Digital health on the front lines of coronavirus checking, treatment and prevention (updated 2 Mar)

Coronavirus (COVID-19), which originated in Wuhan, China and has spread to at least 40 countries and 80,000 victims, with 2,700 fatalities, has been roiling both financial and healthcare markets. The stock price of payers in the US have been hit hard due to an anticipated uptick in illness, but interestingly, Teladoc has been up quite smartly in the past few days. Teladoc reported that one of eight virtual visits in January was due to flu, which isn’t atypical–but half had not used Teladoc before. Analysts do expect that there’s an opportunity for telehealth and telemedicine providers to attract new users due to what this Editor has dubbed ‘conscious contact’–that if you even feel remotely sick, you’re going to turn to a virtual visit.

COVID-19 is not remotely near a pandemic outside of China. The three hallmarks of a pandemic are cross-seasonal outbreaks (so far only in China), cross-geography (done), and most importantly, attacking the well. The fatalities have been among those with compromised immune systems, not among the young and healthy who do get it. It’s alarming, like SARS, because of the origination in animals, and the ease of person-to-person transmission via travel, as the outbreaks in Iran, South Korea, Italy, and on cruise ships visiting Asia have confirmed. In the US, the CDC is reporting that it is not currently spreading in the community, but is preparing for that scenario including containment, and has been since January.

But beyond the virtual visit, there are other areas where digital health is part of dealing with COVID-19:

  • Preventing the spread to the patient’s family members. Avaya has been working in China since January to provide enterprise customers with home agents to prevent the spread of the virus. For hospitals, they have donated equipment to enable remote consultation services and remote visiting video at the hospitals, including observation of isolation wards. They have provided a case study of their work with the Tongxiang Hospital at the Tongxiang Branch of Zhejiang Province People’s Hospital. (Photo at left courtesy of Avaya.) 
  • Another is remote patient monitoring. Sheba Medical Center in Tel Hashomer, Israel, is using Tyto Care to monitor the 12 Israeli returnees from the Diamond Princess cruise ship, who continue to be in isolation. The patients will perform the tests on themselves, especially respiratory tests. Jerusalem Post 
    • Update 2 Mar: A representative from Sheba, the largest hospital system in the Middle East, was kind enough to contact me with additional information on their RPM program for COVID-19. For patients requiring isolation in that stage of treatment, Sheba has implemented a modular ‘field hospital’ setup, similar to what the Israeli (and US) military use, which can be set up in any open area. This isolation is to protect immunosuppressed patients from disease spread in the main hospitals. Telehealth being used in addition to Tyto are the Vici telemedicine robot and the Datos Health app for home treated patients. This Editor believes that both European and US public health systems are looking at the Sheba and Israeli approach.
  • Robots–actually a telehealth cart–are being tested for patient self-testing, much like Tyto Care’s use at Sheba. Robots could also deliver food (although they could also carry germs) and sweep streets.
  • Other monitoring can be done via symptom checkers (Babylon, K, and others). 98point6 released a coronavirus screening chatbot app as early as January, but what they’ve turned up so far is more cases of the flu. STAT
  • Data analytics can pinpoint outbreaks. The Epic, Athenahealth, and Meditech EHRs have released new guidance, testing orders and screening questions (e.g. around travel and contacts) that will help to identify outbreaks.

Update 28 Feb: This Editor would like to know more about UV disinfection being used versus coronavirus for large spaces such as in hospitals and aircraft. If you have information on technologies such as PurpleSun which have been tested against hospital pathogens also being used against coronavirus, please contact Editor Donna.

Healthcare technologies which weren’t around during the SARS and swine flu epidemics may make a big difference in the spread, treatment and mortality rate of COVID-19. Healthcare Dive, HealthTechMagazine

UPDATE 28 FEB

As a service to our Readers, we are providing the following health service update links:

The UK Department of Health and Social Care and Public Health England has provided the following links to coronavirus guidance (hat tip to DOHSC via LinkedIn):

👩‍⚕️ Health:
🚂 Transport:
👩‍🎓 Education:
👨‍💼 Employers:
🏡 Social care:

US Centers for Disease Control (CDC)

World Health Organization (WHO) main website on coronavirus:https://www.who.int/health-topics/coronavirus

Health Canada’s main page: http://ow.ly/bLtF50yfJb7

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

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 JanMobihealthnews

Robots, robots, everywhere…even when they’re NHS 111 online algorithms

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/Overrun-by-Robots1-183×108.jpg” thumb_width=”150″ /]The NHS continues to grope its way towards technology adoption, gets slammed–but is it justified? The Daily Telegraph (paywalled–see The Sun) revealed a draft December NHS report that recommended that the NHS 111 urgent non-emergency care line’s “enquiries will be handled by robots within two years.” Moreover, “The evaluation by NHS England says smartphones could become “the primary method of accessing health services,” with almost 16 million inquiries dealt with by algorithms, rather than over the telephone, by 2020.” (That is one-third of demand, with one-quarter by 2019.)

Let’s unpack these reported statements.

  • An algorithm is not a ‘robot’. This is a robot.[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/06/robottoy-1.jpg” thumb_width=”100″ /]
  • What is so surprising about using algorithmically based questions for quick screening? Zipnosis in the US has been using this method for years as a pre-screener in major health systems. They call it an ‘online adaptive interview’ guiding the patient through branching logic of relevant questions; a provider can review the provided clinical note and make a diagnosis and treatment recommendation in 2 minutes. It also captures significant data before moving to an in-person or telemedicine visit if needed. Babylon Health uses a similar methodology in its chatbot-AI assisted service [TTA 26 Apr 17].
  • Smartphones as a primary means of accessing health services? How is this surprising when the Office of National Statistics says that 73 percent of adults use the internet from their mobiles? 51 percent go online for health information.
  • Based on the above, 66 percent would still be using telephonic 111 services.

It seems like when the NHS tries to move forward technologically, it’s criticized heavily, which is hardly an incentive. Over New Year’s, NHS 111 had a 20 percent unanswered call rate on its busiest day when the flu epidemic raged (Sun). Would an online 111 be more effective? Based on the four-location six-month test, for those under 35, absolutely. Yes, older people are far less likely to use it, as undoubtedly (but unreported) the disabled, sight-impaired, the internet-less, and those who don’t communicate in English well–but the NHS estimates that the majority of 111 users would still use the phone. This also assumes that the online site doesn’t crash with demand, and that the algorithms are constructed well.

Not that the present service has been long-term satisfactory. David Doherty at mHealth Insight/3G Doctor takes a 4G scalpel to its performance and offers up some alternatives, starting with scrapping 111.

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

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

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

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

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

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

Older adults anticipate their relationships with ‘helper’ robots: study

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2016/02/Penn-State.png” thumb_width=”150″ /]How older adults (65+) respond to the idea of ‘helper robots’ which may be a part of their future lives span a wide range. The key seems to be that they are ‘most advanced, yet acceptable’ (designer Raymond Loewy’s MAYA dictum) when they perform passive ‘physical, informational and interactional’ tasks–‘helpers and butlers’ in the researchers’ terms. Robots which kick it up a notch and are more autonomous, making its own decisions without direction, are far less acceptable and perceived as ‘robot masters’. “Seniors do not mind having robots as companions, but they worry about the potential loss of control over social order to robots.” That is a leap that goes forward, in the lead researcher’s terms, to how the media has portrayed robots as shaping older adults’ perceptions. A team from Penn State University’s Media Effects Research Laboratory surveyed 45 older adults — between ages 65 and 95 years old — at a senior citizens’ center in Pennsylvania. Published in the Interaction Studies journal. Penn State News Hat tip to our former Northern Ireland Contributing Editor Toni Bunting. On the other end of the age spectrum, an earlier study by the same lead researcher noted that older people were quite concerned about the effects of robots on young people and the desire for parental controls, lest the robots might encourage laziness and dependency. Penn State News (2014)

The dilemma of design for older people

Is the best design for older people and the disabled not specifically designed for them, but an adaptation of basic good design? Laurie Orlov in one of her apt Aging In Place Technology Watch articles questions the market viability of all those specially designed products we’ve seen since, say 2008. We recall ‘smart homes’, senior desktop computers, simplified phones and the robot caregivers which never seem to get past the prototype stage [TTA 25 July 14]. Her POV is that in most cases ‘designing for all ages is feasible today’ except for healthcare–durable medical equipment (DME) and healthcare delivery (and,this Editor would add, monitoring). One of her commenters points out that not everything can be designed ‘universally’, linking to this excellent article from Smashing on guidelines for designing tech to be used by those over 50. The section on blue color perception was especially interesting, as blue is healthcare’s #1 color. I would also point out that design which avoids stigma (as in ‘it screams OLD’) and has good aesthetics also wins.

Is AARP admitting that ‘tech designed for seniors’ is not a winning notion, as this May’s Life@50+ National Event in Miami is likely the last national event they sponsor? And it would be interesting to go back to the previous ‘Live Pitches’ to see how they are doing. Ms Orlov profiles this year’s five.

Humanoid robots and virtual humans in the ‘uncanny valley’

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/10/uncanny_2.jpg” thumb_width=”150″ /]One of the challenges that designers of both robots and ‘virtual humans’ in online simulation settings is to make them, in the dictum of pioneering industrial designer Raymond Loewy, MAYA–‘most advanced yet acceptable’. The MAYA of robotics appearance was stated about 40 years ago by Professor Masahiro Mori at the Tokyo Institute of Technology; the more human and less machine-like the appearance, the more positive a real human’s emotional response will be. But as simulated humans have progressed in commercial animation and in online settings to ‘almost human’, there is a ‘creepiness factor’ that emerges (more…)

Perhaps the cutest robot to date

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/07/20140715211029-Read_Important_Messages.png” thumb_width=”150″ /]Responsive and fitting into the home for multiple ages works. Cute makes it a ‘want to buy’. JIBO may not be the first operative ‘family robot’ (the EU/UK MOBISERVE/Kompaï companion robot [TTA 23 Aug 2013] likely was), it’s not child-sized like the ‘Robot’ of ‘Robot and Frank’ nor the mini-me of ‘Jimmy the Humanoid Robot’, but it’s got the Cute Factor in abundance. It’s a robot designed along the lines of ‘social robotics’ that doesn’t try to look humanoid. It stands at a non-threatening 12 inches high, suitable for tables or desktop. It’s white topped by a large orb serving as a screen that plays videos, reminders and teleconferences. It also speaks. But the big difference is that it responds to touch–dramatically. JIBO moves like a dancer and its ‘face’ follows you. Its response is framed in a companionate way and it’s not a toy–it also does practical things like deliver messages and two-way conversation. It’s easy to think of this not only as a natural companion and connector for various ages in a home, but also where someone lives alone.  The development team headed by Dr. Cynthia Breazeal is delivering this at an attractive price point–$499 for a December 2015 delivery. It’s flown past its $100,000 Indiegogo goal (currently past $500,000) which is a gauge of its appeal. Can you, our Reader, imagine this in your home? Glowing article in Mashable, YouTube video), an grumpy review in Time (which maintains that wearables and smartphones are far more practical. No, it’s not The Gimlet Eye freelancing!)

The CES of Health (Wednesday)

Qardio, Withings, CSR, iOptik, ‘Robotics on the Runway’, 3D printing and…Mother

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/Qardioarm.jpg” thumb_width=”150″ /]Qardio is making its official debut with the QardioArm blood pressure cuff and the QardioCore chest strap for monitoring EKG (plus heart rate, heart rate variability, physical activity intensity and skin temperature). Both were previewed by this Editor at CEWeek 2013 in June and do not yet have FDA nor CE approvalsA price for QardioCore was revealed in Business Insider–$449. QardioArm is listed at $75 on Indiegogo where $29,500 of their $100,000 goal was raised in the past three days. Video. Also MedCityNews.

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2014/01/Withings-aura.jpg” thumb_width=”130″ /]Withings’ Z-Z-Z-Z market entry, the Aura, gets a fave rave at length from Dan Munro in Forbes, adding that the price will be $299. Its stationary aspect, nothing to wear and pricing makes it ideal for high-end QSers who don’t travel a lot or have multiple homes.  (more…)

Your Friday ‘robot fix’

[grow_thumb image=”https://telecareaware.com/wp-content/uploads/2013/12/69521326_tpstrandscloseup.jpg” thumb_width=”175″ /]EU Robotics Week last week had over 300 separate events all over the region (including Macedonia and Malta!) to popularize robotics to the general public and to stimulate education in the STEM-related fields (science, technology, engineering and math). eHealthNews picked five EU-funded projects as ‘cool’ across several assistive technologies: RoboHow (learning tasks from instructions or human example); the RADHAR intelligent wheelchair; Stiff-Flop (a surgical robot ‘arm’ modeled after an elephant trunk; ROBOFOOT (for use in footwear manufacture); and the STRANDS robot project which is being used during a challenge to patrol a populated environment. STRANDS robots (left) are designed to have cognitive/learning ability and are being tested on site, according to the article, in a care home for the elderly in Austria (assisting human carers), and in an office environment patrolled by a security firm in the UK (BBC News England 28 August). These all seem to be variations on AT themes, and we note that eHealthNews didn’t choose any clinical/telepresence ‘bots, but one wonders what happened to the MOBISERVE/Kompaï companion robot [TTA 23 Aug].

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…)