International CES unveils in NYC

The trends and items of note for next January’s show in Las Vegas

  • The ‘Internet of Things’ is the phrase-du-jour–embedding anything and everything with sensors (digital elements) and blending the physical and digital worlds
  • Consumer Digital Health Care was listed as #3 of CEA’s 2014 Technology Trends to Watch (PDF link). What is hot is self-tracking (1/3 of mobile users have tracked using a smartphone and tablet, and over half are now concerned about data security), integrating tech for seniors (touching on Selfhelp’s Virtual Senior Center [TTA 17 Mar 2010], remote monitoring (telehealth and telecare) including GrandCare Systems and kiosk HealthSpot Station, patient adherence, FDA approval of apps and the home as a healthcare hub.
  • Robots were the #4 trend: consumer robots such as home cleaners Roomba, Ecovacs; robots in eldercare; humanoid robots like NAO; robotic prosthetics and exoskeletons.

Digital health will again be showcased as a TechZone  (more…)

New York, New York, it’s a health tech town (Part 3/wrapup)

Part 3: When is a Summit only a hill? And The Pioneers overload the Conestoga Wagons.

(Disclosure: TTA was a media partner of DHS at CEWeek. We also remain a proud sponsor of and provide volunteer services for Health 2.0 NYC, the presenter of Healthcare Pioneers. Our readers should know that these relationships do not exclude this Editor from noting the thick and thin of both events, not rendered in pale pastels.)

Digital Health Summit @ CEWeek

Four floors up from a busy show floor, and after interviewing Tal Givoly, CEO and Oren Fuerst, PhD, Executive Chairman, of startup health information company Medivizor (Part 2), assistants moved attendees into the room for the start of the New York/CEWeek edition of the Digital Health Summit at 11:30 am. It opened with a fairly anodyne presentation by the Executive Director of the NYC Economic Development Corporation (NYCEDC),   (more…)

New York, New York…it’s a health tech town (Part 1)

New York, New York, a helluva town.
The Bronx is up, but the Battery’s down.
The people ride in a hole in the groun’.
New York, New York, it’s a helluva town!

From ‘On The Town’, lyrics Betty Comden/Adolph Green, music Leonard Bernstein

Last week’s three events convinced even The Gimlet Eye that New York City is finally a helluva town for many things eHealthy. There were full houses at both Health 2.0’s Matchpoint|East and Health 2.0 NYC’s first-ever Healthcare Pioneers: Healthcare 2020. CE Week, presented by the Consumer Electronics Association (CEA), prominently featured health tech on the packed show floor and hosted the Digital Health Summit (DHS). Matchpoint|East is our starting point in Part 1. (more…)

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.

Concussion monitoring in test in NY high school (US)

Following our coverage of CTE and mTBI (mild traumatic brain injury) at the GCRI presentation last week, a small-town football team is one of the first to pilot, albeit for three days, a new concussion detection technology developed by i1Biometrics. The Middletown, NY high school tested their Impact Sensing Mouth Guard that measures hits to better assess the likelihood of cumulative blows and outright head injuries. The mouth guards recognize cheek tissue for activation, and function as a standard mouth guard plus accelerometer and gyroscope to detect the hard-to-determine rotational acceleration. Data is then transmitted wirelessly to a monitoring station (laptop) where trainers can analyze the data. The i1Biometrics system will be further tested this fall at Purdue and the University of South Carolina.  Article (Times Herald Record); i1 Biometrics website.

Contact sports, long term effects and CTE

The effects of chronic traumatic encephalopathy (CTE) are likely far more widespread than the National Football League (NFL) and thousands of combat soldiers in Iraq and Afghanistan. That evidence was presented this past Monday at the German Center for Research and Innovation (GCRI)  by two leading researchers in the field: Robert A. Stern, MD of Boston University and Inga Koerte, MD of the Ludwig-Maximilians-Universität München (LMU). The panel was moderated by Alan Schwarz of The New York Times, a freelance sportswriter/baseball stats expert-turned-concussion investigator/writer whose articles on sports concussions and long term effects are helping to change US sports safety. Update 10 June: video (1:38:00), event summary. (more…)

Update on Health+Care 2013 pre-event

As reported previously, on Tuesday 14 May, the organisers of Health+Care 2013 held a pre-event telecare/telehealth exhibition called The Home Care House of the Future hosted by Circle Housing Group at one of its newest Circle Living shared ownership flats in London. Thanks to the organisers and exhibitors, we can now post the following 3½ minute video and additional information provided by the exhibitors. (more…)

Med-e-Tel 2013 presentations available

Copies of the presentations at Med-e-Tel 2013 (10-12 April 2013) are now available. Click on the ‘full presentation’ links to access the presentations. The Med-e-Tel Knowledge Resource Center also still contains the presentations from previous events (2002-2012). You can access the Resource Center here.

The Med-e-Tel 2013 proceedings, published as Global Telemedicine and eHealth Updates – Knowledge Resources, Vol. 6, 2013 (610 pages) are now also available for purchase. It contains 133 short papers of presentations that were submitted for the Med-e-Tel 2013 conference program. To order a copy contact info@medetel.eu.

Healthcare IT–New York’s Next Big Thing

Sponsored by MIT’s Enterprise Forum and held on 8 May 2013, this event reviewed the efforts of entrepreneurs, investors, public entities and accelerators in changing the New York area from a ‘dead zone’  for health tech to a new hub of innovation–in what this Editor considers a record (two-three year) time. (Was it only July 2011 that 90% of local investment went to internet shopping and mobile?)

Moderator: Steven Krein, founder and CEO of health tech accelerator StartUpHealth (most recently in our news for their joint program with GE Ventures’ Healthymagination)

Panel: Jahan Ali, PhD, Senior Vice President, Partnership Fund for New York City; Serge Loncar, Founding President and CEO, CareSpeak Communications; Philippe Chambon, Managing Director, New Leaf Venture Partners

Steve Krein set the tone with predicting that NYC will be the hub of health IT. It is heading towards its tipping point; that healthcare is not only overdue for its time in investment but also where key factors are converging to make this possible–money, universities and companies within reach. Key factors are investors such as the Partnership Fund for NYC, which helped to fund the NY Digital Health Accelerator with the New York eHealth Collaborative (NYeC), which on the day of the meeting graduated eight startups (see ‘Related’ and video) with $300,000 of funding plus three provider pilots; and VC funds such as New Leaf Venture Partners. Updated 14 May (more…)

Who’s exhibiting at ATA?

More from the American Telemedicine Association conference, by James Barlow.

A tour of the cavernous exhibition hall at the Austin Convention Center and a rigorous back of envelope analysis of the catalogue reveals where the corporate action is: of the 229 or so exhibitors, the runaway top health condition targeted by companies is (surprisingly?) mental health, with 34 exhibitors. Cardiology, diabetes and the other conditions forming the basis of remote care trials around the world all make an appearance, along with other familiar tele-applications.

The 2013 Exhibitors League Table:
Mental health and telepsychiatry (34 exhibitors)
Telecardiology (16)
Telestroke (16)
Paediatric telehealth (16)
Diabetes management (15)
Teleneurology (14)
Teledermatology (10)
Telerehabilitation (6)
Telehospice / palliative care (4)
Oncology (3)
Teledentistry (3)
‘Infectious disease management’ (2)

And by application? Home healthcare (63 exhibitors) beats mHealth (49) – well served with its own conference circuit – with ‘remote monitoring'(48) and ‘videoconferencing’ (36) hot on their heels.

Other reports by James Barlow.

Telemedicine advances in Latin America

Some welcome news out of the ATA 2013 meeting are the advances that telemedicine is making in Latin America and the Caribbean. Honored at ATA’s Sunday session were Jennifer Lopez and her eponymous family foundation for funding telemedicine outreach in Puerto Rico and Panama via the Children’s Hospital of Los Angeles (CHLA). In Puerto Rico, the work is concentrating on pediatrics genetics, and a monthly clinic that counsels four families per session. In Panama, the emphasis is on extending pediatric care beyond Panama City to the low-serve country areas through Panama City’s three major hospitals. The point is that the Lopez Family Foundation is only the start in the region, and that other healthcare providers and funding entities should be joining in kicking off development (Telefónica should be noting) HealthcareITNews

HealthSpot, Netsmart ally for telemedicine kiosks

HealthSpot, which debuted its staffed telemedicine/telehealth Stations at CES 2013 (and this Editor previewed at CES New York in November), is partnering with behavioral health EHR/practice/clinical case management software provider Netsmart to add that capability to its kiosk consults. Announced at ATA yesterday, the MedCityNews article is sketchy on exactly how this will be integrated–will it be an option or will select kiosks be dedicated to behavioral health only–but this is likely a first for telementalhealth (another term in our lexicon!) Kiosk placements can be especially useful in rural areas which have a paucity of mental health/psychiatric providers (see TTA on Forefront TeleCare’s ATA announcement). It also follows this year’s ATA theme of telemedicine to more effectively serve rural US areas. HealthSpot also announced a pilot with Nationwide Children’s Hospital in its hometown of Columbus, Ohio; their CEO claims it has orders for 150 units in hand for its now three health system partners. Surprisingly, as of April they are already at Series C funding with a $10.4 million financing (of a $20 million offering) from giant Cardinal Health and other private investors.

Where the real remote care innovations are

Another report by James Barlow from the ATA Conference.

More evidence that the really innovative thinking in the remote care world is coming from lower income countries. Dr Sikder Zakir from the Telemedicine Reference Centre (TRC – www.trclcare.com) in Bangladesh reported on the use of mHealth to improve access to underserved populations. Usually this would involve telemedicine – in its m- or non-mHealth guises – bringing healthcare to remotely located rural populations. Bangladesh is no exception, with 40,000 doctors and 25,000 nurses for 160 million people. But as is only too obvious to anyone who has been to countries in the Gulf there is a huge population of migrant workers living there. The 5 million expats from Bangladesh have 20 million dependents back home dependent on remittances, but neither side is well served for healthcare. The TRC is using mHealth to provide expats with access to doctors in Bangladesh via SMS messaging and voice calls, and extends the service – free – to up to five of their family members. Funding is via a $3 a month subscription paid via the migrant worker’s mobile phone network. The scheme is being tried out with 80,000 migrant workers in Singapore, before moving to Saudi Arabia and the UAE.

We also heard from Dr Zakir about AMCARE (www.amcare24.com), an example of mHealth being used to extend diabetes care from hospitals to villages. This uses microinsurance payments (50 US cents / month) to cover the costs, a business model that is now gathering momentum in developing countries’ health systems.

Other reports by James Barlow.

Surgical telemonitoring – the next milestone for telemedicine?

The first in a series of real-time reports from American Telemedicine Association annual conference in Austin, Texas, by James Barlow, Imperial College London.

The ATA conference has just included an interesting session on surgery as the next milestone for telemedicine. While telesurgey has long been an area of interest in remote care, pressures in the health system and developments in technology are combining to create new opportunities for supporting surgeons in their work. But many of the familiar implementation challenges are also looming large. So what were the reflections from the panel and discussion?

The consensus was that we need to shift the state of the art in operating room practices from considering volume and quality to broader notions of ‘value’ embracing cost, quality and access. Hospitals will be increasingly rewarded on outcomes and patient satisfaction, and telesurgery potentially helps improve both.

Two kinds of broad telesurgery model are envisaged – the expert surgeon ‘broadcast’ their operations to a wide audience and a more 1:1 relationship where the expert is remotely located and provides support for a specific operation. The ‘new telesurgery’ will involve three things.

  1. Just phoning another surgeon for advice in the middle of an operation is no longer good enough. There will be much more collaboration between surgeons, using new collaborative tools for bringing people together at a distance. The possibility of virtual environments around the operating room is already here and should be widely embraced.
  2. Large peer-supported integrated surgery networks will emerge with surgeons paid for the time they spend providing advice or moderating discussions. Spending 10% of your time mentoring other surgeons – perhaps around the world – will become part of the norm.
  3. A pool of recognised expert mentors will develop. Mentors can be ‘in the room’ virtually during the procedure. Or they can be invited to participate in situations where there is an ‘index case’ – a rarely encountered procedure – where the pool of knowledge is spread thinly.

All this is going to clash with the inherent conservatism of surgeons and their unwillingness to change tried and trusted approaches and technologies. The big challenges for moving forward in telesurgery are:

  1. ‘Network effects’ need to kick in – there has to be a critical mass of users and installed technology to generate the biggest benefits.
  2. Inevitably there are incompatibilities in technical standards for data transfer.
  3. The focus so far has been on audio and video, but integrating patient data into telesurgery and back into patient record systems is also essential.
  4. Tools for virtual collaboration are rapidly developing, allowing crystal clear video, remote access to laparoscopic images, virtual laser pointers, and doing all this on tablets. These need to be made widely available.
  5. Reimbursement and business models – who pays for what? Can we find ways of reimbursing hospitals / surgeons providing experts? How do we schedule expert mentor time and build this into their contracts?
  6. Medico-legal. There are cross border (or cross state issues here in the US) licensing issues and big problems of responsibilities in the event of problems arising in a telesurgery procedure.

Other reports by James Barlow.

Report: RSM event ‘Using apps to transform healthcare delivery’

Many thanks to independent consultant Charles Lowe, President-elect of the Royal Society of Medicine’s (RSM) Telemedicine & eHealth Section for the following report on the one-day conference Using apps to transform healthcare delivery at the RSM, London, 18 April 2013.

Reflecting the importance of the topic, this one-day RSM conference sold out weeks in advance. The audience confirmed the growing trend for RSM Telemedicine Section-organised events to be attended principally by clinicians, in this case mainly hospital-based.

The general themes that emerged from the event included:

The need for greater connectedness among app overseers – the different players in the UK, notably NICE, MHRA, NHS Apps Library and NIHR each have different, often overlapping, concerns about apps before they are able to recommend or approve them for use. There emerged during the day a case to be made for tighter coordination among these bodies and, doubtless, others not represented at the meeting.

Big data doesn’t respond to professional users’ or patients’ needs well – apps are a great way to make big data acceptable to users. The Consent app (ascendinnovations.co.uk) demonstrated was quoted as an excellent example.

Not everyone has to produce apps – by opening up, publishing the APIs to your data, others with the appropriate skill might be able to do the job better than the data owner.

The day began with a presentation by (more…)