News roundup: MHS Genesis EHR completes US rollout, telehealth selective savings by disease, CarePredict’s $29M funding, Amazon Alexa *Spying on You*

July 14, 2023 | by

At least one part of Oracle Cerner’s work is done. The Military Health System (MHS), which covers 9.6 million active duty beneficiaries and 205,000 medical providers, announced yesterday that the rollout of the Genesis EHR is complete in the continental US. The final go-live was at Wright-Patterson Air Force Base, which covers 6,800 clinicians and providers in military hospitals and clinics across Ohio, Virginia, Maryland, Indiana, Texas, and Kentucky. It was also deployed at the National Oceanic and Atmospheric Administration, NOAA Corps, which is under the Department of Commerce. The final 14% of the MHS system is overseas. That rollout will start in September 2023, including Landstuhl Regional Medical Center in Germany and Royal Air Force Lakenheath in the UK. Bases in Guam, South Korea, and Japan will follow in October. DOD’s one joint facility with the VA, the James A. Lovell Federal Health Care Center in Chicago, will deploy in March 2024. All other VA healthcare centers are on hold indefinitely. With the wrapup of MHS Genesis and the pause on VA’s Millenium rollout, Oracle has reportedly laid off over 500 staff on these Federal projects [TTA 16 June]. DVIDS release

 Telehealth’s selective savings. A new study out of the University of Texas-Austin McCombs School of Business found, like other studies such as Epic Research’s, that telehealth visits reduced future outpatient visits, in their study within 30 days, by 14%. This saved $239 per patient in outpatient costs. But telehealth was more effective for some specialties than others. It had the most impact on cost reduction for behavioral health, metabolic disorders, dermatology, and musculoskeletal (MSK) disorders, with a significant reduction of 0.21 outpatient visits per quarter (an equivalent cost reduction of $179). This suggested to the researchers a substitution of telehealth versus traditional clinic visits. But telehealth’s impact was nearly nil when it came to circulatory, respiratory, and infectious diseases, not significantly reducing the number of future visits or costs. The study sampled hospital-based outpatient clinics in Maryland from 2012 (not a typo) to 2021. Becker’s, UT News, Informs Pubonline (abstract only)  

Senior living monitoring system CarePredict adds $29 million from four main investors. This is a Series A-3, which one assumes adds on to an existing Series A, which was $9.5 million in 2019. The round was co-led by SV Health Investors’ Medtech Convergence Fund and Aspire Healthtech Partners with existing institutional investors Secocha Ventures and Las Olas Venture Capital plus private family offices and individual investors. CarePredict pioneered a wearable bracelet, the Tempo, that wirelessly tracks residents’ activities of daily living (ADLs) in assisted living (AL), independent living (IL), and continuing care (CCRC) settings. Interpretation of ADLs in a platform can predict changes in health and wellbeing leading to better health and extended residence. CarePredict has expanded its platform reporting with other tracking such as context beacons, visitor and wander management, PinPoint digital contact tracing, and family communication apps. CarePredict release, Mobihealthnews

How much does Amazon have on you? If you are a user of Amazon’s Echo system, you already know that Alexa is always listening to you. What you may not know is that Amazon stores that information in a database, including parts of overheard conversations that have nothing to do with Alexa, since Alexa is always on. Even if you (like your Editor) don’t have an Echo but have a Kindle (unlike your Editor) or use the app residing on most smartphones, Amazon knows what you read, what you flip through, and your start and stop times. The Amazon Sidewalk mesh network, used with Alexa and Ring cameras, extends the reach of your router and shares your network with your neighbors. This is in addition to your shopping and even what you look at. In the context of the rollout of Amazon Clinic pending, delayed to 19 July [TTA 27 June], where Amazon is 1) only an intermediary to providers but 2) demand access to all your PHI and PII before allowing access to them, can we as professionals admit this is a glaring privacy violation and that the FTC is actually right?

Kim Komando, well known for her radio and online shows advising non-techies on tech, has an excellent article on how Amazon is piling up information on us all. This is based on a 2021 Reuters investigation and also contains a link to her interview with the two Reuters reporters. The article also describes how to find out what Amazon has on you. Warning–they don’t make it easy. She also addresses the Amazon clinic issue in a FoxNews article.

CES roundup: what happened to the excitement around ‘innovation’, robots, VR, and voice assistants?

January 10, 2020 | by

What’s missing? Some sense of excitement. It may be your Editor’s back-to-work deluge after the holiday, but it’s hard not to have a sense of Déjà Vu All Over Again when reading the reporting from CES Las Vegas. So much of it seems lukewarm, a variant of what felt exciting, new, and transformative Back When. And so little of it seems to break through to a wider market. Let’s pick through and see what a Gimlet Eye might.

AARP’s Innovation Labs had yet another showcase of technologies from largely small companies from its own Hatchery and other accelerators with which it works. This year it highlighted VR developer partnerships with Rendever, which creates experiences for LTC residents, and VRHealth’s physical therapy at home. SanaHealth has a pulsed light/sound pain reduction device and the VoiceItt speech recognition device which translates the speech of the severely impaired into intelligible language.

Robots continue to seek a market, albeit tinier and we confess, occasionally more amusing.

  • Samsung’s Ballie robot, about the size of an orange, will roll through your home minding your pets, monitoring your safety, and interfacing with your smart devices and apps to make absolutely sure you get enough exercise and track your fitness. That is, if you don’t step on it, mistake it for a tennis ball, or your dog doesn’t mistake it for a chew toy.
  • The Charmin Rollbot will deliver a pre-loaded roll when you most need it, navigating through your home, although no capability of climbing stairs in its current concept.
  • The Misty II robot is yet again one of those tabletop robots which are developer toys. This one propels itself and has a camera, a microphone and 3D sensors, and could be repurposed for fall detection, companionship, or to bring you a hot towel.
  • The Lovot is a Japanese robot at its second CES which moves around, responds, is red and quite cuddly-looking (except for that weird thing on the top of its head). This ‘happiness robot’ will set you back over ¥299,000 ($2,700) when it finally hits the market.

Babies need both monitoring and changing, and combining the two may actually happen. P&G’s Pampers and Verily Life Sciences brought to CES the Lumi smart diaper with a connected HD video monitor plus an activity sensor in the diaper. It will detect baby’s sleep, feeding and diapering patterns. (But no changing by the Charmin Rollbot)

Voice assistants are getting more ubiquitous to find a way into the home. The war between Amazon Alexa (and siblings) and Google Assistant continues with new applications in cars (a/k/a computers on four wheels) to appliances and a host of third-party devices like garage door openers. A lot of this is ‘sneaky tech’ to get past the hard core of people who have already realized that both always-on Alexa and Assistant collect a lot of behavioral data which one does not necessarily want collected, and that many of these connected devices like Nest have been hijacked through compromised passwords.

More in Fierce Healthcare 7 Jan, 9 Jan; Mobihealthnews

‘Ask Alexa’ if you’re sick, says the NHS

July 18, 2019 | by

The latest in the NHS’ ‘digital first’ effort in the Long Term Plan is to add Amazon Alexa’s voice search capability to the NHS’ online advice service. Using Amazon’s search algorithm, UK users will be able to ask Alexa about their scratchy throat, sneezing, flu symptoms, or headache with information sourced from the NHS website. In the announcement, Secretary of State for Health and Social Care Matt Hancock said that “We want to empower every patient to take better control of their healthcare and technology like this is a great example of how people can access reliable, world-leading NHS advice from the comfort of their home, reducing the pressure on our hardworking GPs and pharmacists.” 50 million GP consultations each year are estimated to be unnecessary; the NHS is actively campaigning for patient awareness on self-care to reduce the patient load on practices (GP). NHSX is also planning of making more NHS services available to all patients through digital technology. 

Physicians have expressed concern that what seems to be a minor symptom could be the start of something big, like an underlying illness. For instance, heart rate monitors which are present in smartwatches and gym equipment have driven many to their doctor because of normal heart rate fluctuations, but that visit could be also picking up the early symptoms of atrial fibrillation.

The Alexa voice assistant adoption by the NHS makes search information more accessible for those with limited mobility or sight, which can help them feel more connected and enhance safety. It also assumes that internet is both available, affordable, and understandable by these users.

This Editor wonders if Alexa will have an emergency feature which calls for assistance or to a GP if the user indicates a worsening condition or is in distress. Voice recognition, as Readers know, is imperfect; Alexa may be puzzled by regional accents, phrasing, or speech impediments.

Current estimates on voice search fluctuate. The oft-repeated ’50 percent by 2020′ assumes an accuracy in digital voice recognition and Alexa/Echo/Android/Siri usage and sales that at this stage are simply not there. An excellent discussion of the voice search market that cuts through the hyped-up predictions is by Rebecca Sentance on the eConsultancy website.

More on NHS and Alexa: Telegraph, Wired UK

Themes and trends at Aging2.0 OPTIMIZE 2017

November 10, 2017 | by

Aging2.0 OPTIMIZE, in San Francisco on Tuesday and Wednesday 14-15 November, annually attracts the top thinkers and doers in innovation and aging services. It brings together academia, designers, developers, investors, and senior care executives from all over the world to rethink the aging experience in both immediately practical and long-term visionary ways.

Looking at OPTIMIZE’s agenda, there are major themes that are on point for major industry trends.

Reinventing aging with an AI twist

What will aging be like during the next decades of the 21st Century? What must be done to support quality of life, active lives, and more independence? From nursing homes with more home-like environments (Green House Project) to Bill Thomas’ latest project–‘tiny houses’ that support independent living (Minkas)—there are many developments which will affect the perception and reality of aging.

Designers like Yves Béhar of fuseproject are rethinking home design as a continuum that supports all ages and abilities in what they want and need. Beyond physical design, these new homes are powered by artificial intelligence (AI) and machine learning technology that support wellness, engagement, and safety. Advances that are already here include voice-activated devices such as Amazon Alexa, virtual reality (VR), and IoT-enabled remote care (telehealth and telecare).

For attendees at Aging2.0, there will be substantial discussion on AI’s impact and implications, highlighted at Tuesday afternoon’s general session ‘AI-ging Into the Future’ and in Wednesday’s AI/IoT-related breakouts. AI is powering breakthroughs in social robotics and predictive health, the latter using sensor-based ADL and vital signs information for wellness, fall prevention, and dementia care. Some companies part of this conversation are CarePredict, EarlySense, SafelyYou, and Intuition Robotics.

Thriving, not surviving

Thriving in later age, not simply ‘aging in place’ or compensating for the loss of ability, must engage the community, the individual, and providers. There’s new interest in addressing interrelated social factors such as isolation, life purpose, food, healthcare quality, safety, and transportation. Business models and connected living technologies can combine to redesign post-acute care for better recovery, to prevent unnecessary readmissions, and provide more proactive care for chronic diseases as well as support wellness.

In this area, OPTIMIZE has many sessions on cities and localities reorganizing to support older adults in social determinants of health, transportation innovations, and wearables for passive communications between the older person and caregivers/providers. Some organizations and companies contributing to the conversation are grandPad, Village to Village Network, Lyft, and Milken Institute.

Technology and best practices positively affect the bottom line

How can senior housing and communities put innovation into action today? How can developers make it easier for them to adopt innovation? Innovations that ‘activate’ staff and caregivers create a multiplier for a positive effect on care. Successful rollouts create a positive impact on both the operations and financial health of senior living communities.

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Toyota’s $14 million bet on Intuition Robotics’ social companion robot (JP/IL/US)

July 21, 2017 | by

Social companion robots for older adults and the disabled are hot again. Tel Aviv and now San Francisco-based Intuition Robotics is enjoying a $14 million second Series A investment from Toyota Research Institute (TRI) for the ElliQ ‘active aging companion’. The ElliQ desktop robot is tethered to a proprietary tablet to connect an older adult with the outside world via video chat, using machine learning about the person to recommend activities, and assist with appointments, medication reminders, music, wellness, and environmental monitoring. ElliQ is still in pre-release. The $14 million is being put to immediate use in initial testing with users in the Bay Area, and Intuition is ramping up with a team there. 

TRI is based in Los Altos CA and is wholly owned by Toyota North America. Earlier seed and Series A investments totaling $8 million were made by iRobot, Terra Venture Partners, Bloomberg Beta and ManivMobility. This is the second older adult-targeted robotics news in as many weeks, with the more fully-featured and ‘humanoid’ KOMPAÏ in France going the crowdfunding route (as Intuition did early on) for €250,000 to fund the next generation [TTA 5 July]. After viewing the video below, it seems to this Editor that a lot of the interactive voice command technology has been overtaken by assistants already in market like Siri, Amazon Alexa, and Google Home. TechCrunch, Home Health Care News

 

HIMSS17 dispatches: Mayo maps neonate telemedicine, Amwell-Samsung, Samsung-T-Mobile

February 23, 2017 | by

Mayo maps out an enterprise telehealth (telemedicine) support structure. Here’s how the Mayo Clinic deployed neonatology remote telemedicine to their sites in Minnesota, Arizona, and Florida. There’s plenty of flow charts and summary points in this presentation deck around team building, staffing consistently and reporting that improves processes. Hat tip to our HIMSS correspondent on the scene, Bill Oravecz of Stone Health Innovations. Update: If you are using Chrome, you may have difficulty downloading session handouts from the HIMSS17 website Schedule pages. Try another browser. If you are interested, you may be able to obtain through contacting the two session presenters, Susan Kapraun and Jenna A. Beck, MHA, directly.

American Well and Samsung are partnering on integrating care delivery. Their joint release is low on details, but towards the end there’s an indication that American Well, its partners, and other providers and payers will be able to offer their services to Samsung customers. Other reports (Healthcare Dive) indicate the partnership is destined to enhance Amwell’s Exchange platform between payers and providers. Partners listed are Cleveland Clinic, New York-Presbyterian Medical Center and Anthem (undoubtedly resting after sparring with Cigna). Also Healthcare IT News.

Separately, Samsung also announced a partnership with T-Mobile for developing IoT in the senior care space. This would pair Samsung’s ARTIK Cloud with T-Mobile’s cellular network for Breezie, a social engagement for seniors interface built on a Samsung tablet which has apps and connects to various peripherals for post-acute care and daily living. It sounds interesting, but once again the release hampers the reporter by being as clear as mud in what it’s all about. See if you can decipher this: ARTIK Cloud permits “Amazon Alexa, Samsung SmartThings, iHealth Feel Wireless Blood Pressure Monitor and the Pulse Oximeter – to intelligently communicate with each other.” “Each Breezie interface has more than 40 preconfigured accessibility settings and sensor driven analytics to adjust for different levels of digital literacy, as well as physical and cognitive ability.” The Breezie website is far more revealing. Healthcare Dive also takes a whack at it towards the end of the above article.