailand but addressing the Asia-Pacific market is Caroline Clarke, CEO for Philips Asean Pacific, on the region’s aging population and the outlook to 2050. Asia is home to 60 percent of the world’s over-60 population which is expected to grow from 547 million in 2016 to nearly 1.3 billion by 2050. She noted that the Future Health Index noted that while the benefits of connected care technologies were known in Asia, there was a lack of understanding on how and why to use them to take better care of their health. Philips has opened a regional headquarters in Singapore with advanced innovation facilities, announcing a partnership with EDBI to co-invest in regional digital health companies. The Nation

September-Autumn Events: The King’s Fund, Aging2.0 London, Health 2.0 NYC, RSM, ATA

August 29, 2017 | by

Summer is evaporating before our eyes. Fill your calendars to shake off the blues! Here are some events that depending on where you are, should go on it:

At The King’s Fund, London:

Monday 4 September, 5:30-8:30pm: HealthChat with Claire Murdoch and Roy Lilley. Ms. Murdoch is Chief Executive of Central & North West London NHS Trust and NHSE’s new National Mental Health Director. Tickets are £39.95 through Eventbrite here. (Note: this is a private event organized by UK HealthGateway, the publisher of the nhsManagers.net newsletter.)

We thank Roy Lilley for the top-of-the-letter mention of our recent article on telemedicine and retail healthcare. Until today, this Editor was not aware that the NHS was the largest purchaser in the UK of fax machines. Will Sarah Wilkinson’s appointment as the head of NHS Digital change that?)

Friday 6 October, 12.00pm-7.00pm: Ideas that change health care–a festival of ideas to inspire and challenge the future of health care. Free, but tickets are limited. Sponsorships available. More information here. #kfIdeas17

Wednesday 29 – Thursday 30 November, 8.30am – 5.15pm both days: The King’s Fund Annual Conference 2017. Day 1 concentrates on population health, Day 2 on modernizing the health and care system. More information here. #kfAnnual2017

Aging2.0 London at Innovation Warehouse

Thursday 7 September, 6-9pm: Aging2.0 London 2-Pint-0 presents Chris Sawyer from Innovate UK on the Digital Health Technology Catalyst 2017 – Round 1 [TTA 14 Aug]. More information here.

Health 2.0 NYC/MedStartr, midtown NYC

Wednesday 27 September, 6-9pm: Mental Health Innovations 2017. The rising need for and increased scarcity of mental health care calls for new approaches in technology and innovation. The usual lively panel of speakers, company presenters, and engaged audience. More information on their Meetup page here. (more…)

Optum/UnitedHealth clinches $1.3 bn deal for Advisory Board’s healthcare practice

August 29, 2017 | by

The Advisory Board consultancy group confirmed its splitup and sale, as originally reported by TTA in mid-July. The Optum data analytics/information/consultancy unit of UnitedHealth Group is acquiring the healthcare practice for $1.3 bn and the education consultancy will be purchased by Vista Equity Partners for $1.55 bn. 

According to Bloomberg, The Advisory Board has 3,800 employees and roughly $807 million in annual revenue. Reports indicate that it has served over 4,400 healthcare clients. According to the Washington Business Journal, regulatory filings show it will operate as a wholly owned subsidiary of Optum headed by Advisory Board Chairman and CEO Robert Musslewhite. As to relocation, Advisory Board spokespersons confirmed that they will still be moving into a new headquarters on New York Avenue NW, indicating that a move to Minnetonka is not imminent and that at least some of the management will stay. There is no word on relocation out of Washington for the education practice. At closing, outstanding shares of Advisory Board will convert at $52.65 per share, plus an additional amount per share based on the after-tax value of Advisory Board’s 7.6 percent stake in publicly traded Evolent Health. The deal is expected to close by early 2018.

This confirms an earlier trend of healthcare consultancies merging and cross-acquiring. In July, Dublin’s UDG Healthcare acquired Philadelphia-based healthcare consultancy Vynamic last week, gaining a US foothold, then added marketing/communications company Cambridge BioMarketing in Boston. Rumors still have publicly-traded Evolent Health as a likely acquirer or acquiree of a healthcare consultancy. WTOP, Reuters

 

Fitbit unveils Ionic smartwatch earlier than expected. Their ‘Hail Mary’ pass?

August 28, 2017 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/08/Ionic-photo.jpg” thumb_width=”150″ /]Surprisingly, Fitbit has formally unveiled today (28 August) its first smartwatch, the Fitbit Ionic, on its 10th anniversary of its first tracker. It’s a slow news week in the US, being the week before the Labor Day holiday 4 Sept and in the UK this Monday with the summer bank holiday. The announcement also feels a bit like a soft reveal in a slow period. However, the industry expected an announcement later this year, so this is considered to be positive.

There’s plenty of functionality, though the watch itself from the photos (this is Engadget’s, as the press release did not supply close up pictures) is rather brick-like on the wrist. Balancing that out is a knockout of a 1.42-inch, 348 x 250 px display, the best and brightest yet in the reviewer’s estimation. It also curves a bit through nano-molding technology (NMT) to fit more comfortably on the wrist than the previous Alta tracker.

Engadget‘s test drive of an early version of the Ionic is thorough. It confirms that Fitbit went with its own proprietary OS, contactless payment and a subscription-based custom workout guide called Fitbit Coach, a rebranded Fitstar. More functions related to healthcare are:

  • Updated heart rate monitor
  • A new SpO2 blood oxygen sensor. There’s a bit of tease in the release which gives its potential in health use: “…a relative SpO2 sensor for estimating blood oxygen levels opens the potential for tracking important new indicators about your health, such as sleep apnea”
  • Sleep tracking through monitoring pulse and movement for stages of sleep (deep, REM, light, etc.). The Engadget reviewer noted the uncertain quality of tracking.
  • Integrated connection to the new edition of the Aria weight scale (release), also due in the fall

Pricing has been set at $300/£300 with the usual extra accouterments of dress and sport bands. If you can’t wait, pre-sale starts today on Fitbit.com with retail on-sale globally starting October 2017, without a specific date. For developers, the Fitbit app software development kit (SDK) will be open to developers in September 2017. 

Will this ‘Hail Mary Pass‘ save Fitbit? Like most smartwatches, it feels like a solution in search of a problem. It depends on how many true believers will upgrade from the Alta to the Ionic, or buy this rather than an Apple Watch, where first-half sales are up 50 percent versus last year to an estimated 2-3 million new units, partly on Fitbit’s faltering back. The big roll of the dice is going with a proprietary OS. Health and other apps are dependent on developers, who are going to have to make a business decision on the watch’s sales and acceptance to commit to a one-off app. 4th Quarter sales will tell….Our earlier coverage of Fitbit and related smartwatches is here.

 

Connected Health Summit 2017 San Diego — last chance to book!!

August 24, 2017 | by

29-31 August, The Omni Hotel, San Diego

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/07/CH17-Banner_20Discount_300x145.jpg” thumb_width=”200″ /]Starting tomorrow, but not too late to book! Take a trip to Southern California for the end of the traditional summer season (sob!). This year’s Connected Health Summit, organized by research organization Parks Associates, spotlights health technologies as part of the Internet of Things (IoT) and the transformational impact of these connected solutions on the US healthcare system. Presentations are organized around:

  • Remote health monitoring for accountable care
  • Consumer-centric wellness and fitness solutions
  • Independent living technologies and services, including reinventing home health
  • Innovative virtual/convenience care models

Keynoters include 

  • John W. Cosgriff, Chief Strategy Officer, UnitedHealthcare
  • Saquib Rahim MD, MBA, Chief Medical Officer, Aetna
  • Vidya Raman-Tangella, Senior Vice President, and Head, UHC Innovation Center of Excellence, UnitedHealth Group
  • Dale Rayman, Senior Vice President, Actuarial Consulting & Business Development, Sharecare
  • Chanin Wendling, AVP, Informatics, Geisinger Health System

Latest press release info on the conference and the convergence of connected health, IoT, and smart home is here.

For more information and to still save 20 percent, click on the Connected Health Summit’s link here. Telehealth & Telecare Aware is pleased once again to be a media supporter of CHS 2017. Twitter at #CONNHealth17

Higi and Interpreta’s data mix partnership–questions on consent, data security

August 23, 2017 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/08/Interpreta-Higi.jpg” thumb_width=”150″ /]Higi (also higi), which has placed health monitoring kiosks in over 11,000 US retail locations and a 5.5 million signup base, and data cruncher Interpreta announced that they are partnering to blend Higi’s vital signs data with Interpreta’s claims, clinical and genomics data analytics. Based on Mobihealthnews’ article and the joint release, an individual’s health information taken at higi retail stations will be “prioritized within Interpreta in real time”. They also claim that for the first time, insurance payers and providers will be able to leverage biometrics data, clinical, claims and additional genomic information a person may obtain from genetic testing services into a ‘personalized care roadmap’ that closes gaps in care. This is positioned as a big advance in population health and it all sounds great.

Perhaps not so great are the details. What about consent and data security? Aside from absolutely no mention of patient consent and HIPAA compliance in the above news, this Editor suspects that past, current and future Higi users may not be made aware that their vital signs data recorded with Higi will be 1) sent into a non-Higi database and 2) integrated with other information that appears in Interpreta’s database. How is this being done? Is consent obtained? What then happens? Is it used on an identified or de-identified basis? Where is it going? Who is doing what with it? Can it be sold, as 23andme’s genomic information is (with consent, but still…)? “Interpreta works in the realm of precision medicine, continuously interpreting and synchronizing clinical and genomics data in real time to create a personalized roadmap to enable the orchestration of timely care.” but they do this for providers and health plans who are then responsible for privacy and data integrity. Consent for Higi to keep a record of your blood pressure when you drop into your local RiteAid or ShopRite is not consent for Interpreta to use or manipulate it. These questions should have been addressed in the release or an accompanying fact sheet. We welcome a response from either Higi or Interpreta.

And one last and exceedingly ‘gimlety’ observation by this Editor: kiosks get hacked, and here we have not a price to a McDonald’s meal but a portal to deep PHI. Here’s a two-part article in an industry publication, Kiosk Marketplace, if you are skeptical. Part 1, Part 2 

VA EHR award to Cerner contested by CliniComp (updated)

August 23, 2017 | by

See update below. CliniComp International, a current specialized EHR vendor to some Department of Veterans Affairs locations and to the Department of Defense for clinical documentation since 2009, has filed a bid protest in the US Court of Federal Claims on Friday 18 Aug, saying that VA improperly awarded a contract to Cerner in June [TTA 7 June] without a competitive bidding process.

At the time, VA Secretary David Shulkin moved the award via a “Determination and Findings” (D&F) which provides for a public health exception to the bidding process. Without this, competitive bidding could take six to eight months, as Dr. Shulkin stated to a Congressional committee after the award–or two years, as DoD’s did–and would have further slowed down the already slow adoption process. Even if all goes well, the transition from VistA to Cerner will not begin at earliest until mid-2019 [TTA 14 Aug]. The Cerner MHS Genesis choice was also logical, given the Federal demand for interoperability with DoD. In June, the House Appropriations Committee approved $65 million for the transition, provided that VA provides detailed reports to Congress on the transition process and its interoperability not only with DoD’s but also private healthcare systems.

CliniComp objected to all that, saying in the protest that VA had enough time for an open bidding procedure, that the failure to do so was “predicated on a lack of advance planning,” and that awarding it to Cerner without it was “unreasonable”. “As shown by the nine counts set forth below, the VA’s decision to award a sole-source contract to Cerner is arbitrary, capricious, an abuse of discretion and violates the CICA and Federal Acquisition Regulations,” according to the suit.

According to Healthcare IT News, “CliniComp said it filed an agency-level protest to contest the sole source award shortly after the announcement, according to the complaint. But the VA Deputy Assistant Secretary for Acquisition denied the protest on Aug. 7. In doing so, the VA violated the Competition in Contracting Act of 1978, the company claims.”

This is not CliniComp’s first bid protest. Before one dismisses the bid protest as sour grapes picked by a minor vendor, this Editor discovered via Law360 that CliniComp was successful in a VA bid protest in August 2014. In this case, VA had a $4.5 million contract for computer systems at several intensive care units for saving patient waveform biometrics. The VA’s award to Picis in October 2013 was overturned because the Court of Federal Claims found that in clarifying the CliniComp bid, VA never had official discussions with CliniComp, only informal requests for clarifications. The court found that the two bids were not evaluated the same way–and that likely both were acceptable, with CliniComp’s bid preferable because it was lower. (More on CliniComp and its 30-year history here)

Update. Arthur Allen in POLITICO Morning e-Health also did his homework and found the same Law360 article on CliniComp’s 2014 bid protest win, adding the following:

  • DoD and VA officials have complained that CliniComp’s software is not compatible with legacy systems. However, some IT experts have noted that neither DoD nor VA can provide platforms which can be interoperable with Cerner. (Circular firing squad?)
  • Oral arguments are set for 2 October, if necessary, after motions are filed next month. Cerner joined in the defense against the protest as of Monday. 

Will the brakes be put on Cerner’s work while the protest wends its weary way through the Federal Claims Court? The bid protest is high-profile embarrassing for VA, though the D&F is completely legal. Stay tuned. Also Modern Healthcare, KCUR, Healthcare Dive

Tender Alert: Tameside and Nottingham (East Midlands)

August 23, 2017 | by

Susanne Woodman, our Eye on Tenders, has another ‘August special’. This is by New Charter for their alarm monitoring service in Tameside and Nottingham. This is for all sheltered housing customers and a significant number of community alarm (Lifeline) customers in Nottingham. Current subscribers are in over 1,500 properties. At this point, New Charter is requesting a preliminary market consultation to replace the current service with one contract for a single service provider to go live in June 2018. More information is on Gov.UK with contacts and an attached brief.

Can unused “TV white spaces” close the rural and urban broadband–and telehealth–gap?

August 22, 2017 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2017/08/Radio-tower.jpg” thumb_width=”100″ /]The digital divide comes one step closer to closing. Microsoft’s release of its white paper proposing an alternative to the expensive build-out of the US broadband network deserved more attention than it received in July. The Rural Broadband Strategy combines TV white spaces spectrum (the unused UHV television band spectrum in the 600 MHz frequency range which can penetrate through walls, hilly topography, and other obstacles) with fixed wireless and satellite coverage to economically deliver coverage to un/under-served areas versus fiber cable (80 percent savings) and LTE fixed wireless (50 percent).

34 million Americans lack broadband connection to the internet. Some of these are voluntary opt-outs, but 23.4 million live in rural areas without access, with huge economic consequences estimated in the hundreds of billions. TV white spaces can also expand coverage in small cities and more densely populated areas, including usages such as within buildings. This effort also presses the FCC, which in turn has pressed for broadband for two decades, to ensure that at least three channels below 700 MHz are kept unlicensed in all markets in the US, with more TV white spaces for rural areas.

The first part, the Rural Airband Initiative, builds on Microsoft’s present 20 programs worldwide, and is planned to connect 2 million people in by July 4, 2022, with 12 projects across the US running in the next 12 months. Much of the connectivity is dedicated to nonprofit efforts like 4-H’s digital literacy program and ‘precision agriculture’ in New York State and Washington. Microsoft is also granting royalty-free access to 39 patents and sample source code related to white spaces spectrum use in rural areas.

A positive move for telehealth’s spread. Rural healthcare providers pay up to three times as much for broadband as their urban counterparts. Telemedicine increasingly connects for consults between hospitals in rural areas and city-based health systems for specialty coverage and to provide assistance in specialized medical procedures. Telemedicine and telehealth remote monitoring has difficulty spreading with poor internet coverage; this has already been a barrier to patients in rural ACOs who can be 1-2 hours from the doctor’s office and notably for the VA in providing rural veterans with home telehealth support. Paramedics increasingly rely on internet connections and dropped connections lead ambulances to go to hospitals at a greater distance. If the FCC cooperates and Microsoft’s partners can find a way to profitably execute, broadband can finally achieve that promise about closing the ‘digital divide’ made back in the Clinton Administration. A Rural Broadband Strategy: Connecting Rural America to New Opportunities  The Verge, mHealth Intelligence, Becker’s Hospital Review

Telemedicine for all creatures great and small? Veterinarians debate.

August 22, 2017 | by

Will veterinarians be covered by ongoing telemedicine legislation? This surprisingly became an issue with the New Jersey telemedicine bill [TTA 11 Aug] S.291 prior to signature by Governor Christie. The debate was whether “health care providers” covered under the licensing statutes in Title 45 of NJ’s Revised Statutes also included veterinarians in the “including but not limited to” language as well as the nature of the “proper provider-patient relationship” and “patient request”. Reportedly the Governor held his signature in order to sort this out, meeting with healthcare and veterinary representatives. The final bill does not appear to specifically address veterinary practice.

For its part, the American Veterinary Medical Association (AVMA) Practice Advisory Panel (AP) came out solidly in favor of non-inclusion in human laws like New Jersey’s in their January report. Their view of the patient-physician relationship is logically different because the animal patient cannot give consent, but an owner/client can, and that difference is not specified in human medicine laws. In the AP’s view, “telemedicine shall only be conducted within an existing VCPR [veterinarian client patient relationship], with the exception for advice given in an emergency care situation until that patient(s) can be seen by or transported to a veterinarian” which is increasingly not true of human telemedicine. Law firm Fox Rothschild’s animal law practice blog cited instances such as when a Texas veterinarian was found to have violated the state practice act by offering advice over the internet. 

Many veterinarians are calling for AVMA to seek guidance from organizations like the ATA to better codify animal telemedicine practice. ATA, for its part, has stayed apart from state debates while remaining generally supportive. The gap in veterinary practice is especially acute with a declining number of practitioners caring for food animals (livestock) and in rural veterinary practice. But who will care for the unicorns? Seriously, here is a gap that needs to be filled. mHealth Intelligence

More creepy monitoring: USAA collecting health information from patient portals

August 19, 2017 | by

Veteran health reporter Anne Zieger has uncovered another instance of data mining that could be a benefit–or not. USAA, a financial services company for military and veteran families, has started to collect health data via electronic records from life insurance applicants at the Department of Veterans Affairs and Department of Defense. They have streamlined the health records process in the application by developing with Cerner a feature called HealtheHistory that retrieves the data via the patient portal from the applicant’s EHR after consent. It cuts application time by 30 days, but the implications raise some alarms. In Ms. Zieger’s view, we should consider this carefully before huzzahing this type of data sharing:

  • Is an insurer going to care much about HIPAA compliance on PHI? In her view, not likely.
  • Is it a good idea to give an insurer full access to health data? There is the case of an otherwise healthy woman who tested positive for the BRCA 1 gene which indicates that the carrier has an increased risk of breast and ovarian cancer, who was turned down for insurance by USAA. To not disclose would be fraud, but the nuance is risk, not the condition.
  • Will the information be shared within USAA for judgment on other financial instruments, such as mortgages–regardless of legality?

EMR and EHR  Our previous look at data gathering on medical conditions run amok is here