TTA’s summer #5: UK’s GPDPR halted, dying Watson Health for sale, Owlet’s $1bn SPAC and more funding, and in-person events slowly come back

July 24, 2021 | by | No Comments

 

 

Weekly Alert

The big news for UK GPs this week was that the GPDPR’s extraction scheduled for 1 Sept is stopped for a Big Rework. Big Blue’s Watson Health dying in pieces, reportedly up for sale. But SPACs and investments have slowed only a bit for the summer with Owlet’s $1bn SPAC and digital health’s torrid $15bn first half. In-person meetings are starting to come back as well (apparently HIMSS21 is still on too).

Softly, softly: GPDPR comes to screeching halt, indefinitely, to be reworked (Don’t hold yer breath!)
News and deals roundup: Owlet’s $1B SPAC, Carbon Health’s $350M Series D, Series Bs by Woebot Health and b.Well, digital health rakes in $15bn (Owlet ‘socks it’ to the market, behavioral health and digital health match the hot weather)
Oh, MAMA! The Medical Alert Monitoring Association meeting, 28-29 September, Chicago (They’ll need the alerts in Chi-Town)
Three healthcare startup events: MedStartr NYC Thursday 21 July, Dallas Startup Week starts 1 August–and apply now for UCSF Health Awards (Look to Texas and California)
IBM Watson Health’s stumble and possible fall (The World Was Not Theirs, leading to Death By A Million Cuts)

Teladoc’s new alliance with Microsoft Teams stakes out real estate with health systems–and more. There’s life in VistA yet as VA throws hands up, puts Cerner EHR on hold. UnitedHealthcare beefs up predictive analytics for SDOH as the Feds make moves, while the parent looks to transform. The King’s Fund’s annual conference is back in November. And just for fun–get your Dead Startup Toys!

Saturday summer morning fun: treat yourself (or your boss) to a Dead Startup Toy (Playtime! If not now, when?)
Volte-face: VA now puts their Cerner EHR implementation on hold (Is this a job for Samson or Superman?)
The King’s Fund annual conference returns in November, virtually (Given all, a good call)
The implications of Teladoc’s integration into Microsoft Teams (Now we know why InTouch Health in health systems was worth the mega-money)
UnitedHealthcare pilots predictive analytics model for SDOH, sets out plan to transform into ‘high-performing health plan’ (Plenty of room for tech in this vision)

PERS makes news with an insider view of what happened at Philips Lifeline as Connect America finalizes its buy, and VRI’s up for a new owner. AliveCor continues to play David to Apple’s Goliath, hospital-at-home gets a $250M boost, UK’s Physitrack IPO raises $20M. 

News roundup: AliveCor’s latest FDA clearance plus antitrust vs. Apple, VRI on the market, Walgreens’ ‘tech-enabled future’ indefinite plus VillageMD status, monthly telehealth usage drops 12.5%
An ‘insider’ point of view on the Connect America acquisition of Philips Lifeline (Good background from industry sources)
News/deals roundup: Connect America finalizes Philips aging/caregiving buy; Amedisys-Contessa $250M hospital-at-home; UK’s Physitrack $20M IPO, Dutch motion tracker Xsens

Summer is speeding up before our eyes as we in the US celebrate our Independence Day (sorry, George III!). Tunstall appeals Swedish procurement exclusion. Bright Health and Olive both had beaucoup funding. StartUp Health spotlights brain health. Cerner and VA, imperfect together. Telehealth usage settling down. And, in product tie-ins–buy a Black+Decker PERS, get a power drill?

Lightning news roundup: AI for health systems Olive scores $400M, VA’s sticking with Cerner EHR, Black+Decker gets into the PERS game (An unseen connection between power drills and PERS units?)
Tunstall under fire in Swedish court on appeal of Adda procurement exclusion (Their Nordic troubles continue)
Four ‘moonshot’ health tech startups aiding cognition and brain health (podcast) (A worthwhile half-hour)
‘Insurtech’ Bright Health’s IPO second largest to date, but falls slightly short of estimates (updated) (Bad market day for an interesting model)
Telehealth usage going flat, off by 1/3 and declining: Trilliant Health study (Not taking over the world)

GPDPR update (what’s the rush?) with a review of NHS’ ‘Data Saves Lives’ white paper, funding/SPAC deals, Amazon gets into the digital health accelerator business. Are we finally reaching takeoff for wearables targeted to older adults? And sobering Weekend Reading on our State of Healthcare Data Insecurity.

Weekend reading: 1/3 of global healthcare orgs ransomwared, 50%+ mobile privacy problems–BMJ study, med device insecurity (Sure to make you feel insecure)
News/deals roundup: Amazon’s health accelerator, digital health library opens, Ziegler’s ‘Hospital at Home’ paper, SEHTA announces MedTech event; $670M in funding for Talkspace, Pear, DrChrono, NuvoAir (Not slowing down yet)
Aging and Health Technology Watch’s latest: The Future of Wearables and Older Adults 2021 (The Next Big Thing?)
GPDPR update: GPs must set own patient opt-out date prior to 1 September extraction (updated for ‘Data Saves Lives’) (Why is NHS Digital rushing?)

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Softly, softly: GPDPR comes to screeching halt, indefinitely, to be reworked

July 23, 2021 | by | No Comments

UK GPs and offices can now take an August holiday. The entire process of GPs extracting their data for the NHS GP Data for Planning and Research (GPDPR) database and patients opting out has been halted–or “deferred” per the letter from Parliamentary Under Secretary of State Jo Churchill. Formally, the Data Provision Notice was withdrawn on 19 June–and quietly. That means no more deadline of 1 September–or, in fact, any deadline, right now. 

According to the letter to GPs:

Instead, we commit to start uploading data only when we have the following in place:

  • the ability to delete data if patients choose to opt-out of sharing their GP data with NHS Digital, even if this is after their data has been uploaded [This is a significant feature that is expanded on later in the letter–Ed.]
  • the backlog of opt-outs has been fully cleared
  • a Trusted Research Environment has been developed and implemented in NHS Digital [Security based on OpenSAFELY and the Office for National Statistics’ Secure Research Service best practices–Ed.]
  • patients have been made more aware of the scheme through a campaign of engagement and communication

The revised scheme will be created in collaboration with the Royal College of General Practitioners (RCGP) and the British Medical Association (BMA). One wonders why these logical steps weren’t taken before deadlines were set, moved, and about five medical associations plus at least one MP excoriated the NHS publicly. Undoubtedly more tap dancing to come. Our most recent and previous coverage here. Also Pulse and HealthcareITNews EMEA.

NHS Digital GPDPR medical database data extraction start postponed from 1 July to 1 September

June 11, 2021 | by

Facing a GP revolt and legal action, NHS Digital has postponed the extraction of patient data records from surgeries until 1 September for the General Practice Data for Planning and Research (GPDPR). Before the House of Commons on 8 June, health minister Jo Churchill announced the extension. “We will use this time to talk to patients, doctors, health charities and others to strengthen the plan, build a trusted research environment and ensure data is accessed securely.” Health secretary Matt Hancock also announced that the patient opt-out deadline, originally 23 June, will be extended (date TBD). Pulse (may require registration), NHS revised release

On 4 June, before the extension announcement, the Doctors Association UK (DAUK), the Citizens, openDemocracy, the National Pensioners Convention, and Conservative MP David Davis were among the signatories to a legal letter sent to the Department of Health and Social Care (DHSC) threatening action to halt the data collection from GPs. Pulse (may require registration)   

While Ms. Churchill, Mr. Hancock, and Simon Bolton collectively insist that the additional time will be used for consultations with patients, doctors, health charities, and others, the proof will be in both the data collection and how informed patients will be of their options. Both the opt-out date and September, given the summer holidays, aren’t much time. In this Editor’s estimation, for a major effort, the end of this year would be far better. Perhaps we should send them this poster? Additional TTA coverage 2 June.

News and deal roundup: OneMedical’s $2.1 bn for Iora, CareDx buys Transplant Hero, Mount Sinai’s Elementa Labs; UK news–NHSX/Babylon, Doro-Everon, Tunstall

June 11, 2021 | by

West Coast-based concierge medical provider One Medical goes ‘mass’ with Iora. One Medical, best known for serving the affluent well through a membership fee, direct pay, commercial insurance, and sponsored contracts with large employers like Google for primary care, announced plans to acquire Boston-based Iora Health. Iora’s primary care providers serve a different market, with primarily Medicare patients moved into full-risk value-based models such as Medicare Advantage plans and practices in shared savings arrangements such as Direct Contracting. The investor presentation here discloses the all-stock purchase with 26 percent of ownership going to current Iora shareholders. Iora for now will be run separately, which makes sense given the disparity in patient base. The major element in common? Primary care practices and ‘white-glove’ services. Healthcare Dive, FierceHealthcare

Consolidation in digital transplant care assistance. CareDx, which provides a wide variety of management services for organ transplant providers and recipients, is acquiring New York-based Transplant Hero. Transplant Hero is an app that reminds recipients to take their vital medications, and was founded by a transplant physician. Financial terms and integration going forward were not disclosed. Release, Mobihealthnews.

Mount Sinai Innovation Partners (MSIP) creates a new health tech incubator. Elementa Labs launched this week, specifically seeking pre-seed or seed-stage healthcare and biotech startups. Companies must also have a clear objective for working with Mount Sinai to develop a comprehensive development plan.The first startup on board is avoMD, a mobile-friendly point of care clinical decision support platform. Applications for the 12-week program close 30 September. FierceHealthcare

UK activity heats up with the late spring…

NHSX and NHS England are assessing Babylon Health’s triage app. According to an exclusive in Pulse (may require registration), a senior delegation from both visited University Hospitals Birmingham NHS Foundation Trust (UHB) last month to look at its use of the Babylon technology. However, NHSX has disclaimed any work towards a national program with Babylon as practices reopen throughout the UK.

DoroCare UK and Everon announced a partnership on products and services for social care, such as Everon’s Lyra, a cloud-based emergency call system, and Doro’s Eliza, a smartcare hub. Release

Tunstall announced the release of the Tunstall Service Platform (TSP) in the UK. It’s described as a connected care software platform supporting the Tunstall Alarm Receiving Centres coordinated by local authorities and social housing providers. It has four unique functions: PNC (call handling), service manager, fieldforce manager, and proactive services. It also will transition these systems from analogue to digital and will be operable in both. Release

NHS touts COVID-19 Test and Trace app; Livi’s MJog notifies users of vaccine jab info

February 13, 2021 | by

The NHS Test and Trace app, launched in September in England and Wales, released its first report on notifications this week. 1.7 million app users have been advised to isolate due to close contact (not defined) with a person then found to test positive for the virus. The app notifies the user of the positive contact as quickly as 15 minutes after a user inputs a positive test result. Over 3.1 million test results have been entered into the app across England and Wales, of which 825,388 were positive. The testing combines both those booked through the app and manually entered there. 

The NHS’ analysis suggests (their term) that the contact tracing has prevented approximately 600,000 cases. Test and Trace incorporates a symptom checker that has been used over 1.4 million times.

As well as contact tracing and booking a test the app allows users to check their symptoms via the symptom checker. Coronavirus symptoms have been reported into the app over 1.4 million times in England and Wales since 24 September.

For a contact tracer, it’s been extremely successful with a download count of 21.63 million. It’s estimated that 56 percent of the eligible population aged 16+ with a smartphone has downloaded the app. It was 2020’s second most downloaded free iPhone app in the App Store in 2020. Gov.UK Department of Health and Social Care release, Mobihealthnews

Seeking info on your vaccine jab? Livi is supporting the NHS through its MJog app, notifying users of vaccination messages including vaccination eligibility, the latest information about vaccines, and whether or not users can phone their GP. Since the December rollout, 25 million vaccination text messages have been sent to NHS patients. The MJog platform saw a 220 percent increase in messages sent during the same period the prior year. The app in addition sent out five million appointment reminders. Livi acquired patient notification app MJog, a patient messaging service for the NHS during the past 12 years, last October. Mobihealthnews.

NHS digital triaging app eConsult closes £7 million funding round

February 9, 2021 | by

Closing out last week was eConsult’s announcement of a new £7 million round of financing. The triage app is currently used by about 40 percent of NHS practices–3,200 NHS GP practices across the UK. The funding, on top of a £5 million Series A raise last October (Crunchbase, AngelNews) was via Gresham House Ventures (this raise and the Series A lead) and Calculus Capital, plus existing investors.

The fresh funding will boost eConsult capabilities for primary and secondary care, plus expansion into urgent care with an Urgent and Emergency Care tool, eTriage, and outpatient triage tool, eSpecialist. They are also developing a triaging service for Emergency Departments (EDs). 

eConsult was formed in 2013 by four NHS GPs. It uses a bank of over 10,000 questions from a number of clinical sources to direct patients to the most appropriate care, assign priority, and direct to a GP surgery. Their research indicates that 70 percent of GP enquiries can be closed without a F2F consult. 

Last August, eConsult, Q doctor, and Cognitant Group jointly created a toolbar that combined eConsult with Q doctor’s video consult technology and Cognitant Group’s ‘Healthinote’ verified patient information service. They later added HCI’s medical video library service. In June, eConsult added the Ministry of Defence; 183,500 service members and dependents in 124 international locations are able to access online consultations with Defence Primary Healthcare (release).

eConsult’s service volume exploded during the early pandemic and has held its leading share versus competitive services such as Babylon Health, Push Doctor, Infermedica, and Livi (Kry). Babylon has had its challenges in the UK market but is aggressively moving into enterprise accounts in the US and Canada, quietly raising just before Christmas $100 million (£74.5m) in a convertible loan led by VNV Global. Mobihealthnews. UKTechNews

News roundup: Pfizer’s COVID-19 vaccine on horizon, CVS’ new CEO, Vodafone UK 5G health survey, Centene acquires Apixio AI, Doro’s 24/7 Response

November 14, 2020 | by

As infection rates continue to rise, Pfizer’s and German partner BioNTech SE’s COVID-19 vaccine was the top of the news this undecided post-US election week. It was found to be “more than 90 percent effective in preventing COVID-19 in participants without evidence of prior SARS-CoV-2 infection in the first interim efficacy analysis” of the Phase 3 clinical study. They exceeded their evaluable case count (total was 94). Protection was achieved 28 days after the initiation of the 2-dose vaccination. Pfizer release. Chain and independent pharmacies have already signed on for distribution at no cost to patients, covering about 60 percent of pharmacies through the US, Puerto Rico, and the USVI. It’s expected that FDA approval will be by end of year with availability early next year. HHS release. Work on 10 other vaccines goes on. The NHS is lining up for distribution with Health Secretary Matt Hancock promising that they’ll be ready from December as coronavirus diagnoses and deaths climb up from summer levels. BBC News

CVS’ CEO Larry Merlo announces 1 Feb 2021 retirement, Aetna head Karen Lynch to take the helm. Ms. Lynch will also join the board of directors. Mr. Merlo will depart after the shareholder meeting and serve as a strategic adviser until 31 May, which is typical of CEO phased departures. He leaves CVS in excellent shape having conducted during his 10-year tenure the acquisition of Aetna in 2018 and the growth of CVS to almost 10,000 store locations, initiating 1,500 HealthHUBs, and over $199 bn in earnings through Q3 this year. Ms. Lynch joined Aetna in 2012 from Magellan Health Services, a specialty/behavioral managed health company, and Cigna. She hit a home run with vitalizing Aetna’s Medicare Advantage business to 2.5 million members from under 1 million in 2013 and became Aetna’s president in 2015. Mark Bertolini, Aetna’s CEO during the merger in 2018 (but not Federally approved till September 2019), lost his spot on the board in an apparent spat/downsizing last February.  FierceHealthcare, Healthcare Dive, Fortune

Vodafone UK’s new survey on 5G and Internet of Things (IoT) devices in UK health and social care has been issued. A key finding is the comfort level of some telehealth consults well past 50 percent, and over 60 percent in the 18-34 and 35-54 age groups. There is 60-70+ agreement with Government investment in digital technology to ‘future proof the UK healthcare sector’ and to pay for care homes’ high-quality broadband and mobile. More in Vodafone’s study here.

Healthcare payer Centene Corporation is acquiring healthcare analytics company Apixio. Apixio’s AI platform analyzes large amounts of unstructured patient data in physician notes and medical charts. It then creates algorithms to extract high-quality insights to support payers’ and providers’ administrative activities. Acquisition cost is not disclosed and close is expected by end of year. It will be an ‘operationally independent entity’ in an Enterprise group, but complement other in-house technologies such as Interpreta. A bit of catch up here as larger plans Anthem, UnitedHealth/Optum, and Humana all have either substantial in-house AI analytics or have contracted with outside vendors (e.g. Microsoft) for this capability. Release. (Disclosure: This Editor was formerly with Centene, via their WellCare Health Plans acquisition)

Doro Mobile UK and Ireland is introducing ‘Response by Doro’, a touch button service to summon help if needed. The alert button is on the back of the phone versus on the screen, which differs it from most mobile systems. The standard level connects to family and friends, with the Response Premium level connecting to a 24/7 service. For BT Mobile and EE mobile customers with a Doro mobile phone, their first month’s access to Response Premium is free. Release (PDF)

Is the NHS ready to adopt telemedicine through and through–and is telemedicine ready?

August 27, 2020 | by

This analysis by Dominic Tyer in Pharmaphorum discusses the rapid adoption of telehealth during the COVID pandemic, both telephonic and online, to keep people in touch with their doctors. Health Secretary Matt Hancock quantified the changes wrought as “I’ve lost count of the number of times someone said to me: ‘what would have taken months took minutes’.” The article goes on to quote him as saying that COVID-19 has “catalysed deep structural shifts in healthcare that were already underway”, citing as examples data-driven decision-making, working as a system, and telemedicine. In fact, to Secretary Hancock, “From now on, all consultations should be teleconsultations unless there’s a clinical reason not to.”

For all the advances, Mr. Tyer points out flaws such as safeguarding sensitive health issues, particularly for young people, use by rare disease patients and those with a genetic condition, and reaching the 10 percent of the population who do not use the internet. All of these are significant. He concludes that “in the UK there’s clearly the political will and healthcare backing for wider use of telemedicine by the NHS, despite some, as-yet not entirely resolved, technological and safety issues.”

Will the UK revert to ‘underuse’, as the US has rolled back as well as practices have reopened? (What is ‘underuse’ defined as anyway?) Will these issues be resolved or ignored in a push forward for telehealth? And teleconsultations as a norm, with in-person an exception, is perhaps at this time, and in improving health outcomes, an overreach? Hat tips to Roy Lilley of the nhsManagers.net newsletter and Steve Hards

Will the rise of technology mean the fall of privacy–and what can be done? UK seeks a new National Data Guardian.

August 21, 2020 | by

Can we have data sharing and interoperability while retaining control by individuals on what they want shared? This keeps surfacing as a concern in the US, UK, Europe, and Australia, especially with COVID testing.

In recent news, last week’s acquisition of Ancestry by Blackstone [TTA 13 August] raised questions in minds other than this Editor’s of how a business model based on the value of genomic data to others is going to serve two masters–investors and its customers who simply want to know their genetic profile and disease predispositions, and may not be clear about or confused about how to limit where their data is going, however de-identified. The consolidation of digital health companies, practices, and payers–Teladoc and Livongo, CVS Health and Aetna, and even Village MD and Walgreens–are also dependent on data. Terms you hear are ‘tracking the patient journey’, ‘improving population health’, and a Big ’80s term, ‘synergy’. This does not include all the platforms that are solely about the data and making it more available in the healthcare universe.

A recent HIMSS virtual session, reported in Healthcare Finance, addressed the issue in a soft and jargony way which is easy to dismiss. From one of the five panelists:  

Dr. Alex Cahana, chief medical officer at ConsenSys Health.”And so if we are in essence our data, then any third party that takes that data – with a partial or even complete agreement of consent from my end, and uses it, abuses it or loses it – takes actually a piece of me as a human.”

Dignity-Preserving Technology: Addressing Global Health Disparities in Vulnerable Populations

But then when you dig into it and the further comments, it’s absolutely true. Most data sharing, most of the time, is helpful. Not having to keep track of everything on paper, or being able to store your data digitally, or your primary care practice or radiologist having it and interpretation accessible, makes life easier. The average person tends to block the possibility of misuse, except if it turns around and bites us. So what is the solution? Quite a bit of this discussion was about improving “literacy” which is a Catch-22 of vulnerability– ‘lacking skill and ability’ to understand how their data is being used versus ‘the system’ actually creating these vulnerable populations. But when the priority, from the government on to private payers, is ‘value-based care’ and saving money, how does this prevent ‘nefarious use’ of sharing data and identifying de-identified data for which you, the vulnerable, have given consent, to that end? 

It’s exhausting. Why avoid the problem in the first place? Having observed the uses and misuses of genomics data, this Editor will harp on again that we should have a Genomic Data Bill of Rights [TTA 29 Aug 18] for consumers to be fully transparent on where their data is going, how it is being used, and to easily keep their data private without jumping through a ridiculous number of hoops. This could be expandable to all health data. While I’d prefer this to be enforced by private entities, I don’t see it having a chance. In the US, we have HIPAA which is enforced by HHS’ Office of Civil Rights (OCR), which also watchdogs and fines for internal data breaches. Data privacy is also a problem of international scope, what with data hacking coming from state-sponsored entities in China and North Korea, as well as Eastern European pirates.

Thus it is encouraging that the UK’s Department of Health and Social Care is seeking a new national data guardian (NDG) to figure out how to safeguard patient data, based on the December 2018 Act. This replaces Dame Fiona Caldicott who was the first NDG starting in 2014 well before the Act. The specs for the job in Public Appointments are here. You’ll be paid £45,000 per annum, for a 2-3 day per week, primarily working remote with some travel to Leeds and London. (But if you’d like it, apply quickly–it closes 3 Sept!). It’s not full time, which is slightly dismaying given the situation’s growing importance. The HealthcareITNews article has a HIMSS interview video with Dame Fiona discussing the role of trust in this process starting with the clinician, and why the Care.data program was scrapped. Of related interest is Public Health England’s inter-mortem of lessons learned in data management from COVID-19, while reportedly Secretary Matt Hancock is replacing it with a new agency with a sole focus on health protection from pandemics. Hmmmmm…..HealthcareITNews.

Propel@YH digital health accelerator open now for applications to 24 September (UK)

August 12, 2020 | by

The Yorkshire & Humber AHSN (Academic Health Science Networks) returns for a second year with Propel@YH, their regional digital health accelerator program.

We will cut to the chase and the key dates: 

Applications Open – Thursday 6th Aug 09:00
Webinar – 2nd September 13:00 GMT
Applications Close – Thursday 24th September 23:59
Assessment Starts – Monday 28th September
Assessment day – Friday 9th October
Cohort Launch – Friday 16th October
Programme commences – Monday 26th October

While Propel is regional, the program’s objective is to attract global applicants who are interested in solutions for the Yorkshire & Humber area. Backing it is the University of Leeds and the Leeds City Council. The accelerator will provide advisory, guidance, and supportive services, enabling digital health solutions to accelerate their growth and market presence in the longer term. An example is masterclasses on how to build clinical safety cases, develop evidence-based proposals, and understanding procurement in the NHS.

What companies accepted for the 2020 cohort will engage with:

  • How the NHS works – an introduction to the health system in England
  • Clinical safety by design – how to design in clinical safety throughout the digital development process
  • Making the grade – how to develop your digital product to meet the requirements of the NHS Digital Tools library
  • Digital by design – how to implement a human-centred design approach to developing digital products and services
  • NASSS Framework assessment clinic
  • Building the evidence base – how to develop a benefits realisation case and generate evidence that really counts
  • Understanding procurement in the NHS – find out from the experts about how procurement works in the NHS
  • Cohort-defined learning clinics

For more information on the program, content providers, partners, and applying–start here. Download application here. 

Breaking: NHSX COVID contact tracing app exits stage left. Enter the Apple and Google dance team.

June 18, 2020 | by | 1 Comment

Breaking News: The NHS finally abandoned the NHSX-designed COVID contact tracing app in favor of the app based on the Apple and Google API.

The NHSX version had issues, seemingly intractable, on the BTE features on distancing and contact duration between devices, as well as the app being inaccurate on the iPhone.

The “Gapple” app is already in use in Italy, Switzerland, Denmark, Latvia, and Poland. As this Editor noted on Tuesday, Austria is in test, Germany just launched their ‘Corona Warning App’ and reported 6.5 million downloads in the first 24 hours. 

The BBC reported that the lead on the NHSX app, Matthew Gould and Geraint Lewis, are “stepping back” and former Apple executive Simon Thompson is joining NHSX to manage it

Depending on reports, the NHS either rejected the Gapple app in April or were working on it in tandem from May. More likely, they revived the latter with the NHSX problems. The Gapple version is decentralized in storing information about user contacts on individual phone handsets because of issues over user privacy, versus the NHSX centralized app.

According to the FT and TechCrunch, the government is de-emphasizing the utility of the app, and relying on its small army of contact tracers. 

But what about all those folks on the Isle of Wight?

More on this: Digitalhealth.net, TechCrunch, Financial Times     Hat tip to Steve Hards for alerting this Editor at the end of a busy day!

NHS’ COVID contact tracing service started today–but where’s the app? Australia? (with comments)

May 29, 2020 | by | 4 Comments

To paraphrase the burger chain Wendy’s long-past spokeswoman, Clara Peller, ‘Where’s The App?’. The NHS debuted a contact tracing scheme for COVID, but it is a manual system dependent upon–people. If you test positive for the virus, you will receive a call from the NHS’ test and trace system. The person will ask for information about your recent contacts with others, and then asked to self-isolate for 14 days. Those names you provide will be contacted as well.

The NHSX-developed Bluetooth LE app remains in beta test on the Isle of Wight, which started on 5 May [TTA 5 May]. Reportedly there were 52,000 downloads in week one, which for an island with only 80,000 households is pretty impressive. 

The original rollout date set by Health Secretary Matt Hancock and NHSX chief Matthew Gould to the House of Commons’ science committee was mid-May, which has come and gone. The new date is now sometime in June. However, Baroness Dido Harding, the new director of NHS’s Test and Trace program, would not confirm that date–as we’d say, tap dancing quite hard. Digitalhealth.net, Telegraph

The US has been hiring contact tracers by state from Alaska to New York. A recent study in preprint in MedRxiv (PDF) by Farzid Mostashari of ACO management company Aledade and others found that in order to reduce the transmission rate by 10 percent, a contact tracing team would have to detect at least half of new symptomatic cases, and reach at least half the people with whom they were in close contact. MIT Technology Review 

Apps have been deployed in Australia (COVIDSafe) and Singapore (TraceTogether) and are in development in Switzerland and Germany. Most use BTE, but South Korea, India, Iceland, and some US states including North Dakota and Utah are using GPS phone location. China has been the most ruthless in using GPS data to monitor citizen locations and activity, to restrict their movements. Previously mentioned here [TTA 19 May] are UnitedHealth Group and Microsoft’s ProtectWell, PWC’s homegrown app–and Google and Apple announced in April a BTE app which hasn’t debuted yet. The Verge

Contact tracing in the UK: the biggest digital health test yet?

May 9, 2020 | by

Is uncertainty over risk of data breaches and violation of data privacy in the NHS contract tracing app the real barrier to adoption? Or is the risk more complicated–the user perception of  app reliability for them to upend their life? A person might not want to have the government on record as telling them that they were “sufficiently near” a person diagnosed with coronavirus–and also believe that the app does not provide reliable information. The person receiving the alert very well may not be infected, but the risk is that they may be compelled to self-isolate and even test with repeated alerts that may or may not be accurate.

In other words, the ‘false positive’ alert syndrome. We go back to this syndrome to understand that the real test of confidence is the perception that the algorithms will, with a good deal of confidence, screen for the number and duration of contacts of other people with symptoms, and that the complex algorithms will create a correct evaluation.

With a system that relies on about 80 percent of adoption, according to a University of Oxford team, the real factor in a successful contract tracing app may be Human Behavior– how users with smartphones perceive the app as reliable in alerting them for enough risk to self-isolate, with privacy and security lesser concerns.  UKAuthority  Hat tip to reader Alistair Appleby

Contact tracing app ready for Isle of Wight trial this week: Hancock. But is it ready for rollout? (updated)

May 5, 2020 | by

Announced today was what in normal times we’d call a beta test of the contact tracing app [TTA 25 April] developed by NHSX on the Isle of Wight. Transport Secretary Grant Shapps announced it Sunday to Sky News. BBC News detailed today that council and healthcare workers will be first to try the contact-tracing app starting Tuesday at 4pm, with the rest of the island able to download it starting Thursday. Gov.UK  The Isle of Wight has approximately 80,000 households.

Update: How the Isle of Wight residents reacted to the app. BBC News

How the app works: if someone reports COVID-19 symptoms through the app, that information goes to the NHS server and the server downloads that tracking information. The app then notifies the other app users that the person has been in contact with over the past few days, contact being defined as within 6 feet for 15 minutes. This can include someone a person has sat next to on public transport. The tracking in the app is via Bluetooth LE to other mobile phones. The app then alerts contacts with the app and gives advice, including how to get a test to confirm whether or not they do have COVID-19. Users will be able order tests through the app shortly.

Use of the app is voluntary and personal data is limited to postal code and what the user opts in to. So the intent of the app is to warn and test to reduce future outbreaks, as full lockdown is not and cannot be a permanent state. Mr. Shapps stated to Sky that the goal is 50 to 60 percent of the country using the app.

Unfortunately, many of the most vulnerable–older, sicker, and poorer adults–won’t have the smartphone, much less the app, and even with the smartphone, won’t be able to download the app or use it. It’s dependent on self-reporting, which may or may not be reliable. Phones can turn off Bluetooth LE. Another consideration, and one this Editor hopes has been tested, are extremes: extreme density in population and contact areas, and extreme distance, as in rural areas. Additional from BBC News, including a short Matt Hancock clip from the Monday briefing with an almost-touch of his nose or mouth right at the start (!)

The Guardian brings up privacy concerns as well as a Health Service Journal (HSJ) report that the app was ‘wobbly’ and had cybersecurity concerns which would exclude it from the NHS’ own app store. The HSJ story quoted their source stating that the government is “going about it in a kind of a hamfisted way. They haven’t got clear versions, so it’s been impossible to get fixed code base from them for NHS Digital to test. They keep changing it all over the place”.  The reporting data also will reside on NHS servers, not individual phones, but pushes out the alert from the server.

Worldometer gives the current UK statistic as total of 190,584 with 28,734 deaths. While case diagnosis continues to increase, fatalities have been steeply declining. There is concern that COVID is yet to spike in rural areas, as cases have concentrated in Greater London, the Midlands, and the North West. New York and New Jersey alone in the US have over 456,000 cases with just under 32,900 fatalities attributed to COVID-19, 3/4 of which have been in NY–almost as much as the entire UK. (However, the fatality statistic is widely questioned as not screened for contributing causes, since there are certain incentives for attribution.)

In other NHS news, NHS Digital, the information and tech side of NHS (not the innovation unit) has named a new deputy chief executive. Pete Rose will also take on the role of chief information security officer for the Health and Care System, including live services, cybersecurity, solutions assurance, infrastructure, and sustainability.

NHSX announces TechForce19 challenge awards (updated), COVID-19 contact tracing app in test for mid-May launch (UK)

April 25, 2020 | by

NHSX, the group within the NHS responsible for digital technology and data/data sharing, made two significant announcements yesterday.

TechForce19 Challenge Awarded

NHSX, with the Department of Health and Social Care (DHSC) and the Ministry for Housing Communities and Local Government (MHCLG), yesterday announced the 18 finalists in the TechForce19 challenge. This challenge was set up quickly to support the problem of vulnerable, elderly, and self-isolating people during this COVID-19 quarantine to reduce actual and feelings of loneliness and lack of safety.

Like most everything around coronavirus, this was fast tracked: the challenge announcement in late March, submissions closing on 1 April, and the selection announced on 24 April. Each finalist is being awarded up to £25,000 for further development of their technology systems.

The 18 finalists include a number of familiar names to our Readers (who also may be part of these organizations): Feebris, Neurolove, Peppy, Vinehealth, Beam, TeamKinetic, Alcuris MemoHub, Ampersand Health, Aparido, Birdie, Buddi Connect, Just Checking, Peopletoo/Novoville, RIX Research & Media (University of East London), SimplyDo, SureCert, VideoVisit, and Virti. Their systems include checking for the most vulnerable, volunteering apps, mental health support, remote monitoring, home care management, and in-home sensor-based behavioral tracking. Details on each are in the NHSX release on their website. NHSX partners with PUBLIC and the AHSN Network (15 academic health science networks). Hat tip to reader Adrian Scaife

Updated 29 April. Adrian was also kind enough to forward additional information to Readers on Alcuris MemoHub (left) as a finalist in the remote care category. Partners in the test are Clackmannanshire and Stirling Health and Social Care Partnership (HSCP), East Lothian HSCP, South Tyneside Council, and Stockton on Tees Borough Council and last for about two to three weeks. Release

COVID-19 contact tracing

NHSX announced the release, in coming weeks, of a contact tracing app to track your movements around people and if you become positive for coronavirus, “you can choose to allow the app to inform the NHS which, subject to sophisticated risk analysis, will trigger an anonymous alert to those other app users with whom you came into significant contact over the previous few days.” The app is being tested in ‘early alpha’ at RAF Leeming (Computer Weekly). The app will tell users that they are OK or if they need to self-isolate. Far more controversial, if one cares about privacy, despite all the caveats. Based on the articles, NHSX is targeting a release of the app by mid-May according to the BBC, which also broke the RAF test. It will presumably acquire a snappy name before then. ComputerWeekly 24 April (may require free business registration), Matt Hancock Commons statement 22 April

A ‘digital wall’ gives thanks and praise to UK healthcare workers (updated)

April 10, 2020 | by

In a deluge of press releases to TTA linking every app, service, virtual event, or device to the coronavirus, no matter the stretch, putting this Editor into ocular overload, a message from James McLoughlin at a small company based in Ascot called Thank And Praise Ltd. (TAP)  was a refreshing change. TAP’s social Healthcare “Thanking Wall’ lets individuals thank NHS workers–individuals, groups, or in general–for their work. TAP is primarily focused on both healthcare and education in the UK, including Northern Ireland. Their objective is to be ‘the global platform of thanks.’

I’ll let James, who is their commercial director, take it from here.

TAP (Thank And Praise), a unique social thanking platform, was created in January 2019 to enable the general public to show their appreciation for the unsung heroes in healthcare and education. In response to the COVID-19 crisis, TAP launched a free-to-use Digital Thanking Wall to enable members of the public to post messages of thanks to the courageous and selfless people working in healthcare/NHS and education at this time. Our campaign has resulted in 1000s of visitors to our website to read the hundreds of heart-felt messages, mainly for healthcare workers.

Readers, do drop in and leave a message on the Healthcare Thanking Wall and follow their LinkedIn page. At this Easter and Passover time, I cannot think of anything more appropriate. Hat tip to James McLaughlin. And thanks.

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