Soapbox: Is ‘disruptive innovation’ a theory gone off the tracks?

June 24, 2014 | by | 2 Comments

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/04/Thomas.jpg” thumb_width=”200″ /]Having publicly stood as a huge fan of Clayton Christensen’s theories of disruptive innovation, particularly the ‘broken circle of innovation’ as an explanation of our current economic stagnation (if not ‘stagflation’ which was a hallmark of my early adulthood and yes, now) and disruption in healthcare (even if it hasn’t started yet because it’s been sidetracked), this Editor was prepared to savage, demolish and otherwise lay waste to a New Yorker article by Jill Lepore (a Harvard professor of American History, for Pete’s sake).

Having read and digested the article, I am surprised in largely agreeing with Prof. Lepore. She brings forth certain weaknesses and concerns I had about the entire Weltanschauung of disruptive innovation, first as an overarching theory equivalent to Darwin’s theory of evolution. There is a veritable industry around disruptive innovation which she outlines, reminding me that hype of this type around any theory I find profoundly irritating because theories are just that–to be reality checked early and often, just like voting in the 1930s in Jersey City, New Jersey. Prof. Lepore then points out where fellow Harvard Prof. Christensen didn’t paint the complete picture (e.g. Bucyrus, US Steel) and–to me quite importantly–discounts external events and even aggressive, defensive business strategy (as Ron Hammerle’s Soapbox on sidetracked innovation pointed out). Many of Prof. Christensen’s acolytes ignore history (and business strategy) altogether in a near-religious form of Determinism-by-Innovation.

There is also another circle–a circular logic prevalent in Mr Christensen’s theories summarized aptly by Ms Lepore: (more…)

Is consumer digital device engagement sticky? Or just the hype?

June 20, 2014 | by

A wonderfully cranky essay by Laurie Orlov on her new blog Boomer Health Tech Watch might make you think The Gimlet Eye was her guest writer (see below). Ms Orlov observes the ratched-up noise level around wearables, fitness bands, smartwatches (in which your Editor will be drenched quadrophonically next Wednesday at CEWeek NYC, glutton for punishment as she is). Yes, we’re swooning around Apple Health [TTA 3 June] and having a minor swivet around Samsung’s Simband and SAMI [TTA 2 June]. The bucket of cold water in Ms Orlov’s grip is the high dropout rate among fitness band users (33-50 percent, cited from Endeavour Partners and NPD Group); this Editor will also add the devices’ relative inaccuracy, fragility and glitches [TTA 10 May]. But ‘the investor community (via the media) clearly IS being transformed, at least temporarily’ as well as outside the health industry, by a belief that these devices will push the world into Quantified Selfing for the Masses. Will wearables herald our arrival at the New Jerusalem of Health? Certainly it’s been trumpeted and tromboned by the D3H (Digital Health Hypester Horde) badly needing a fresh fave rave. But can digital health survive another Hype Curve dive? Can we? The Consumerization of Health Care — is it working?

Further in this jugular vein, Business Investor, in a superficial swipe, dubs smartwatches uncool just because they trail fitness bands by six points. They did a better job in March delving into the real challenges that wearables face: smartwatches look and feel like a brick on your wrist (Ed. D’s term), Google Glass is socially unacceptable in many quarters (banned in Silicon Valley!) and wearables are still in Early Adopter-Ville.

Update: Ms Orlov just sent to this Editor a brief comment with a link to a thoughtful NY Times article not only on The Trouble with Apple’s Health App, but also how the barriers are more subtle–and more common-sensical–than the hype around how consumers are eager to register every burp on a PHR (they’re not), they don’t want to be nagged by technology (easier than your mom to be rid of) and the group that needs it most (the old, poor) has the least, for now, access to it. But largely ignored by the D3H.

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/02/gimlet-eye.jpg” thumb_width=”75″ /]On assignment off Cape May, New Jersey inventorying readiness of coastal defense fortifications. Just between us. Shhhh!

Addiction: Improving Outcomes using Computer-based Therapy

May 27, 2014 | by

Computer-Based-Behavioral-Therapy-Shows-Promise-For-Addiction-Treatment

A recent randomised control trial gives support to the use of computer-based therapy for treatment of addictions. The results were reported this week at the annual convention of the Association for Psychological Science in San Francisco, following publication in the American Journal of Psychiatry. Although the trial focused specifically on cocaine-dependent individuals, it replicates findings of a RCT carried out in 2008, in which participants had a wider range of substance addictions.

Results of this latest study show that those who received computer-assisted therapy were significantly more likely to attain three or more consecutive weeks of abstinence from cocaine as compared to those not receiving any form of Cognitive Behavioural Therapy (CBT) – 36% compared with 17%. And the effects appear to last; the control group also had better outcomes six months after treatment had ended.

Individuals who receive CBT learn to identify and correct problematic behaviours by applying a range of techniques.  Central elements of the therapy include anticipating likely problems, correcting harmful thought patterns, and developing effective coping strategies. The techniques enable people to counteract addiction’s powerful effects on the brain, so they can regain control of their behaviour and lives. (more…)

digihealth pulse Virtual 2014

May 8, 2014 | by

19-21 May 2013, Virtual

Can’t make ATA 2014? Possibly the first fully virtual conference in digital health, DHPV 2014 has 25+ speakers and is fully accessible online plus archived (helpful as all times are NY/Eastern). Speakers include Unity Stoakes of StartUp Health, Esther Tyson of HICCup (The Way to Wellville–more here), Bertalan Meskó, MD, PhD: medical futurist, Matthew Holt of Health 2.0, Ryan Beckland of Validic [TTA 27 Jan], Jim Lefevere of Roche digital marketing, and more. Register here: pre-event price is $195.97 which goes up on 10 May to $225.97.  Agenda  Hat tip to Fard Johnmar of the Enspektos digital health consultancy organizing the event.

Insomnia Apps: A replacement for sleeping pills?

May 2, 2014 | by

sleepstation

For those of us suffering from insomnia there’s no denying it can be a real pain! For some it means wakening up a number of times throughout the night, while others are unable to get back to sleep after only a few hours rest. In my case it means drifting off into a peaceful slumber before inevitably waking just minutes later with a jolt, looking like Frankenstein’s monster and wondering if someone just hit me up the face with a bolt of lightning!

The latest NHS approved sleep app is Sleepstation. It’s one of three listed on the NHS Choices Health Apps website, the others are Sleepio and Sleep Diary. (more…)

A focus on Parkinson’s with Google Glass

April 20, 2014 | by

Some pretty exciting work is happening at Newcastle University’s Digital Interaction Group with researchers evaluating the potential of Google Glass to support people with Parkinson’s. Much of the work is relevant to other conditions that affect movement, including Stroke and Multiple Sclerosis.

The great thing about Google Glass for people with motor control problems such as tremors, is that it gets around the difficulties in trying to negotiate the touch screen of a phone, or when trying to press a panic button. This is because the technology can be voice-operated and links to the internet. So in an emergency you can just tell it to call someone and it will. (more…)

Scanadu hitting the tech ‘glitch’ wall?

April 5, 2014 | by

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/04/Blog-04-04.jpg” thumb_width=”150″ /]Tricorder XPrize-qualifying Scanadu, which eventually raised a stunning $1.6 million on Indiegogo [TTA 23 May 13], has stopped delivery of units to its early backers which started on 31 March. According to its blog late this week, their readings were not working as expected for temperature, there were inconsistencies in reading scans between the Scanadu device (categorized as ‘investigational’) and the app (via the smartphone), and the manufacturing tool to make the devices broke. Scanadu CEO Walter De Brouwer stated that “We hope that this (the delay) will not be more than 8-12 weeks.” The Scanadu Scout was also submitted for FDA clearance but requires usability studies to gain approval. In this Editor’s experience, all tech devices eventually hit the ‘glitch wall’, either at or near the outset or when the system scales up. Better to fix now than later, and kudos for their C-level for being forthcoming–because most are not. Also MedCityNews.

Excellent new report on using digital tech in health

March 27, 2014 | by

An excellent new report is out now on the use of digital technologies in health systems covering all the [grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/03/A-digitally-enabled-health-system.jpg” thumb_width=”150″ /]key areas of application. A digitally-enabled health system studies the Australian health system and how it is to be improved by the use of various digital technologies.

Published by the Commonwealth Scientific and Industrial Research Organisation (CSIRO), Australia’s national science agency, this is a well researched and written report with the underlying analysis applicable to most countries, not just Australia. With contributions from eight experts, and presented in clear language, this is well worth a read. A free download of the report and links to infographics are available on the CSIRO report page.

Australia, in common with many other countries, faces pressures on its health system: “Treasury estimates suggest that at current rates of growth, and without significant change, health expenditure will exceed the entire state and local government tax base by 2043, and require almost half of all government taxation revenue” says Sarah Dods in the introduction to the report. CSIRO suggests several developments to meet this challenge – no surprises here, but nevertheless useful to remind ourselves of these: reduce reliance on hospitals, better manage hospital resources, make in-home patient monitoring (telehealth) the norm and introduce rigorous data security and privacy.

On hospital admissions there is a discussion on managing CSIRO logoEmergency Departments and re-routing ambulances to hospitals with shorter queues, a practice that is already taking place in some parts of the country. There is a section on the use of RFID tags to manage both equipment and continuity of care in hospitals. Another section looks at telehealth and self-monitoring. Other sections look at video conferencing (“tele-presence”) and remote diagnosis.

Proteus to build UK plant, work with NHS; PM’s 5G may save the day

March 11, 2014 | by

The Proteus smart pill, once found to be so ‘creepy’, is making its first significant international move by planning to build a UK plant ultimately capable of turning out 10 billion units annually, and also partnering with several NHS-affiliated groups: Eastern Academic Health Science Network (EAHSN), The Northern Health Science Alliance (NHSA) and Oxford University, Oxford University Hospitals NHS Trust and Oxford Academic Health Science Network (OAHSN). According to their CEO Andrew Thompson (quoted in Mobihealthnews), this starts the long NHS tendering and commissioning process. Beyond the sensors in the Proteus pill, the signal is picked up by a disposable patch receiver which transmits via Bluetooth to a smartphone and a tracking app. The business model in their current and future projected digital health devices is based on delivering an outcome, providing vital information about medication-taking behaviors and how your body is responding, not selling the device. How this will blend with the NHS model is a good guess, but the article points out that this may take up some of the loss of pharmaceutical manufacturing business in the UK–a big plus.

And all the bandwidth that Proteus will take up will be no problem, since UK and Germany will be jointly developing 5G wireless networks in the next two years which verily will gulp down all that data, along with having all your devices share the IOT (Internet of Things) chat line while you fast forward that 800 MB movie. The team consists of the University of Dresden, King’s College University in London and the University of Surrey. Note PM David Cameron’s writing pad versus Chancellor Angela Merkel’s tablet/folder combo at the photo taken at the CeBIT 2014 announcement. Daily Mail. Hat tip on both items to reader Mike Short and our own Editor Charles Lowe.

Recent Developments in Digital Health – RSM conference summary

March 3, 2014 | by

Editor Charles summarises the one day conference at the Royal Society of Medicine on 27th February

This was the first  conference in 2014 organised by the Royal Society of Medicine’s Telemedicine & eHealth Section.  The day began with one of Dr Kevin Doughty’s excellent presentations on telecare. Kevin is Deputy Director of CUHTec. One key message was that the oldest people in society – those most in need of support to remain in the community – were best communicated with using televisions.  In response to this requirement he particularly picked out the Speakset set-top box as a low cost, easy-to-use add-on to make any television into a videoconferencing unit.

This was followed by an excellent summary by Julie Bretland, Director, OurMobileHealth, on the maturity of the use of mobile apps, in particular the need for good curation. (This subject will be explored in much greater detail in the RSM’s 10th April apps event, where there are still just a few places left.)

Next came (more…)

National Health Summit Ireland–Special Report

February 21, 2014 | by

Reader Andrew Macfarlane, Commercialisation & Centre Manager, CASALA at The Netwell Centre of the Dundalk Institute of Technology, stepped forward to report on this past Wednesday’s Summit. (Please note the excellent cross-references for those who may not be familiar with Ireland-specific programs.) Many thanks Andrew from Editors Toni and Donna!

From an Industrial Age to Information Age Healthcare – National Health Summit, Ireland

The 10th National Health Summit, which took place in Dublin, Ireland, saw a good attendance and an impressive range of speakers. The event is primarily targeted at decision-makers involved in leading and managing the delivery of healthcare services in Ireland.

The morning session outlined the changing landscapes of healthcare delivery both in an Irish and International context. Next up, separate tracks covering Health Insurance (as the Irish government seeks to introduce Universal Health Insurance), Hospital Management & Digital Healthcare (the primary topic covered by this post). The final session covered helping patients stay healthy at home and an insightful panel discussion on reform of the health service.

Tony O’Brien, Director General of the Health Services Executive (HSE) provided the opening address, entitled “Choices for our health service”. The HSE is a large organisation of over 100,000 people, whose job is to run all of the public health services in Ireland. He highlighted that like most health care systems, they are facing rising demand and costs (current budget €13.6bn), and that at the same time has endured significant health budget cuts, 26% since 2008, with €600+m planned savings in 2014. The annual National Service Plan sets out key priorities.

Key takeaway from a digital health point of view is the policy aim of A New Model of Care Treatment at the Lowest Level of Complexity that is Safe, Timely, Efficient and as Close to Home As Possible. The HSE envisages transforming from an industrial age healthcare to information age healthcare, with cost-effective use of ICT. Challenging perhaps with a historical under-investment in ICT at 0.85% of budget vs EU average of 2-3%, a number of speakers referenced the “Ghost of PPARS” as reason for under investment.

Professor Aidan Halligan, Director of Education, University College London & Principal, NHS Staff College, England in a lively storytelling highlighted that the Cathedrals to Disease  (more…)

International Digital Health Congress (UK): call for papers

February 18, 2014 | by

Call for papers due 31 March

The King’s Fund’s International Digital Health and Care Congress has opened their call for speaker papers which showcase new ideas in telehealth and telecare. This year the Congress has widened its focus to include ehealth, mobile health and digital health innovations. Abstracts for oral and poster presentations should be targeted to one of the main topics below:

Sustaining independence as people age.
Preventing and managing chronic illness effectively.
Supporting people with mental health issues.
Digitally enabling service transformation.
Innovations in technology.

Formats for presentations (including PDF) are available at the Congress’ page. More information for the Congress on 10-12 September is available here.

$1.2 million in digital health funding from Aetna Foundation

February 14, 2014 | by

The Aetna Foundation has earmarked $1.2 million to fund digital health, including mobile health, specifically to support public health in “vulnerable and minority populations.” The grants will go to 23 organizations in 13 states, including regional hospitals and grassroots efforts. Cited in the release (reprinted in HITECH Answers) as an example was the Institute for eHealth Equity (IEHE) and Text4Wellness. The $1.2 million grant is part of a three-year, $4 million commitment to technology innovation in public health. Aetna is also supporting a call for papers to be published in the American Journal of Public Health. Deadline is 1 March, so get your skates on!

Rock Health opens new HQ to wonder, sums up 2013

January 23, 2014 | by
[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/RockHealth_Photo©BruceDamonte_02.jpg” thumb_width=”175″ /]As seems to be the way in the West Coast Digital Health scene, the opening of accelerator/funder Rock Health’s new HQ in the Mission Bay district of San Francisco gained more heavy-breathing hype than its mostly positive 2013 digital health investment report. The soireé during last week’s JP Morgan Healthcare Conference, glowingly reported in Xconomy with plenty of pics of the achingly trendy interior design and Health Digerati/D3Hers (Digital Health Hypester/Hipster Horde) at play also was a demo of a different type–how insular interests interlock and circle in Fog City. Star guest San Francisco Mayor Ed Lee spearheaded the remaking of the district into a life sciences/tech center; the Xconomy-moderated panel discussion paired him with Rock Health founder/CEO Halle Tecco and Alexandria Real Estate CEO Joel Marcus;  Alexandria underwrites Xconomy and has a huge investment in life sciences real estate; the new Rock Health HQ is on the ground floor of an Alexandria-owned building. Of course Mission Bay is now hyped as the ‘US Digital Health Hub’ for all those Rock Health-accelerated, funded startups. It does give one pause: how much of this is substance, or is it the peak of style before tipping into The Trough of Disillusionment? The tartest takedown on this is courtesy of Neil Versel’s Meaningful HIT News column. Pointed pokes abound: at Silicon Valley for its health tech failures (Google Health among them), the odd duplications (Google-funded telemedicine provider Doctor On Demand sounds like American Well, Ameridoc, etc.) and the even odder lack of considering integration with payer/provider systems and workflows.  Keep wasting your money, Silicon Valley venture capitalists (Note to Neil: the circular swings seem to be a feature of Alexandria’s properties–they’re present at Alexandria Center NYC too. Image © Bruce Damonte/Studios Architecture)

With that aside, the highlights of the Rock Health Digital Health Funding Year In Review were generally positive, but some of them, looked at critically, weren’t, even when depicted in attractive charts and graphs: (more…)

Royal Society of Medicine events that should appeal

January 17, 2014 | by

This year the RSM kicks off with Recent developments in digital health on 27th February, in association with the Royal Academy of Engineering. This event aims to update attendees on all the latest advances in the field of digital health that will affect care delivery. Perhaps the highlight of the day will be the demonstration of a smartphone that, on its own, can measure a person’s systolic and diastolic blood pressures, pulse, blood oxygen saturation, respiration and temperature – as this is a facility that will appear on the next generation of smartphones, the discussion on how app developers and the medical profession will respond will be particularly interesting. In addition there will be presentations by leading thinkers in the field on topics like big data, mHealth, medical apps, point-of-care-testing, genomic technology, evidence gathering and NHS England’s digital priorities.

Another event, that sold out early last year, is our medical apps day, this year on 10th April, entitled  (more…)

The 10th National Health Summit (Ireland)

January 14, 2014 | by

Wednesday, 19 February 2014, Croke Park, Dublin, Ireland

Ireland’s most important annual healthcare management summit brings together the range of stakeholders in the management and delivery of Ireland’s health service to discuss and debate the ever-changing healthcare environment. In 2014, they will have three separate tracks: Health Insurance, Hospital Management & Digital Healthcare. The last will be chaired by David Doherty, CEO of 3G Doctor/mHealth Insight. “This track concerns itself with how technology can enable a radical improvement in the quality, productivity and accessibility of healthcare. It will, through the effective implementation and use of smart technologies, explore strategies to improve patient engagement, IT integration, process development and productivity. But, can it do all this against a background of budget cuts i.e. can better outcomes be achieved whilst still saving money?” Find out on the conference website and on Mr. Doherty’s brief article containing the speaker/panelist list. Editor Toni is scheduled to attend and report from the conference.